Exploring the Implementation of Age-Friendly Health Systems in Long-Term Care: A protocol for a mixed-methods study.

<ns7:p> Introduction The Age-Friendly Health Systems (AFHS) framework is an evidence-based model of care that is designed to address the multifactorial needs of the older population. However, evidence exploring the implementation of an AFHS in Long-term Residential Care (LTRC) centres is lacking. This study aims to explore the implementation process of an AFHS for older adults in LTRC centres in Ireland. Methods The conceptual framework proposed by Karami <ns7:italic>et al.</ns7:italic> (2023) will be used to characterise the dimensions of the AFHS within the LTRC centres. This framework covers core dimensions including governance, resources, service delivery, intermediate objectives, goals, stakeholders, information and an age-friendly environment. In terms of mapping activities to this framework, our study will employ a mixed-methods approach and will include both a qualitative and quantitative component. Participants will include older adults aged 65 years and over residing in one of the three Mowlam LTRC centres, along with those important to them andstaff members. Focus groups and individual interviews will be conducted with representatives from each stakeholder group. Findings will be reported in line with the consolidated criteria for reporting qualitative research (COREQ). Qualitative data will be analysed thematically. Clinical and patient-reported outcomes, as well as care processes received by older adult residents in the LTRC centres will be explored through conduct of a prospective cohort study. This study will adhere to The STrengthening the Reporting of the OBservational studies in Epidemiology (STROBE) standardised reporting guidelines. Descriptive statistics will be employed to characterise the study participants, while multivariate logistic and linear regression analyses will be utilised to evaluate the risk of adverse outcomes. Ethics and dissemination Ethical approval for this study was received. The authors will disseminate study findings through publication in a peer-reviewed journal and presentation at national and international conferences. </ns7:p>