Social Prescribing for people to Live ENjoyably with Dementia/memory problems In Daily lifeSPLENDID

Abstract: Background: In the UK, there are 850,000 people living with dementia (PLWD). Guidance states PLWD should be offered tailored interventions including non-medication approaches such as lifestyle interventions and social support interventions. Healthcare systems have struggled to respond adequately to this growing burden of complex needs. In the absence of adequate tailored support, complex needs like sleep and behavioural problems, anxiety and low mood associated with isolation could be inappropriately medicalised. Alternative approaches are urgently needed and Social Prescribing (SP) may be a way to deliver this and answer - Does a Co-designed SP pathway for PLWD provide benefit and is it implementable in current health and social care systems? SPLENDID aims to: describe the components necessary to deliver a sustained and effective model of SP for PLWD describe the expected outcomes/impact of social prescribing to inform future service/resource allocation and planning implement and evaluate a SP intervention for PLWD co-developed with people with dementia, family carers, and stakeholders OBJECTIVES To design and implement a novel co-created blended approach to SP for PLWD; To assess the feasibility of a cluster randomised control trial of the SPLENDID intervention To undertake a full-scale trial of efficacy with internal pilot To disseminate findings widely to promote the programme, optimise access and encourage implementation. Methods: SPLENDID integrates evidence, theory and experienced based co- design in WP1 to design the intervention. Framing this development using Normalisation Process Theory we keep implementation as a central concept through the programme supported by behavioural approaches to ensure the intervention is acceptable feasible motivating and most likely to lead to behaviour change. WP 2 refines the intervention using NPT informed implementation research to identify enablers and barriers to front line delivery. WP3 assesses the feasibility of a cluster randomised trial of SPLENDID. Participants will receive the SPLENDID intervention or receive treatment as usual. We will test recruitment, retention and outcomes. WP4 is 2-arm cluster randomised controlled trial of clinical and cost effectiveness of SPLENDID designed with information from WP3 feasibility study and includes an internal pilot. Health economics will have two components feeding in across the work-packages. Discrete Choice Experiments will develop understandings of barriers and facilitators for the SP outcomes to assist design. A cost effectiveness analysis will take a personal, carer and societal perspective. Attention will be paid throughout to inclusivity, equality and diversity aspects of such healthcare interventions which will be addressed throughout the programme in WP5. Timelines for delivery: The programme is 60 months, development, co-design and refinement take place up to month 18, the implementation study months 18-57, CRCTs months 19–57. Dissemination activities take place throughout as work-packages report with results and final report will be written in months 54-60. Anticipated impact and dissemination: There is the potential for widespread impact due to the possibilities offered by SP for people living with dementia and their families. Dissemination will be proactively managed and deliver for academic, policy, professional/practitioner and lay audiences.