scholarly journals A workplace-based intervention to increase levels of daily physical activity: the Travel to Work cluster RCT

2019 ◽  
Vol 7 (11) ◽  
pp. 1-128
Author(s):  
Suzanne Audrey ◽  
Harriet Fisher ◽  
Ashley Cooper ◽  
Daisy Gaunt ◽  
Chris Metcalfe ◽  
...  
Keyword(s):  
Physical Activity ◽  
Public Transport ◽  
Health Research ◽  
Intervention Group ◽  
Travel Behaviour ◽  
Public Health Research ◽  
Behavioural Intervention ◽  
Activity Levels ◽  
Physical Activity Levels

Background There may be opportunities for working adults to accumulate recommended physical activity levels (≥ 150 minutes of moderate-intensity physical activity in bouts of ≥ 10 minutes throughout the week) during the commute to work. Systematic reviews of interventions to increase active transport indicate that studies are predominantly of poor quality, rely on self-report and lack robust statistical analyses. Objectives To assess the effectiveness, cost and consequences of a behavioural intervention to increase walking during the commute to work. Design A multicentre, parallel-arm, cluster randomised controlled trial incorporating economic and process evaluations. Physical activity outcomes were measured using accelerometers and GPS (Global Positioning System) receivers at baseline and the 12-month follow-up. Setting Workplaces in seven urban areas in south-west England and south Wales. Participants Employees (n = 654) in 87 workplaces. Interventions Workplace-based Walk to Work promoters were trained to implement a 10-week intervention incorporating key behaviour change techniques. Main outcome measures The primary outcome was the daily number of minutes of moderate to vigorous physical activity (MVPA). Secondary outcomes included MVPA during the commute, overall levels of physical activity and modal shift (from private car to walking). Cost–consequences analysis included employer, employee and health service costs and consequences. Process outcomes included barriers to, and facilitators of, walking during the daily commute. Results There was no evidence of an intervention effect on MVPA at the 12-month follow-up [adjusted difference in means 0.3 minutes, 95% confidence interval (CI) –5.3 to 5.9 minutes]. The intervention cost was on average, £181.97 per workplace and £24.19 per participating employee. In comparison with car users [mean 7.3 minutes, standard deviation (SD) 7.6 minutes], walkers (mean 34.3 minutes, SD 18.6 minutes) and public transport users (mean 25.7 minutes, SD 14.0 minutes) accrued substantially higher levels of daily MVPA during the commute. Participants who walked for ≥ 10 minutes during their commute were more likely to have a shorter commute distance (p < 0.001). No access to a car (p < 0.001) and absence of free workplace car parking (p < 0.01) were independently related to walking to work and using public transport. Higher quality-of-life scores were observed for the intervention group in a repeated-measures analysis (mean 0.018, 95% CI 0.000 to 0.036; scores anchored at 0 indicated ‘no capability’ and scores anchored at 1 indicated ‘full capability’). Conclusions Although this research showed that walking to work and using public transport are important contributors to physical activity levels in a working population, the behavioural intervention was insufficient to change travel behaviour. Broader contextual factors, such as length of journey, commuting options and availability of car parking, may influence the effectiveness of behavioural interventions to change travel behaviour. Further analyses of statistical and qualitative data could focus on physical activity and travel mode and the wider determinants of workplace travel behaviour. Trial registration Current Controlled Trials ISRCTN15009100. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 11. See the NIHR Journals Library website for further project information. Living Streets, a UK charity promoting everyday walking, provided funding for the intervention booklets and free pedometers for distribution to participants in the intervention group.

Active Classrooms: A Cluster Randomized Controlled Trial Evaluating the Effects of a Movement Integration Intervention on the Physical Activity Levels of Primary School Children

2017 ◽  
Vol 14 (4) ◽  
pp. 290-300 ◽  
Author(s):  
Rosemarie Martin ◽  
Elaine Murtagh
Keyword(s):  
Physical Activity ◽  
Primary School ◽  
School Children ◽  
Controlled Trial ◽  
Intervention Group ◽  
Primary School Children ◽  
Activity Levels ◽  
Significant Difference ◽  
Physical Activity Levels

