The Dunhill Medical Trust, NIHR, University of Manchester PhD student­ships

Falls Management Exercise(FaME) is an evidence-based programme normally delivered face-to-face.

This project will investigate how/if FaME can be delivered digitally alongside a more extensive rollout of the programme, and what factors act as barriers/facilitators, based on the lived experience of older people garnered through PPIE.

This project will complement ongoing work assessing implementation of the FaME programme in Greater Manchester.

There has been a rapid push to digital access of services during the COVID-19 pandemic. It is not clear how this has affected older people's use of services, health and wellbeing. We do not know enough about the effect of factors such as deprivation and ethnicity on service access.

This studentship will participate in exploration of how routine datasets (big-data) can give us insight into these changes to explore how digitalisation relates to health inequalities. We will use PPIE work to give voice to older people experiencing these changes.

Frailty Index algorithms can identify people at risk of becoming frail or losing independence. Identification from either GP or shared care records could permit phenotyping and then signposting people to suitable services such as exercise/activity or dietary interventions to reduce risk of frailty progression.

This studentship will be linked to our work with the Greater Manchester Frailty Reference Group and PPIE to identify how best to move non-medical but effective interventions up the health policy agenda, to facilitate implementation of a signposting to health programme within the emerging landscape of integrated care systems.

Public Health England has highlighted the social determinants related to the 'deconditioning epidemic'. Our own work using UKHLS data has also revealed the importance of social determinants of inactivity during lockdowns among older people.

This project will further explore these social determinants, and use understanding from our reviews of behaviour change, updated MRC framework for developing interventions, and PPIE work to design and feasibility-test tailored interventions to help older people from socially deprived backgrounds to become more active.

Inactivity has been described as pandemic among older Chinese people. Older Chinese people in the UK become more inactive with age and have activity levels overall among the lowest three ethnic groups.

This project will explore mechanisms underlying inactivity to develop a culturally appropriate intervention to promote activity levels among older UK dwelling Chinese people. PPIE will help co-produce any intervention from inception.

* Although we identify specific ethnic minority populations, the self-same projects could be presented for different ethnic minority communities, with justification of the choice.

During older old age, people can struggle to remain independent and in their own homes, and this is often driven by social determinants of health.

This project will use mixed-methods and PPIE to explore social determinants of health, such as caring and housing, and how these support ageing in place.

Exercise has major beneficial health effects. Emerging evidence suggests digital approaches can help motivate older people to participate, but age, ethnicity, poverty, geography are all associated with digital and health inequality. This studentship will explore cultural, environmental, social, economic and physical factors that affect use of digital health solutions in older adults and take an effective digital intervention (Keep-On-Keep-Up) and adapt it to be accessible and usable for older people with a minority ethnic background.

* We have not identified any specific ethnic minority populations for this project, the project could be presented for different ethnic minority communities, with justification of the choice.

Analysis of home working during the pandemic reveals clear deleterious effects of physical inactivity on physical and mental health. Promoting anti-sedentary behaviour to counter these effects in office workers/home workers aged 55+ should be a priority.

Following the updated MRC framework for development of complex interventions, this project will develop and feasibility-test an activity promotion programme in workplace/homeworking settings.