Co-developing and evaluating the acceptability of a Dyadic mind-body intervention for Relieving Enduring sleep disturbances Among older individuals with deMentia and their caregivers (DREAM) in both white and ethnic minority communities in Bristol

What is the problem?

Focus group interviews, funded by an RCF-type 1 award, were conducted recently with 24 pairs of older individuals with dementia and their caregivers from a local white community and various ethnic minority groups, including Caribbean, Chinese, and South Asian backgrounds, to investigate non-drug coping methods for handling sleep issues. Participants consistently reported disrupted sleep patterns and poor sleep quality, echoing existing research findings¹. Although some had tried short-term medications, they often experienced excessive daytime drowsiness and other side effects. Many participants indicated that integrating relaxation techniques and gentle movement exercises into a holistic mind-body approach is a priority for effective non-drug alternatives. This feedback is consistent with findings from my other ICB-funded project on melatonin use in individuals with dementia, which also highlights the growing interest in non-pharmacological coping strategies.

DH&SC is formulating a strategy to tackle significant health concerns, particularly dementia, impacting individuals in England². As such, dementia is a key priority in the BNSSG area³. While many people need support, health inequalities among minority ethnic groups often make it harder for them to access essential services⁴. This gap in community support highlights the necessity for culturally appropriate interventions designed to meet the unique needs of diverse communities.

What is the aim of the research?

To engage in a co-development process with stakeholders, including older adults with dementia and their caregivers from four distinct ethnic communities: White British, Caribbean, Chinese, and South Asian, as well as PPI representatives and mind-body practitioners.
To implement the co-designed dyadic mind-body intervention by testing it with 12 pairs of individuals with dementia and their caregivers from these four ethnic communities.
To assess the acceptability of the intervention using the Consolidated Framework for Implementation Research (CFIR)⁵.
To gather data and develop a funding proposal for a feasibility trial to submit for NIHR RfPB Tier 2 funding.

How will BNSSG ICB RCF be used?

Co-development (0-4 months):

Organize two co-creation workshops in each of the four Bristol communities, involving a mind-body practitioner, three pairs of individuals with dementia and their caregivers, and a PPI representative from each community.
Co-design a dyadic mind-body intervention using key themes from focus group discussions on non-medication approaches to sleep problems (RCF Type 1), insights from a scoping review on mindfulness and sleep⁶, and previous research^7-10 by my team on similar intervention protocols.

Implementation (5-8 months):

As an experienced mindfulness teacher and Tai Chi practitioner, I will lead the implementation of the co-designed intervention.
The intervention will be conducted in each of the four communities, with three pairs of people with dementia and their caregivers from each community.

Acceptability evaluation (9-10 months):

Identify key CFIR domain constructs (e.g., intervention characteristics, outer setting, or individual characteristics) affecting intervention acceptability.
Collect stakeholder perspectives on their experiences and perceptions of the intervention.

Preparation for NIHR funding proposal (11-12 months):

Convene a meeting with potential co-applicants and the NIHR Research Support Service before drafting the proposal.
Collect data and evidence to prepare a funding proposal for NIHR to develop a training manual, train-the-trainer program, and conduct a feasibility trial.

Who is leading the research?

The research is being led by Dr Sunny Chan, School of Health and Social Wellbeing, University of West of England, Bristol.

Further information

For more information or to get involved in this project, please contact bnssg.research@nhs.net.