BRIDGE-CARE: Life Course Living Conditions, Care Provision Pathways, and Frailty – Applying 'Experience-Based Co-Design' to Develop Integrated Healthcare Models for Equitable Care
Short description
BRIDGE-CARE examines inequalities in care continuation and transitions between frailty stages from a life-course perspective. It brings together healthcare professionals, informal carers, and care receivers to co-design and test strategies for improving care continuity. It asks: (1) How do midlife living conditions influence frailty transitions in later life, and do care continuation and type mediate these effects? (2) What barriers and facilitators affect care continuity for caregivers and care receivers? (3) How can co-designed strategies reduce frailty risk among socioeconomically vulnerable groups? The project is led by four interdisciplinary researchers from the University of Gothenburg and the Västra Götaland Region.
Problem and questions
Equitable care continuation is essential for preventing frailty and promoting healthy ageing among older adults. However, individuals with socioeconomic vulnerabilities face a higher risk of care fragmentation, leading to poorer health outcomes and accelerated frailty trajectories. Understanding how life course living conditions disrupt care continuity is key to designing inclusive and effective strategies.
BRIDGE-CARE investigates inequalities in care continuation and transitions between frailty stages from a life-course perspective. It brings together formal carers (healthcare professionals), informal carers, and care receivers to co-design and test strategies for improving care continuity. It addresses three key questions:
- Pathways: How do midlife living conditions shape frailty transitions in later life, and do care continuation and type mediate these effects?
- Experiences: What are the barriers and facilitators of care continuation reported by formal and informal carers and care receivers?
- Intervention: How can co-designed priorities and strategies improve care continuation for all and reduce frailty risk among socioeconomically vulnerable groups?
Design and method
BRIDGE-CARE is a mixed-methods project comprising three interlinked studies that integrate longitudinal data analysis, participatory research, and intervention development.
- Study 1: Analyses Swedish register and survey data using Sequence Analysis Multistate Models (SAMM) and Marginal Structural Models (MSM) to examine how life course living conditions at ages 50–70 influence frailty transitions after age 70 and whether these effects are mediated by care provision pathways.
- Study 2: Uses Experience-Based Co-Design (EBCD) to engage formal and informal carers and care receivers in exploring care provision pathways and identifying barriers and facilitators through narrative in-depth interviews.
- Study 3: Applies EBCD to co-design strategies for improving care continuation and preventing frailty among socioeconomically vulnerable groups.
Societal relevance and utilization
BRIDGE-CARE addresses societal challenges related to frailty, health inequalities, and care system sustainability. Its findings have significant societal relevance, benefiting:
- Patients and care receivers: Promotes equitable access to care, reducing frailty risk and care discontinuity, particularly among socioeconomically vulnerable groups.
- Decision-makers and practitioners: Provides a practical, evidence-based toolkit for improving care continuation, including pilot-tested, scalable solutions for integration into care systems.
- Society: Contributes to more equitable, efficient, and sustainable care for older people, improving health outcomes and reducing healthcare costs associated with frailty progression.