The effectiveness of trained volunteer delivered interventions in adults at risk of malnutrition: A systematic review and meta-analysis

Latif, Jawairia; Dabbous, M.; Weekes, C. Elizabeth; Baldwin, Christine

doi:10.1016/j.clnu.2020.06.008

Cited by 10 publications

(10 citation statements)

References 54 publications

(98 reference statements)

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“…Intervention studies specifying MN populations (or at risk of) and measuring physical performance are scarce and showed mixed results. One systematic review in RMN adults showed no improvements in gait speed, balance, and HGS due to volunteer-delivered interventions ( 110 ). Other systematic reviews showed no effect on HGS ( 111 ) and TUG ( 14 ) after dietary counseling or oral nutritional supplementation, respectively.…”

Section: Discussionmentioning

confidence: 99%

The Association between Malnutrition and Physical Performance in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

Kramer

Groenendijk

Beers

et al. 2022

Current Developments in Nutrition

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In recent years the focus of healthcare and nutritional science in older adults has shifted from mortality towards physical performance and quality of life. The aim of this review was to summarize observational studies on physical performance in malnourished (MN) or at-risk of malnutrition (RMN) older adults compared to well-nourished (WN) older adults. Eligible studies had to report on nutritional status and objectively measured physical performance in older adults (≥60 years). MN or RMN groups had to be compared to a WN group, measured with a validated nutrition screener. Ovid Medline and Web of Science were searched until November 13th, 2020. Study quality was scored using a modified Newcastle Ottawa Scale (NOS). Results were analysed by meta-analysis when possible, or narratively reviewed otherwise. Forty-five studies (16.911 participants in total) were included from studies in outpatient clinics (n = 6), nursing homes (n = 3), community-dwelling older adults (n = 20), hospitalized patients (n = 15), or a combination (n = 1). Studies used 11 different screeners of malnutrition, and 8 types of physical performance measures. Meta-analysis showed that compared to MN, WN groups had better hand grip strength (MD = 4.92 kg; 95%CI: 3.43, 6.41; P<0.001; n = 23), faster gait speed (MD = 0.16 m/s; 95%CI: 0.05, 0.27; P = 0.0033; n = 7), performed faster on timed-up-and-go (MD = –5.94 s; 95%CI: –8.98, –2.89; P < 0.001; n = 8), and scored 1.2 more short physical performance battery points (95%CI: 1.32, 2.73; P < 0.001; n = 6). Results were less pronounced when compared to RMN. Narratively, all studies showed an association for knee extension strength, 6-minute walking test, and multicomponent tests, except for chair-stand test. Study limitations include no studies scoring ‘good’ on NOS, lack of confounder adjustment and high heterogeneity. Overall, evidence from cross-sectional studies indicate an association between malnutrition and worse physical performance in older adults. This study is registered in PROSPERO (CRD42020192893).

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Section: Discussionmentioning

confidence: 99%

The Association between Malnutrition and Physical Performance in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

Kramer

Groenendijk

Beers

et al. 2022

Current Developments in Nutrition

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“…[12][13][14] Healthcare professionals advocate multimodal and multidisciplinary approaches to frailty management, such as consideration of the appropriate type, effectiveness and feasibility of interventions to implement in practice, including online and volunteer-led approaches. [15][16][17][18][19] In response to the COVID-19 pandemic, healthcare, including frailty management, has increasingly turned to virtual modes of delivery, such as telehealth methods. 20 21 Moreover, online communication tools have gained popularity among older people to remain socially connected, allowing PA and nutrition interventions to be delivered online.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…27 There is growing interest in the use of volunteer-led PA and nutrition interventions to support older adults' health and well-being. [17][18][19] A recent systematic review explored the impact of PA interventions conducted by trained volunteers on health-related outcomes for community-dwelling older people (≥65 years). 28 Volunteers implemented strength and balance exercises one to three times per week, which led to improvements in functional status, frailty status, a reduction in fear of falls and improved quality of life.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…Similarly, more adequately powered research has been recommended to explore volunteer-led nutritional interventions in the community. 17 Existing research suggests that volunteer-led PA and nutrition interventions reduced frailty risk among community-dwelling older adults, and showed improvements in handgrip strength, quality of life, social participation and physical function. 18 19 26 29 30 For example, an RCT found that volunteers trained to perform nutrition-related discussions and strength exercises with older adults, resulted in a 25% reduction in prevalence of impaired nutritional status, and improvement in frailty.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…Similarly, more adequately powered research has been recommended to explore volunteer-led nutritional interventions in the community. 17 …”