Background:A cluster randomized controlled trial was conducted to assess the effectiveness of the Active Classrooms intervention, which integrates movement into academic lessons, on the moderate-to-vigorous physical activity levels (MVPA) of primary school children during class-time and throughout the school day.Methods:Ten classroom teachers and their students aged 8 to 12 years were recruited and randomized into the Active Classrooms intervention group (n = 131students, n = 5teachers) or a delayed-treatment controlled group (n = 117students, n = 5teachers). The intervention group participated in active academic lessons taught by the classroom teacher over an 8 week period. Accelerometers were used to gather physical activity data at baseline, postintervention and at 4 months follow-up. Teachers completed a questionnaire to evaluate the program.Results:A significant difference for change in daily class time MVPA levels was identified between the treatment (n = 95) and control (n = 91) groups from pre- to postintervention (P < .001) and this difference was maintained at follow-up (P < .001). No significant difference emerged between the treatment and control groups for change in school day MVPA levels from pre- to postintervention (P = .52) or follow-up (P = .09). Teachers reported that they were highly satisfied with the program.Conclusions:Movement integration has the potential to improve physical activity levels of primary school children in the classroom.

scholarly journals Employer schemes to encourage walking to work: feasibility study incorporating an exploratory randomised controlled trial

2015 ◽  
Vol 3 (4) ◽  
pp. 1-60 ◽  
Author(s):  
Suzanne Audrey ◽  
Sunita Procter ◽  
Ashley Cooper ◽  
Nanette Mutrie ◽  
William Hollingworth ◽  
...  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Feasibility Study ◽  
Health Research ◽  
Research Collaboration ◽  
Controlled Trial ◽  
Public Health Research ◽  
Full Scale ◽  
Activity Levels

BackgroundPhysical inactivity increases the risk of many chronic diseases, including coronary heart disease, type 2 diabetes, obesity and some cancers. Increasing physical activity levels, particularly among the most sedentary, is an important aim of current public health policy in the UK. An opportunity for working adults to increase physical activity levels may be through walking during the daily commute.ObjectivesTo build on existing knowledge and resources to develop an employer-led scheme to increase walking to work; to test the feasibility of implementing and evaluating the intervention; and to explore other requirements of a full-scale trial.DesignFeasibility study incorporating phase 1 resource review, focus groups with employees and interviews with employers in three workplaces (one small, one medium and one large); and phase 2 exploratory cluster randomised controlled trial (RCT) including process and economic evaluations.SettingWorkplaces (eight small, five medium and four large) in Bristol.ParticipantsOne hundred and eighty-seven employees (89 male and 98 female) at baseline.InterventionsWalk to Work promoters were recruited and trained about the health, social, economic and environmental benefits of walking to work and how to identify and promote safe walking routes for employees. They were given resource packs based on nine key behaviour change techniques. The role of the Walk to Work promoter was to encourage participating employees in their workplace to walk to work; to help to identify walking routes; to encourage goal setting; and to provide additional encouragement through four contacts over the following 10 weeks (face to face, e-mail or telephone, as appropriate).Main outcome measuresRecruitment and retention rates; sample size calculation and estimation of the intracluster correlation coefficient (ICC); acceptability of the intervention and evaluation methods; and estimation of costs.ResultsWorkplace and employee recruitment appeared to be restricted by the initial requirement to identify employees living within 2 miles of the workplace. Once recruited, no workplace withdrew from the study between baseline and 1-year follow-up. It proved feasible to recruit and train workplace Walk to Work promoters. The response rate was 132 (71%) at 1-year follow-up. Although the study was not powered to measure effectiveness, accelerometer data suggest that overall physical activity and moderate to vigorous physical activity (MVPA) were higher in the intervention arm than in the control arm at 1-year follow-up. The ICC was estimated at 0.12 (95% confidence interval 0.00 to 0.30). Based on an average cluster size of eight, an ICC of 0.15 and attrition of 25%, a total sample size of 678 would have 80% power with 5% significance to detect a 15% increase in mean MVPA. The average cost of the intervention was estimated at £441 per workplace. Activity levels were similar in the intervention and control arms at baseline.ConclusionsThe intervention and evaluation were feasible, and acceptable to participants. There was sufficient evidence of promise to justify a full-scale trial incorporating lessons learned during the feasibility study. Future work: an application is being submitted for a follow-on full-scale cluster RCT.Trial registrationCurrent Controlled Trials ISRCTN72882329.FundingThis project was funded by the NIHR Public Health Research programme and will be published in full inPublic Health Research; Vol. 3, No. 4. See the NIHR Journals Library website for further project information. The work was undertaken with the support of The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UK Clinical Research Collaboration Public Health Research Centre of Excellence. Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.

