Developing age-friendly communities in an emergent post-pandemic world

This work is funded by the Dunhill Medical Trust as part of its Building and Developing Suitable and Sustainable Living Environments and Communities for an Ageing Population. The work will provide new insight to the impact of the Covid-19 pandemic on older people’s social connections and develop evidence-based recommendations on how places can continue to support older people. Across the UK, older people are reported to have been disproportionately negatively affected by the disease and restrictions imposed to limit its risks. This includes reduced physical activity and, potentially, heightened isolation. However, we do not yet know the full impact of the pandemic on how older people can remain socially connected in the places where they live, nor do we understand how age-friendly initiatives can encourage and support older people’s social (re)connections over coming years. The project will address three questions: • How have older people made connections within and around their environments during the pandemic and what can we learn from this as we move out of it? • What has the impact of Covid-19 been on older people and their living environments; and how can the development and adaption of new and existing support activities help age-friendly places to succeed? • How have activities for older people changed and might these continue to adapt post Covid-19? We will work with Age-Friendly Salford to test out how places can continue to be made age-friendly as the UK moves to the next phase of Covid-19. We will do this by collecting and analysing new data gathered using a range of techniques in five phases: • Phase 1: Focus groups with individuals from organisations that support older people or develop policies to support them. • Phase 2: Interviews with older people to gather new insight to experiences of accessing and engaging with remote support and engagement activities. • Phase 3: Completing an audit of age-friendly locations, services and businesses • Phase 4: Engaging in a series of ‘Conversations about Ageing’, led by older people, based on the findings from Phases 1, 2 and 3 • Phase 5: Developing recommendations and informing others of findings Older people will be involved in all stages of the project, from contributing ideas and sharing their experiences to working as co-researchers on the team. They will be supported to undertake an assessment of how age-friendly activities adapt in an emerging post-pandemic UK using an age-friendly standards toolkit. The group will also work with the project team to host a series of Conversations with service providers, policy makers and other older people

A 'Performative' Social Movement: The Emergence of Collective Contentions within Collaborative Governance

The enmeshment of urban movements in networks of collaborative governance has been characterised as a process of co-option in which previously disruptive contentions are absorbed by regimes and reproduced in ways that do not threaten the stability of power relations. Applying a theoretical framework drawn from feminist philosopher Judith Butler this paper directs attention to the development of collective oppositional identities that remain embedded in conventional political processes. In a case study of the English tenants' movement, it investigates the potential of regulatory discourses that draw on market theories of performative voice to offer the collectivising narratives and belief in change that can generate the emotional identification of a social movement. The paper originates the concept of the ‘performative social movement’ to denote the contentious claims that continue to emerge from urban movements that otherwise appear quiescent

Researcher identity : exploring the transformatory power of the research experience

In consumer research we frequently focus on the phenomenon of transformation; be that the transformatory effects of a particular consumption community or the great body of work being carried out under the banner of Transformative Consumer Research. However there is a particular transformation which occurs in the field of interpretivist consumer research that, we would argue, is overlooked – that of researcher transformation. We present as data our reflexive considerations on the ways in which our own research with vulnerable consumers has affected and changed us. We consider short term transformations in the field, reflecting on the various ways that researcher identity is carefully managed and negotiated to fit with the social-cultural setting. We also consider longer term transformations and discuss the enduring impact of the research process – the people we have met, the homes we have visited and the stories we have heard. By reflecting on the shaping of identities ‘in the field’ we aim to deepen our appreciation of the interpretive consumer research process and contribute to theoretical understanding of transformative identity research

Self-management toolkit and delivery strategy for end-of-life pain: the mixed-methods feasibility study

Background: Pain affects most people approaching the end of life and can be severe for some. Opioid analgesia is effective, but evidence is needed about how best to support patients in managing these medicines. Objectives: To develop a self-management support toolkit (SMST) and delivery strategy and to test the feasibility of evaluating this intervention in a future definitive trial. Design: Phase I – evidence synthesis and qualitative interviews with patients and carers. Phase II – qualitative semistructured focus groups and interviews with patients, carers and specialist palliative care health professionals. Phase III – multicentre mixed-methods single-arm pre–post observational feasibility study. Participants: Phase I – six patients and carers. Phase II – 15 patients, four carers and 19 professionals. Phase III – 19 patients recruited to intervention that experienced pain, living at home and were treated with strong opioid analgesia. Process evaluation interviews with 13 patients, seven carers and 11 study nurses. Intervention: Self-Management of Analgesia and Related Treatments at the end of life (SMART) intervention comprising a SMST and a four-step educational delivery approach by clinical nurse specialists in palliative care over 6 weeks. Main outcome measures: Recruitment rate, treatment fidelity, treatment acceptability, patient-reported outcomes (such as scores on the Brief Pain Inventory, Self-Efficacy for Managing Chronic Disease Scale, Edmonton Symptom Assessment Scale, EuroQol-5 Dimensions, Satisfaction with Information about Medicines Scale, and feasibility of collecting data on health-care resource use for economic evaluation). Results: Phase I – key themes on supported self-management were identified from evidence synthesis and qualitative interviews. Phase II – the SMST was developed and refined. The delivery approach was nested within a nurse–patient consultation. Phase III – intervention was delivered to 17 (89%) patients, follow-up data at 6 weeks were available on 15 patients. Overall, the intervention was viewed as acceptable and valued. Descriptive analysis of patient-reported outcomes suggested that interference from pain and self-efficacy were likely to be candidates for primary outcomes in a future trial. No adverse events related to the intervention were reported. The health economic analysis suggested that SMART could be cost-effective. We identified key limitations and considerations for a future trial: improve recruitment through widening eligibility criteria, refine the SMST resources content, enhance fidelity of intervention delivery, secure research nurse support at recruiting sites, refine trial procedures (including withdrawal process and data collection frequency), and consider a cluster randomised design with nurse as cluster unit. Limitations: (1) The recruitment rate was lower than anticipated. (2) The content of the intervention was focused on strong opioids only. (3) The fidelity of intervention delivery was limited by the need for ongoing training and support. (4) Recruitment sites where clinical research nurse support was not secured had lower recruitment rates. (5) The process for recording withdrawal was not sufficiently detailed. (6) The number of follow-up visits was considered burdensome for some participants. (7) The feasibility trial did not have a control arm or assess randomisation processes. Conclusions: A future randomised controlled trial is feasible and acceptable