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Care home resident and staff perceptions of the acceptability of nutrition intervention trial procedures: a qualitative study embedded within a cluster randomised feasibility trial
  1. Ruth Elizabeth Stow1,
  2. Christina H Smith2,
  3. Alison B Rushton3
  1. 1 School of Health Sciences, Birmingham City University, Birmingham, UK
  2. 2 Language and Cognition, Division of Psychology and Language Sciences, University College London, London, UK
  3. 3 Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
  1. Correspondence to Ruth Elizabeth Stow; ruth.stow{at}


Objectives To examine care home resident and staff perceptions of the acceptability of participating in a feasibility trial evaluating nutritional interventions in the treatment of malnutrition.

Design Exploratory qualitative methodology was used to gather descriptions of resident and staff perceptions of trial procedures, using semi-structured interviews with residents and focus groups with staff. The interviews were used to explore individual perceptions of the acceptability of the assigned intervention and the outcomes measured. Focus groups were used to explore staff experiences of trial participation and perspectives of nutritional support interventions.

Setting The study was embedded within a cluster randomised feasibility trial, which randomised six care homes to provide standard care (SC), food-based (FB) intervention or oral nutritional supplement (ONS) intervention to residents with, or at risk of, malnutrition.

Participants Residents in the trial with capacity to consent (n=7) formed the sampling frame for inclusion. Four agreed to be approached by the researcher and to take part in the individual interviews. All were women, representing two arms of the trial (ONS and SC). Twelve staff participated in six focus groups, one at each care home. All participants were women, representing all three arms of the trial.

Results Major themes that emerged from both interviews and focus groups included the perceived acceptability of trial involvement, the value of residents completing participant-reported outcome measures and the challenges associated with outcomes measurement in this setting. Themes that emerged from the focus groups alone, included the importance of individualising an intervention, and the perceived value of FB and ONS interventions and dietetic input.

Conclusions Residents and staff perceived involvement in a trial evaluating nutritional interventions to be acceptable, although the challenges associated with research in this setting were acknowledged. Resident preferences were highlighted by staff as an important consideration when implementing a nutrition support plan.

Trial registration number ISRCTN38047922

  • malnutrition
  • care homes
  • older adults
  • geriatric medicine
  • focus groups

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  • Contributors RES designed the study, performed the interviews and focus groups and drafted the article. RES analysed the data following peer debriefing and agreement of the final themes with ABR. ABR and CHS have made substantial contributions to the conception, design and data interpretation of the study. All authors have read and approved the final manuscript.

  • Funding This study was undertaken as a student project (RS was the MRes student), as part of the National Institute for Health Research (NIHR) Clinical Academic Training Programme for AHP’s (Masters in Research). The study was self-funded and involved no research costs for the NHS trust sponsoring the research (The Heart of England NHS Foundation Trust).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The trial was approved by the West Midlands NHS Local Research Ethics Committee (Ref: 13/WM/0390) and the Research and Development Department of the Heart of England NHS Foundation Trust prior to commencement.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No further unpublished data are available.

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