Physical activity levels and hepatic steatosis: A longitudinal follow-up study in adults

2018 ◽  
Vol 33 (3) ◽  
pp. 741-746 ◽  
Author(s):  
Aline Mendes Gerage ◽  
Raphael Mendes Ritti-Dias ◽  
P Babu Balagopal ◽  
Raquel Dilguerian de Oliveira Conceição ◽  
Daniel Umpierre ◽  
...  
Keyword(s):  
Physical Activity ◽  
Hepatic Steatosis ◽  
Activity Levels ◽  
Follow Up Study ◽  
Physical Activity Levels

scholarly journals An online family-based self-monitoring and goal-setting intervention to improve children’s physical activity: the FRESH feasibility trial and three-arm pilot RCT

2021 ◽  
Vol 9 (9) ◽  
pp. 1-116
Author(s):  
Esther MF van Sluijs ◽  
Helen E Brown ◽  
Emma Coombes ◽  
Claire Hughes ◽  
Andrew P Jones ◽  
...  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Health Research ◽  
Delphi Study ◽  
Family Members ◽  
Public Health Research ◽  
Feasibility Trial ◽  
Recruitment Strategies ◽  
Family Based

Background Family-based physical activity promotion presents a promising avenue for promoting whole-family physical activity, but high-quality research is lacking. Objectives To assess the feasibility, acceptability and preliminary effectiveness of FRESH (Families Reporting Every Step to Health), a child-led online family-based physical activity intervention; and to identify effective and resource-efficient family recruitment strategies. Design The project consisted of (1) a randomised feasibility trial, (2) a randomised controlled pilot trial and (3) a systematic review and Delphi study. Setting Norfolk/Suffolk counties, UK. Participants Families, recruited from schools, workplaces and community settings, were eligible to participate if one child aged 7–11 years and one adult responsible for their care provided written consent; all family members could participate. Interventions The FRESH intervention, guided by self-determination theory, targeted whole families and was delivered via an online platform. All family members received pedometers and were given website access to select family step challenges to ‘travel’ to target cities around the world, log steps, and track progress as they virtually globetrotted. Families were randomised to FRESH intervention, pedometer-only or control arm. Main outcome measures Physical (e.g. blood pressure), psychosocial (e.g. family functioning) and behavioural (e.g. device-measured family physical activity) measures were collected at baseline and at 8- and 52-week follow-up. A mixed-methods process evaluation assessed the acceptability of the intervention and evaluation. Data sources review Systematic search of four databases (Cochrane Library, PubMed, PsycINFO and SCOPUS). Review methods Articles were screened in duplicate, and data extraction was fully checked. Academic experts participated in the three-round Delphi study. Data were combined to identify effective and resource-efficient family recruitment strategies. Inclusion criteria Included generally healthy school-aged children and at least one adult; intervention attempted to change physical activity, sedentary behaviour, screen use, diet, or prevent overweight/obesity in multiple family members; presented relevant measure of effect in children and adults. Results The feasibility study (12 families, 32 participants; 100% retention at 8 weeks) demonstrated the feasibility and acceptability of FRESH, but highlighted that adaptations were required. Of 41 families recruited in the pilot study (149 participants), 98% and 88% were retained at the 8-week and 52-week follow-up, respectively. More children in the FRESH arm self-reported doing more family physical activity, and they thought that FRESH was fun. There were no notable between-group differences in children’s outcomes. Change in moderate to vigorous physical activity at 8 weeks favoured FRESH intervention adults [vs. control: 9.4 minutes/week (95% confidence interval 0.4 to 18.4) vs. pedometer only: 15.3 (95% confidence interval 6.0 to 24.5)], and was stronger in fathers, but this was not maintained. In 49 included studies, apart from recruitment settings and strategies used (reported in 84% and 73% of the studies, respectively), recruitment details were scarce. School-based recruitment was predominant. The Delphi study identified a wide range of recruitment settings and strategies. Limitations Recruitment was the main limitation of the FRESH studies; generalisability of the proposed recruitment strategies may be limited. Conclusions This study has demonstrated the feasibility and acceptability of the FRESH intervention. However, we failed to recruit the target sample size and were unable to demonstrate a signal of effectiveness. Future research should employ a multifaceted recruitment approach. Future work Further refinements to intervention delivery and recruitment methods should be investigated. Study registration Current Controlled Trials ISRCTN12789422 and PROSPERO CRD42019140042. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 9. See the NIHR Journals Library website for further project information.

