Maximising inclusivity in care home research: Lessons learned from the AFRI-c randomised controlled trial

TL;DR

This paper shares lessons from a study in care homes to improve inclusivity in research involving older adults.

Contribution

The paper provides practical recommendations for conducting inclusive research in care home settings.

Findings

Flexible consent models and staff training were key facilitators for inclusive research.

National research infrastructure and embedded research nurses are recommended for success.

Advance directives and guidance for ethics committees can help navigate legal challenges.

Abstract

Ethical and procedural requirements make research in care homes challenging. With people living longer globally, it is essential that older people are included in research, including within the care home setting. We conducted a randomised controlled trial (AFRI-c) in 91 care homes across England, aiming to make the study available to every eligible resident. Facilitators included flexible models for receiving consent; commitment from care home staff, residents and families; tailored and specific training for care home staff; and support from national research infrastructure to engage care homes in research. To facilitate inclusive care home research, we recommend consulting with care homes about their research priorities; continuing investment in national research infrastructure for care homes; using advance directives for research planning for care home residents; embedding research nurses in care home environments; and more guidance for researchers and ethics committees on applying legal frameworks regarding capacity to research settings.