title: Bathing adaptations in the homes of older adults (BATH-OUT): protocol for a feasibility randomised controlled trial (RCT).
abstract: The Care Act 2014 has placed a responsibility on local authorities in England to provide services that prevent deterioration and minimise the use of other health and social care services. Housing adaptations have been identified as 1 of the 10 most promising prevention services for older adults, with bathing adaptations being the most requested. However, many local authorities have lengthy waiting times which may increase costs, reduce effectiveness and reduce the preventive effect. There is no robust evidence of the effect of these adaptations on: health, well-being and functional ability.
  
  
  
  This is a feasibility randomised controlled trial (RCT) with nested qualitative interview study. The RCT will recruit between 40 and 60 people who have been referred for an accessible showering facility, and their carers, from 1 local authority in England. They will be randomised to either usual adaptations (∼3-month wait) or immediate adaptations (no wait). The primary outcome is the feasibility of conducting a powered study. The outcomes assessed will be: health and social care-related quality of life, independence in activities of daily living and bathing, falls and use of health and social care services. Outcomes will be assessed at 3 and 6 months. Preliminary health economic feasibility will be established.
  
  
  
  Favourable ethical opinion was provided by the Social Care Research Ethics Committee (reference number 16/IEC08/0017). The results of this study will lay the foundations for a further powered study. This would investigate the effect of bathing adaptations on quality of life and whether increased waiting times are associated with poorer outcomes and increased costs. The results have further potential to inform trials of other housing or social care interventions using the novel waiting list control method. Dissemination will include peer-reviewed publications and presentations at national and international conferences.
  
  
  
  ISRCTN14876332; Pre-results.
authors.affiliation: Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: Phillip J
authors.identifier: 0000-0003-1310-4020
authors.initials: PJ
authors.lastname: Whitehead
authors.affiliation: Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: Marilyn
authors.initials: M
authors.lastname: James
authors.affiliation: Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: Stuart
authors.initials: S
authors.lastname: Belshaw
authors.affiliation: Nottingham City Council, Nottingham, UK.
authors.forename: Tony
authors.initials: T
authors.lastname: Dawson
authors.affiliation: Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: Miriam R
authors.initials: MR
authors.lastname: Day
authors.affiliation: Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: Marion F
authors.initials: MF
authors.lastname: Walker
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001494:Baths; D003362:Cost-Benefit Analysis; D004739:England / Q000453:epidemiology; D005240:Feasibility Studies; D006699:Home Care Services / Q000191:economics; D006801:Humans; D057187:Independent Living; D036301:Qualitative Research; D011788:Quality of Life; D012648:Self Care; D012946:Social Welfare
keywords: Bathing; Housing Adaptations & Modifications; Older Adults; Quality of Life