scholarly journals Evaluation of a voucher scheme to increase child physical activity in participants of a school physical activity trial in the Hunter region of Australia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathryn Reilly ◽  
Adrian Bauman ◽  
Lindsey Reece ◽  
Christophe Lecathelinais ◽  
Rachel Sutherland ◽  
...  
Keyword(s):  
Physical Activity ◽  
New South ◽  
Team Sports ◽  
Activity Levels ◽  
Organized Sport ◽  
Child Physical Activity ◽  
South Wales ◽  
Physical Activity Levels ◽  
Hunter Region

Abstract Background Global population data suggest that physical activity levels in children remain unacceptably low. Improved participation in organised sport has been recommended by the WHO as one strategy to improve population levels of physical activity. In 2018, in the state of New South Wales, Australia, the government introduced the Active Kids scheme, to help families meet the cost of getting children into organized sport. The aim of this study is to describe the uptake of Active Kids and assess the impact of the scheme on organized sport participation and child physical activity in a region of New South Wales. Methods A pragmatic longitudinal study was undertaken of parents/carers from primary school aged children (5–12 years) in the Hunter region of NSW, Australia. Baseline data were collected between Oct-Dec 2017, with follow-up 12 months later. A telephone survey occurred at both time points, asking questions regarding registration and redemption of an Active Kids voucher for their child, child participation in organised sports and child physical activity levels. Results Of the 974 parents/carers who consented to participate, 511 (52.5%) completed the telephone surveys at both time points. A very large proportion of children (n = 454, 89.0%) were reported by their parents/carers at baseline as meeting the minimum physical activity guideline of 60 min per day. Of participating parents/carers in this study, 407 (96.0%) reported redeeming an Active Kids voucher. Children who redeemed a voucher had three times the odds to participate in organized team sports from baseline to follow-up (p = 0.009). Sub group analyses identified that females who redeemed a voucher had four times the odds to participate in organized team sports (p = 0.012). Conclusions Given the already active nature of this sample, no significant improvements in physical activity levels were noted, but the positive contribution community sport can have on health and wellbeing amongst children is reinforced. Whilst voucher schemes can address financial burdens across all socio-economic groups, more population targeting is needed to deliver voucher schemes to the most disadvantaged and inactive segments of the population in order to increase physical activity.

Determinants of changes in physical activity levels in late adolescence; prospective analysis in urban communities

2020 ◽  
Author(s):  
Natasa Zenic ◽  
Admir Terzic ◽  
Ivan Kvesic
Keyword(s):  
Physical Activity ◽  
Logistic Regression ◽  
Sport Participation ◽  
Rank Order ◽  
T Test ◽  
Childhood And Adolescence ◽  
Activity Levels ◽  
Related Factors ◽  
Physical Activity Levels

Purpose: Physical activity levels (PA-levels) significantly decline during adolescence, and sport participation during childhood and adolescence is frequently emphasized as protec-tive factors of PA-decline. However, there is a lack of studies which specifically examined sport-related factors and its influence on changes in PA (PA-changes) in adolescence. This study aimed to prospectively observe sport factors as: (i) correlates of PA-levels and (ii) pre-dictors of PA-changes in the period between 16 and 18 years of age among urban adoles-cents from Bosnia and Herzegovina. Methods: The sample of participants comprised 324 adolescents (44% females) who were prospectively observed over two testing waves: (i) baseline, when participants were 16 years old; and (ii) follow-up, 20 months later (18 years of age). The variables were collected by previously validated questionnaires including questions on predictors (sociodemographic variables and various sport factors [current/former/ever participation in individual and team sports, experience in sports, competitive result achieved]), and criteria (PA level obtained at study baseline and follow up, measured by Physical Activity Questionnaire for Adolescents [PAQ-A], and difference between PA-levels at baseline and follow-up). The t-test was used to compare PA-levels. The associations between variables were evidenced by: (i) Spear-man’s rank order correlations (between predictors and PA-levels), and (ii) logistic regression analysis (between predictors, and PA-changes observed as binomial criterion [PA-incline vs. PA-decline] – excluding those participants who reported active sport participation at study baseline). Results: The PA-level significantly declined over the study course (t-test: 6.60, p < 0.01). Sport-related predictors were significantly associated with PA at baseline (Spearman’s R: 0.33–0.45, p < 0.01), and PAat follow-up (Spearman’s R: 0.32-0.45, p < 0.01). Meanwhile, there was no significant correlation between studied predictors and differences in PA-levels between baseline and follow-up. Also, logistic regression did not reveal any significant influ-ence of predictors obtained at study baseline and PA-changes observed as binomial criterion (PA-incline vs PA-decline). Conclusion: While studied sport-related predictors significantly influence the PA-levels in the age of 16 and 18, with the higher level of PA among those adolescents who are actively in-volved in sports, sport-participation do not predict changes in PA-levels over the observed period of life. Knowing the influence of PAon overall health status, future studies should pro-vide additional details on possible predictors of PA-changes in adolescence.

