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Agile support for care homes leads to South West recruitment success in important respiratory infection study

Images of an air purifier and care worker and masked older man, with AFRI-C logo superimposed

Staff from the NIHR Clinical Research Network South West Peninsula (CRN SWP) have been helping care homes to get involved in research as part of a study to see if portable HEPA air filters can reduce winter respiratory infections, including COVID-19.

The NIHR-funded AFRI-C study is running over three winters (2021-22, 2022-23 and 2023-24) and aiming to work with 91 care homes, divided at random into two groups. Both are continuing to follow usual infection prevention strategies, such as hand-washing, but one group also receives air filters to place in communal areas and some residents’ private bedrooms. Care home staff record infection symptoms their residents experience during each winter (each care home takes part for one winter period). The results from the two groups will be compared.

There are currently 220,000 people aged over 65 living in UK care homes. This number is predicted to double by 2040, and as highlighted by the devastating effects of COVID in care homes, reducing the spread of infections in these settings is a research priority.

In the South West, the NIHR CRN SWP Agile Research Team (ART) has had great success helping ‘research naïve’ care homes to run AFRI-C. Led by the Mid-Devon ART, staff have worked hard to engage the homes, their management and owners, and then to support them in all aspects of delivering a randomised controlled trial.   

Angela Willberry, NIHR CRN SWP Senior Research Nurse and Research Assistant Practitioner Sarah Greenham have been key to the ART’s success and encouraging care homes to take part in AFRI-C.

Angela said: “There was a lot of groundwork, Sarah was on the phone for days trying to speak to the managers and care home owners. When you first visit, you realise just how busy they are, and for them to take on a research study is a huge commitment. Although keen to take part in research, the staff don’t necessarily understand what research involves, how a study works or about governance. It can be quite challenging discussing the study and taking consent from an older person. However, we worked together as a team with each care home to ensure the study would run smoothly.

“We found that the care home staff were really grateful that they were able to get involved in research with our support, especially as AFRI-C is looking at ways to reduce COVID and other respiratory infections. The staff were all able to share with us their personal reflections on the pandemic, and how they often felt like they were on their own in social care. Taking part in this study has felt that this is now being acknowledged.”

Sarah added: “We've now got a database of care homes who are willing to participate in research, which will help us to get more studies going in social care. Prior to COVID there had been no engagement with any care homes for research, and even during COVID there was just one or two light touch studies in social care.

“It can be quite hard to get through to care homes initially. But once they were engaged and got going on this study, I think they realised there wasn’t too much that they actually needed to do on a daily basis.”

Tracey Mills is Manager of Asher Care in Newton Abbot, one of the South West care homes involved in AFRI-C, and was invited by the central study team to address a meeting promoting the next phase of the research. Summarising how she felt about participating in the study, Tracey said: “Taking part in the AFRI-C study has been interesting for all of us at Asher Care. The whole process was very easy, with great support from all involved in the study, especially local support from Angela and Sarah.”

The ART is in the process of supporting new care homes recruited to AFRI-C for winter three. The study has now closed to further applicants.

To find out more about research in your area, visit the NIHR’s Be Part of Research website:

AFRI-c is funded by the NIHR Public Health Research (PHR) Programme NIHR129783.