DIALOR (DIgitAL cOaching for fRailty): a feasibility and acceptability study of a digital health coaching intervention for older people with frailty in primary care

Abstract

Abstract Purpose To assess the acceptability and feasibility of a digital health platform for long-term disease management combined with health coaching for people living with mild-moderate frailty in Southwest England. Methods Older adults (65 years+) with frailty (using electronic Frailty Index) and one or more co-morbidities were recruited from four primary care networks in a pre-post mixed methods study. They engaged with a digital health coaching programme with access to a digital platform between June 2023 and February 2024. Feasibility was assessed from participant recruitment, retention and adherence to the intervention. Eleven older adults with frailty, 5 health and wellbeing coaches and 2 health care professionals were interviewed to assess acceptability. Outcome measures included frailty, function, quality of life, social engagement, diet quality, self-reported indicators. Results Of 38 eligible participants, 34 accessed the online platform (mean age 77 years). Of these 34 participants, 24 (70.6%) started health coaching and 22 (64.7%) completed the intervention. No adverse events were reported. The intervention was acceptable to older adults with frailty and health and wellbeing coaches. Facilitating factors included trained health and wellbeing coaches, digital competence, access to digital support, perceived benefits. Barriers were low digital literacy, limited capacity among staff, lack of interest in the intervention, challenges related to use of appropriate language for recruitment and engagement. Conclusion It was feasible to deliver a digital health coaching intervention safely for older people with mild-moderate frailty. A future RCT is needed over a longer study period to determine intervention clinical effectiveness and healthcare costs.