scholarly journals Effect of Statewide Lockdown in Response to COVID-19 Pandemic on Physical Activity Levels of Hemodialysis Patients

2021 ◽  
pp. 1-8
Author(s):  
Maggie Han ◽  
Priscila Preciado ◽  
Ohnmar Thwin ◽  
Xia Tao ◽  
Leticia M. Tapia-Silva ◽  
...  
Keyword(s):  
Physical Activity ◽  
New York ◽  
New York City ◽  
New York State ◽  
Hemodialysis Patients ◽  
Activity Levels ◽  
Physical Activity Levels ◽  
National Emergency ◽  
The Impact

<b><i>Background/Objectives:</i></b> On March 22, 2020, a statewide stay-at-home order for nonessential tasks was implemented in New York State. We aimed to determine the impact of the lockdown on physical activity levels (PAL) in hemodialysis patients. <b><i>Methods:</i></b> Starting in May 2018, we are conducting an observational study with a 1-year follow-up on PAL in patients from 4 hemodialysis clinics in New York City. Patients active in the study as of March 22, 2020, were included. PAL was defined by steps taken per day measured by a wrist-based monitoring device (Fitbit Charge 2). Average steps/day were calculated for January 1 to February 13, 2020, and then weekly from February 14 to June 30. <b><i>Results:</i></b> 42 patients were included. Their mean age was 55 years, 79% were males, and 69% were African Americans. Between January 1 and February 13, 2020, patients took on average 5,963 (95% CI 4,909–7,017) steps/day. In the week prior to the mandated lockdown, when a national emergency was declared, and in the week of the shutdown, the average number of daily steps had decreased by 868 steps/day (95% CI 213–1,722) and 1,222 steps/day (95% CI 668–2300), respectively. Six patients were diagnosed with COVID-19 during the study period. Five of them exhibited significantly higher PAL in the 2 weeks prior to showing COVID-19 symptoms compared to COVID-19 negative patients. <b><i>Conclusion:</i></b> Lockdown measures were associated with a significant decrease in PAL in hemodialysis patients. Patients who contracted COVID-19 had higher PAL during the incubation period. Methods to increase PAL while allowing for social distancing should be explored and implemented.

scholarly journals Exercise prescription improves exercise tolerance in young children with CHD: a randomised clinical trial

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001599
Author(s):  
Sinead Callaghan ◽  
Margaret Louise Morrison ◽  
Pascal P McKeown ◽  
Christopher Tennyson ◽  
Andrew J Sands ◽  
...  
Keyword(s):  
Physical Activity ◽  
Young Children ◽  
Daily Activity ◽  
Exercise Tolerance ◽  
Intervention Group ◽  
Peak Exercise ◽  
Activity Levels ◽  
Intervention Programme ◽  
Physical Activity Levels ◽  
Structured Intervention

ObjectiveThe main objective of this study was to ascertain if a structured intervention programme can improve the biophysical health of young children with congenital heart disease (CHD). The primary end point was an increase in measureable physical activity levels following the intervention.MethodsPatients aged 5–10 years with CHD were identified and invited to participate. Participants completed a baseline biophysical assessment, including a formal exercise stress test and daily activity monitoring using an accelerometer. Following randomisation, the intervention group attended a 1 day education session and received an individual written exercise plan to be continued over the 4-month intervention period. The control group continued with their usual level of care. After 4 months, all participants were reassessed in the same manner as at baseline.ResultsOne hundred and sixty-three participants (mean age 8.4 years) were recruited, 100 of whom were male (61.3%). At baseline, the majority of the children were active with good exercise tolerance. The cyanotic palliated subgroup participants, however, were found to have lower levels of daily activity and significantly limited peak exercise performance compared with the other subgroups. One hundred and fifty-two participants (93.2%) attended for reassessment. Following the intervention, there was a significant improvement in peak exercise capacity in the intervention group. There was also a trend towards increased daily activity levels.ConclusionOverall physical activity levels are well preserved in the majority of young children with CHD. A structured intervention programme significantly increased peak exercise capacity and improved attitudes towards positive lifestyle changes.

