EMPoWER Effectiveness of a Multi-modal intervention to Promote Independence and WEllbeing among oldeR adults of South Asian heritage: a feasibility study

Research question What would a culturally adapted multi-modal intervention aimed at improving independence and wellbeing among older adults of South Asian heritage look like and is it feasible to deliver this intervention in a community setting? Background The proportion of older adults from South Asian heritage who are frail is growing and culturally adapted interventions tailored to meet their needs are required. Multi-modal interventions, incorporating exercise, nutritional advice, and social support, are effective in slowing the progression of frailty however, there is a lack of data on the effectiveness of these for South Asian older adults. Aims and Objectives To adapt a multi-modal intervention involving exercise, nutrition, and peer support so that it is culturally sensitive and examine the feasibility of delivering this adapted intervention among South Asian older adults who are pre/mildly frail. This feasibility study will inform the design of a larger trial with an internal pilot study and embedded economic evaluation that aims to assess the effectiveness and cost effectiveness of this intervention. Our objectives are to: Conduct a systematic review and perform a qualitative study incorporating Experience Based Co-design with South Asian participants to adapt current interventions to ensure that they are culturally sensitive and acceptable. Conduct a feasibility study focussed on acceptability and deliverability of the intervention, recruitment, engagement and adherence, appropriateness of outcomes, and data completion rates to inform a future trial and economic evaluation. Use semi-structured interviews to explore participants , carers , and health professional's perspectives to understand how we can refine the intervention and maximise experience and adherence. Methods We will recruit 50 community-dwelling South Asian older adults aged 65 and over who are pre/mildly frail (Clinical Frailty Score 3-5), and able to provide informed consent from Southampton and London. The project comprises three work packages (WP) that build sequentially. WP1: Reviewing the current evidence around multi-modal interventions for frailty and exploring how best to adapt these interventions to be culturally appropriate. Conducting a qualitative study to explore potential participants and their carers views about the choice of multi-modal intervention, how to adapt it, and how best to engage them in the intervention. Co-designing the intervention through workshops. WP2: Examining the feasibility of the culturally adapted intervention addressing key uncertainties around acceptability, implementation, recruitment and engagement. WP3: Process evaluation designed to understand participants , carers and health professionals experiences of the intervention to prepare for the future effectiveness trial. Timelines for delivery A 30-month study, with a 20-week intervention period, and assessments at baseline, 3 and 6 months. Anticipated Impact and Dissemination We will develop and test the deliverability of a culturally adapted multi-modal intervention, aiming to inform a future trial with an internal pilot and embedded economic evaluation. Our study targets an underserved population, focusing on culturally tailored approaches to improve uptake, adherence, and independence among pre/mildly frail South Asian older adults. The findings could be transferable to future research with this group. We will disseminate results through community forums, stakeholder events, academic conferences, and publications in partnership with Southampton s Public Policy Unit.