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Abstract

Background
People with dysphagia who require mealtime assistance are at greater risk of emergency hospitalisation and other negative outcomes. However, the abilities and experiences of family-carers providing mealtime assistance to children are unknown. This multi-method PhD investigation will create a toolkit to support family-carers and Speech & Language Therapists (SLT) when developing mealtime recommendations, including the change(s) targeted (texture, pacing) and adherence approaches.

Methods
The ‘develop intervention’ stage of the MRC framework for complex intervention development guided 4 studies:
Best research evidence: systematic literature review (Study A)
Clinical expertise: survey of UK SLT clinical practice (Study B)
Patient and/or carer values: qualitative family mealtime exploration (Study C)
These findings will be synthesised and a prototype toolkit produced via co-creation (Study D)

Outcomes
Study A: Prospero registration [CRD42021257596], searches and screening completed. Included studies are highly heterogeneous in both participant type (child, carer or dyad), targeted changes, location and outcomes.
Study B: Recruitment completed (May-July 2021). 102 participants progressed to final question. SLTs used multiple mealtime recommendation targets (n=27) e.g., positioning, utensils. Many frequently (n=22, >60% reporting sometimes-often). Qualitative analysis revealed two main SLT working styles, ‘Consultative collaboration’ or ‘Informative prescription’.
Study C: NHS ethics approval anticipated with planned protocol registration and data collection (October-December 2023).
Study D: Planned (2024-25).

Discussion
Findings so far highlight the complexity of creating mealtime recommendations due to multiple potential targets and a limited research evidence base. Future and current findings will guide the toolkit creation to support this complex practice area.

Publication Type:	Poster
Additional Information:	Presented at: UK Swallowing Research Group 2024 on 09 Feb 2024.
Subjects:	R Medicine > RF Otorhinolaryngology
Departments:	School of Health & Psychological Sciences School of Health & Psychological Sciences > Language & Communication Science
SWORD Depositor:	Symplectic Administrator

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