scholarly journals Randomised controlled trial with economic and process evaluations of domiciliary welfare rights advice for socioeconomically disadvantaged older people recruited via primary health care (the Do-Well study)

2019 ◽  
Vol 7 (3) ◽  
pp. 1-228
Author(s):  
Catherine Haighton ◽  
Suzanne Moffatt ◽  
Denise Howel ◽  
Mel Steer ◽  
Frauke Becker ◽  
...  
Keyword(s):  
Older People ◽  
Health Research ◽  
Controlled Trial ◽  
Intervention Group ◽  
Public Health Research ◽  
Welfare Rights ◽  
North East ◽  
And Control

BackgroundWelfare rights advice services are effective at maximising previously unclaimed welfare benefits, but their impact on health has not been evaluated.ObjectiveTo establish the acceptability, cost-effectiveness and effect on health of a domiciliary welfare rights advice service targeting older people, compared with usual practice.DesignA pragmatic, individually randomised, parallel-group, single-blinded, wait-list controlled trial, with economic and process evaluations. Data were collected by interview at baseline and 24 months, and by self-completion questionnaire at 12 months. Qualitative interviews were undertaken with purposive samples of 50 trial participants and 17 professionals to explore the intervention’s acceptability and its perceived impacts.SettingParticipants’ homes in North East England, UK.ParticipantsA total of 755 volunteers aged ≥ 60 years, living in their own homes, fluent in English and not terminally ill, recruited from the registers of 17 general practices with an Index of Multiple Deprivation within the most deprived two-fifths of the distribution for England, and with no previous access to welfare rights advice services.InterventionsWelfare rights advice, comprising face-to-face consultations, active assistance with benefit claims and follow-up as required until no longer needed, delivered in participants’ own homes by a qualified welfare rights advisor. Control group participants received usual care until the 24-month follow-up, after which they received the intervention.Main outcome measuresThe primary outcome was health-related quality of life (HRQoL), assessed using the CASP-19 (Control, Autonomy, Self-realisation and Pleasure) score. The secondary outcomes included general health status, health behaviours, independence and hours per week of care, mortality and changes in financial status.ResultsA total of 755 out of 3912 (19%) general practice patients agreed to participate and were randomised (intervention,n = 381; control,n = 374). In the intervention group, 335 participants (88%) received the intervention. A total of 605 (80%) participants completed the 12-month follow-up and 562 (75%) completed the 24-month follow-up. Only 84 (22%) intervention group participants were awarded additional benefits. There was no significant difference in CASP-19 score between the intervention and control groups at 24 months [adjusted mean difference 0.3, 95% confidence interval (CI) –0.8 to 1.5], but a significant increase in hours of home care per week in the intervention group (adjusted difference 26.3 hours/week, 95% CI 0.8 to 56.1 hours/week). Exploratory analyses found a weak positive correlation between CASP-19 score and the amount of time since receipt of the benefit (0.39, 95% CI 0.16 to 0.58). The qualitative data suggest that the intervention was acceptable and that receipt of additional benefits was perceived by participants and professionals as having had a positive impact on health and quality of life. The mean cost was £44 per participant, the incremental mean health gain was 0.009 quality-adjusted life-years (QALYs) (95% CI –0.038 to 0.055 QALYs) and the incremental cost-effectiveness ratio was £1914 per QALY gained.ConclusionsThe trial did not provide sufficient evidence to support domiciliary welfare rights advice as a means of promoting health among older people, but it yielded qualitative findings that suggest important impacts on HRQoL. The intervention needs to be better targeted to those most likely to benefit.Future workFurther follow-up of the trial could identify whether or not outcomes diverge among intervention and control groups over time. Research is needed to better understand how to target welfare rights advice to those most in need.Trial registrationCurrent Controlled Trials ISRCTN37380518.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 7, No. 3. See the NIHR Journals Library website for further project information. The authors also received a grant of £28,000 from the North East Strategic Health Authority in 2012 to cover the costs of intervention delivery and training as well as other non-research costs of the study.

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