University of Worcester Worcester Research and Publications

Sustaining community-based interventions for people affected by dementia long term: the SCI-Dem realist review

Morton, Thomas ORCID:, Wong, G., Atkinson, Teresa ORCID: and Brooker, Dawn ORCID: (2021) Sustaining community-based interventions for people affected by dementia long term: the SCI-Dem realist review. BMJ Open, 11 (7). e047789. ISSN Online: 2044-6055

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Objectives Community-based support for people with earlier-stage dementia and their care partners, such as regularly meeting groups and activities, can play an important part in postdiagnostic care. Typically delivered piecemeal in the UK, by a variety of agencies with inconsistent funding, provision is fragmented and many such interventions struggle to continue after only a short start-up period. This realist review investigates what can promote or hinder such interventions in being able to sustain long term.

Methods Key sources of evidence were gathered using formal searches of electronic databases and grey literature, together with informal search methods such as citation tracking. No restrictions were made on article type or study design; only data pertaining to regularly meeting, ongoing, community-based interventions were included. Data were extracted, assessed, organised and synthesised and a realist logic of analysis applied to trace context–mechanism–outcome configurations as part an overall programme theory. Consultation with stakeholders, involved with a variety of such interventions, informed this process throughout.

Results Ability to continually get and keep members; staff and volunteers; the support of other services and organisations; and funding/income were found to be critical, with multiple mechanisms feeding into these suboutcomes, sensitive to context. These included an emphasis on socialising and person-centredness; lowering stigma and logistical barriers; providing support and recognition for personnel; networking, raising awareness and sharing with other organisations, while avoiding conflict; and skilled financial planning and management.

Conclusions This review presents a theoretical model of what is involved in the long-term sustainability of community-based interventions. Alongside the need for longer-term funding and skilled financial management, key factors include the need for stigma-free, person-centred provision, sensitive to members’ diversity and social needs, as well as the need for a robust support network including the local community, health and care services. Challenges were especially acute for small scale and rural groups.

Item Type: Article
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This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

A pdf file of this article is available to download from this WRaP record.

Uncontrolled Discrete Keywords: dementia, community-based support, community-based intervention
Divisions: College of Health, Life and Environmental Sciences > School of Allied Health and Community
Copyright Info: Open Access article
Depositing User: Thomas Morton
Date Deposited: 20 Jul 2021 07:23
Last Modified: 20 Jul 2021 07:23

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