Calling On The Experts: The Perspectives Of Multidisciplinary Professionals In Designing An Exercise And Nutrition Intervention For Frailty

PURPOSE: Frailty is not inevitable with age, with research identifying transitions between states. Evidence indicates exercise and protein supplementation as the most effective and easily implemented intervention. Although widely recognised, such interventions are rarely fully integrated into geriatric medicine, combined with an inconsistency in implementation regarding design, prescription and delivery. Engaging experts in intervention design enables interdisciplinary interpretation of evidence, highlights contextual factors, and informs implementation. The aim of this research was to ascertain multi-professional perspectives on the design and delivery of an exercise and protein intervention for frail older adults and gain expert consensus on intervention components. METHODS: A two-round online Delphi study was conducted. Academics, health care professionals and implementers (exercise and nutrition professionals) (n = 36) were identified and invited to participate via email. Round one used a combination of open and closed questions to gather opinion on setting, delivery model, exercise prescription, protein supplementation and recruitment. The results informed round two, which used Likert scale and rank questions to ascertain level of agreement for the delivery model, exercise prescription, and behaviour change techniques. RESULTS: Response rates in rounds one and two were 69% (25/36) and 76% (19/25). Supervised delivery was the preferred option (74%), with hybrid (9%) and home-based (4%) less popular, but if implemented, 47% favoured in person delivery. Multicomponent interventions were favoured with equal weighting (33%) given to strength, aerobic and balance. A frequency of 2 sessions emerged for both supervised (42%) and home-based delivery (52%), but session duration differed with 45mins (47%), 30 mins (57%), respectively. Education was superior (73.75%) regarding behaviour change strategies CONCLUSIONS: Integrating multi-profession perspectives to the design of exercise and nutrition interventions for frailty provides valuable insights into appropriate options and considerations. Although expert consensus was limited, recommendations can be embedded into multi-component interventions in the co-design of feasible, effective and sustainable interventions. Supported by: This study is funded by the Irish Research Council Ireland enterprise partnerscholarship with industry partner Tirlan.