Introduction
The aim of the Health Technology Assessment (HTA) Programme is to ensure that high quality research information on the effectiveness, cost-effectiveness and broader impact of treatments and tests are produced in the most efficient way for those who plan, provide or receive care from NHS and social care services. The commissioned workstream invites applications in response to calls for research on specific questions which have been identified and prioritised for their importance to the NHS, patients and social care.
Research question
What are the social and mental wellbeing benefits of intergenerational practices in care homes and schools?
- Intervention: Intergenerational Practice, bringing the care home residents and school/further education students together for group activities (applicants are invited to specify and justify the design of the intergenerational programme used, ensuring there is service user input in the development, and should include a relevant plan for safeguarding in their application).
- Target group: Residents in care homes and children/young people in school/further education (applicants are invited to specify and justify age brackets used for each group, applicants should specify whether or not exclusion criteria will include residents with dementia). Applications are encouraged which include recruitment from geographic populations with high levels of disadvantage which have been historically underserved by research activity in this field.
- Setting: Community setting.
- Control/Comparator: Care homes and/or schools running the same activities with no intergenerational links.
- Study design: A randomised controlled trial with an internal pilot phase to test key trial processes such as recruitment and adherence. Clear stop/go criteria should be provided to inform progression from pilot to full trial.
- Important outcomes:
- Children/Young People: happiness with a measure of feeling of isolation, confidence to engage with others of a different or same generation, attitudes towards older people.
- Care Home Residents: Quality of life, happiness with a measure of feeling of isolation, confidence to engage with others of a different or same generation, attitudes towards younger people.
- Care Providers: Mental health, attitudes towards both target groups.
- Other outcomes:
- Children/Young People: career inspiration, leadership ability, academic ability.
- Care Providers: financial implications of the intervention, job satisfaction/retention.
- Existing Core Outcomes should be included amongst the list of outcomes unless a good rationale is provided to do otherwise. Applicants are encouraged to report recruitment and findings disaggregated by sex (and other demographic factors where relevant).
- Minimum duration of follow-up: 12 months.
- Longer-term follow-up: If appropriate, researchers should consider obtaining consent to allow potential future follow-up through efficient means (such as routine data) as part of a separately funded study.
Rationale
In 2015 there were an estimated 617.1 million adults aged over 65, representing 9% of the population; by 2050 it is estimated that the number of adults aged over 65 will rise to 1.6 billion, representing 17% of the global population. This is compounded by the fact that those aged over 65 report higher level of loneliness or feeling isolated. The Office for National Statistics Community Life Survey for 2020-2021 2021 reported that 6% of adults in the UK said they often or always felt lonely, this percentage significantly increases when narrowing the range by age, such that for people aged over 65 it is 9%. The same report also noted that the same statistic for people aged 16-24 rises to 11%. These two groups, split by generation, lack a strong predetermined interaction in society. This lack of contact has resulted in both older adults and younger people having persistent negative stereotypes associated with them, where older adults can be seen as incompetent, grouchy, and weak, while young people are associated with antisocial behaviour and mistrusted by society. These stereotypes are maintained by the lack on direct contact between these two groups.
Well-being in both age groups can be supported by social interactions and strong social networks, with evidence suggesting that intergenerational interactions are able to reduce loneliness and improving mental health. Intergenerational practice aims to connect two or more generations to facilitate knowledge and skills exchange as well as meaningful social interactions between older and younger groups. Guidance on the wellbeing of older people published by NICE looks to involve older people in group activities that have an intergenerational aspect. The current provision of such schemes, however, is not consistent and based on a post-code lottery of what programmes are organised locally by volunteers or charitable organisations. These sorts of programmes have been shown to reduce age-related intergroup anxiety, improving the perceptions of each age group of the other, and that participation in such programmes leads to improvements in mental wellbeing in the older adults involved.
Multiple studies in several countries have examined the effects of intergenerational practice, with a particular focus on the outcomes for the older age group. As such, there is a gap in understanding the effect of intergenerational practices on young people’s mental health, loneliness/social isolation, and the effect on caregiver wellbeing, mental health and economic outcomes. A future trial looking at intergenerational practice should therefore examine outcomes for both groups participating in the intergenerational programme as well as outcomes for their respective caregivers.
Additional commissioning brief background information
A background document is available that provides further information to support applicants for this call. It is intended to summarise what prompted the call and the existing evidence base, including relevant work from the HTA and wider NIHR research portfolio. It was researched and written on the basis of information from a search of relevant sources and databases, and in consultation with a number of experts in the field. If you would like a copy please email htaresearchers@nihr.ac.uk.
Making an application
If you would like to apply for this funding opportunity, you can begin your application via the funding opportunity page.
Your application must be submitted online no later than 1pm on 28 March 2024. Applications will be considered by the HTA Funding Committee at its meeting in May 2024.
Guidance notes and supporting information for HTA Programme applications are available.
Shortlisted Stage 1 applicants will be given eight weeks to submit a Stage 2 application. The Stage 2 application will be considered at the Funding Committee in November 2024.
For commissioned topics, the Programme strongly discourages the practice of the same co-applicant joining more than one competing team, other than in unusual circumstances (for example, a lead from a named charity or a unique national expert in a condition).
For such exceptions, each application needs to state the case as to why the same person is included. The shared co-applicant should not divulge application details between teams, and both teams should acknowledge in their application that they are aware of the situation, and that study details have not been shared.
Should you have any queries please contact us htacommissioning@nihr.ac.uk.