Section: Introductionmentioning

confidence: 99%

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Frail2Fit study protocol: a feasibility and acceptability study of a virtual multimodal intervention delivered by volunteers to improve functional outcomes in older adults with frailty after discharge from hospital

et al. 2023

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IntroductionPhysical activity (PA) and replete nutritional status are key to maintaining independence and improving frailty status among frail older adults. In response to the COVID-19 pandemic, healthcare has increasingly turned to virtual modes of delivery and there is interest in the use of trained volunteers to deliver PA and nutrition interventions. We aim to evaluate the feasibility and acceptability of training hospital volunteers to deliver an online intervention, comprising exercise, behaviour change and nutrition support, to older people with frailty after discharge from hospital.MethodsWe will use a quasi-experimental mixed methods approach. Hospital volunteers (n=6) will be trained to deliver an online, 3-month, multimodal intervention to frail (Clinical Frailty Scale ≥5) adults ≥65 years (n=30) after discharge from hospital. Feasibility will be assessed by determining the number of volunteers recruited, trained and retained at the end of the study; the proportion of intervention sessions delivered; participant recruitment, retention and adherence to the intervention. To determine the acceptability of the intervention, interviews will be conducted among a purposive sample of older adults, and volunteers. Secondary outcomes will include physical function, appetite, well-being, quality of life, anxiety and depression, self-efficacy for managing chronic disease and PA. Outcomes will be measured at baseline, 3 months and 6 months.AnalysisDescriptive statistics will be used to describe feasibility and adherence to the intervention. Secondary outcomes at baseline will be compared at 3 and 6 months. Interviews will be transcribed verbatim and analysed using thematic analysis.Ethics and disseminationHealth Research Authority ethical approval was obtained on 30 May 2022 (reference: 22/WA/0155). Results will be disseminated through peer-reviewed journal articles, volunteer organisations, National Health Service communication systems and social media platforms. A toolkit will be developed to facilitate roll out of volunteer training.Trial registration numberNCT05384730.

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What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map

Price

Bell

Shaw

et al. 2022

Campbell Systematic Reviews

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Background: Peer support interventions involve people drawing on shared personal experience to help one another improve their physical or mental health, or reduce social isolation. If effective, they may also lessen the demand on health and social care services, reducing costs. However, the design and delivery of peer support varies greatly, from the targeted problem or need, the setting and mode of delivery, to the number and content of sessions. Robust evidence is essential for policymakers commissioning peer support and practitioners delivering services in health care and community settings. This map draws together evidence on different types of peer support to support the design and delivery of interventions.Objectives: The aim of this map was to provide an overview of the volume, diversity and nature of recent, high quality evidence on the effectiveness and costeffectiveness of the use of peer support in health and social care. Search Methods: We searched MEDLINE, seven further bibliographic databases, and Epistemonikos for systematic reviews (in October 2020), randomised controlled trials (in March 2021) and economic evaluations (in May 2021) on the effectiveness of peer support interventions in health and social care. We also conducted searches of Google Scholar, two trial registers, PROSPERO, and completed citation chasing on included studies.Selection Criteria: Systematic reviews, randomised controlled trials and economic evaluations were included in the map. Included studies focused on adult populations with a defined health or social care need, were conducted in high-income countries, and published since 2015. Any measure of effectiveness was included, as was any form of peer support providing the peer had shared experience with the participant and a formalised role.

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The effectiveness of trained volunteer delivered interventions in adults at risk of malnutrition: A systematic review and meta-analysis

Abstract: The effectiveness of trained volunteer delivered interventions in adults at risk of malnutrition: a systematic review and meta-analysis. CLINICAL NUTRITION.

Cited by 10 publications

References 54 publications

The Association between Malnutrition and Physical Performance in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

The Association between Malnutrition and Physical Performance in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

Frail2Fit study protocol: a feasibility and acceptability study of a virtual multimodal intervention delivered by volunteers to improve functional outcomes in older adults with frailty after discharge from hospital

What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map

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