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IntroductionWith digital and social media advances, animated health communications (health animations) are highly prevalent globally, yet the evidence base underpinning them remains unclear and limited. While individual studies have attempted to explore the effectiveness, acceptability and usability of specific features of health animations, there is substantial heterogeneity in study design, comparators and the animation design and content. Consequently, there is a need to synthesise evidence of health animations using an approach that recognises this contextual complexity, which may affect their impact.Methods and analysisThis project aims to understand why, how, for whom, to what extent and in which contexts health animations are expected to promote preventive health behaviours. We will conduct a realist review following Pawson’s five iterative stages to (1) define the review scope and locate existing theories; (2) search for evidence; (3) select and appraise evidence; (4) extract data and (5) synthesise data and refine theory. Engagement with stakeholders involved in developing, testing, implementing or commissioning health communications, including animations, will allow the initial programme theory to be tested and refined. The findings will be reported in accordance with Realist and Meta-narrative Evidence Syntheses: Evolving Standards.Ethics and disseminationEthical approval for the public stakeholder work was provided by the Northumbria University Research Ethics Committee. We will disseminate the findings widely through outputs tailored to target specific professional, public and patient audiences. Dissemination will occur through stakeholder engagement as part of the research, a peer-reviewed publication and conference presentations.PROSPERO registration numberCRD42023447127.

Globally, there is an urgent need for solutions that can support our aging populations to live well and reduce the associated economic, social and health burdens. Implementing smart technologies within homes and communities may assist people to live well and ‘age in place’. To date, there has been little consultation with older Australians addressing either the perceived benefits, or the potential social and ethical challenges associated with smart technology use. To address this, we conducted five World Cafés in two Australian states, aiming to capture citizen knowledge about the possibilities and challenges of smart technologies. The participants (n = 84) were aged 55 years and over, English-speaking, and living independently. Grounding our analysis in values-based social science and biomedical ethical principles, we identified the themes reflecting the participants’ understanding, resistance, and acceptance of smart technologies, and the ethical principles, including beneficence, non-maleficence, autonomy, privacy, confidentiality, and justice. Similar to other studies, many of the participants demonstrated cautious and conditional acceptance of smart technologies, while identifying concerns about social isolation, breaches of privacy and confidentiality, surveillance, and stigmatization. Attention to understanding and incorporating the values of older citizens will be important for the acceptance and effectiveness of smart technologies for supporting independent and full lives for older citizens.

Introduction Quality indicators are explicitly defined and measurable items that evaluate and describe healthcare (Campbell, 2002). They can provide care users, staff, providers, and purchasers with feedback in relation to the quality of care, sometimes against benchmarks or previous quality assessments. In addition, by providing a valid and reliable means of measuring quality of care, quality indicators (although not sufficient by themselves) can act as a starting point for quality improvement. There are currently no quality indicators designed to assess the quality of palliative day services (PDS). Aim To develop a set of quality indicators to appraise the care provided by PDS in the UK. Methods The RAND/UCLA appropriateness method was utilised. This multi-stage method combines best available evidence alongside expert consensus. The resultant draft set of indicators was tested for feasibility in 5 UK hospices. A parallel strategy of stakeholder engagement was implemented throughout the research lifecycle. Results The initial list of 185 candidate indicators identified by a systematic review was reduced to a final list of 30 core indicators, which were found to be appropriate and feasible. Conclusions This quality indicator set is the first to be produced for PDS, and is available for use by services. It represents a valuable, acceptable and feasible means to assess quality of care in PDS, and a means of identifying goals for quality improvement. Successful implementation of quality indicators in routine practice requires attention to a range of key enablers and barriers. Reference . Campbell, S M. (2002) 'Research Methods Used In Developing And Applying Quality Indicators In Primary Care'. Quality and Safety in Health Care, 11(4), pp. 358-364

Introduction Evaluating quality of palliative day services is essential for assessing care across diverse settings, and for monitoring quality improvement approaches. Aim To develop a set of quality indicators for assessment of all aspects (structure, process and outcome) of care in palliative day services. Methods Using a modified version of the RAND/UCLA appropriateness method (Fitch et al., 2001), a multidisciplinary panel of 16 experts independently completed a survey rating the appropriateness of 182 potential quality indicators previously identified during a systematic evidence review. Panel members then attended a one day, face-to-face meeting where indicators were discussed and subsequently re-rated. Panel members were also asked to rate the feasibility and necessity of measuring each indicator. Results 71 indicators classified as inappropriate during the survey were removed based on median appropriateness ratings and level of agreement. Following the panel discussions, a further 60 were removed based on appropriateness and feasibility ratings, level of agreement and assessment of necessity. Themes identified during the panel discussion and findings of the evidence review were used to translate the remaining 51 indicators into a final set of 27. Conclusion The final indicator set included information on rationale and supporting evidence, methods of assessment, risk adjustment, and recommended performance levels. Further implementation work will test the suitability of this 'toolkit' for measurement and benchmarking. The final indicator set provides the basis for standardised assessment of quality across services, including care delivered in community and primary care settings. Reference Fitch K, Bernstein SJ, Aguilar MD, et al . The RAND/UCLA Appropriateness Method User's Manual . Santa Monica, CA: RAND Corporation; 2001. http://www.rand.org/pubs/monograph_reports/MR1269