Open Access Open Badges Study protocol

Southampton mealtime assistance study: design and methods

Helen C Roberts1, Anna L Pilgrim23, Marinos Elia3, Alan A Jackson3, Cyrus Cooper2*, Avan Aihie Sayer12 and Sian M Robinson2

Author Affiliations

1 Academic Geriatric Medicine, University of Southampton, Southampton General Hospital, Tremona Road, Southampton Hampshire, SO16 6YD, UK

2 MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton Hampshire, SO16 6YD, UK

3 Southampton NIHR Biomedical Research Centre in Nutrition, Diet and Lifestyle, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK

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BMC Geriatrics 2013, 13:5  doi:10.1186/1471-2318-13-5

Published: 7 January 2013



Malnutrition is common in older people in hospital and is associated with adverse clinical outcomes including increased mortality, morbidity and length of stay. This has raised concerns about the nutrition and diet of hospital in-patients. A number of factors may contribute to low dietary intakes in hospital, including acute illness and cognitive impairment among in-patients. The extent to which other factors influence intake such as a lack of help at mealtimes, for patients who require assistance with eating, is uncertain. This study aims to evaluate the effectiveness of using trained volunteer mealtime assistants to help patients on an acute medical ward for older people at mealtimes.


The study design is quasi-experimental with a before (year one) and after (year two) comparison of patients on the intervention ward and parallel comparison with patients on a control ward in the same department. The intervention in the second year was the provision of trained volunteer mealtime assistance to patients in the intervention ward. There were three components of data collection that were repeated in both years on both wards. The first (primary) outcome was patients’ dietary intake, collected as individual patient records and as ward-level balance data over 24 hour periods. The second was clinical outcome data assessed on admission and discharge from both wards, and 6 and 12 months after discharge. Finally qualitative data on the views and experience of patients, carers, staff and volunteers was collected through interviews and focus groups in both years to allow a mixed-method evaluation of the intervention.


The study will describe the effect of provision of trained volunteer mealtime assistants on the dietary intake of older medical in-patients. The association between dietary intake and clinical outcomes including malnutrition risk, body composition, grip strength, length of hospital stay and mortality will also be determined. An important component of the study is the use of qualitative approaches to determine the views of patients, relatives, staff and volunteers on nutrition in hospital and the impact of mealtime assistance.

Trial registration

Trial registered with NCTO1647204

Nutrition; Older; Volunteer; Mealtime assistance; Dietary intake; Hospital