How is personalisation used in exercise for people with dementia, in what circumstances and why? A rapid realist review

Abstract Background Realist reviews are a type of systematic theory‐driven approach for making sense and evaluating the literature with the intention to identify plausible theories or models. This review will determine what literature and theoretical knowledge is available on “personalisation” in the context of exercise for people living with dementia (PwD). The aim of the review is to develop an initial programme theory that can be used to inform the development and testing of resources to support exercise interventions for PwD. Method Electronic databases and gg terms: personalisation, tailoring, adaptations, person‐centred, etc. Inclusion criteria were: • PwD (any type, severity, or location) • Exercise intervention (all forms) • Explicit discussion of theoretical concepts or rationale to Personalisation Articles were not excluded based on study design. A preliminary search to scope the evidence, refine search terms and criteria was undertaken before the start of this review. Data were collected from the included articles and managed through data analysis software that accommodates both qualitative and quantitative data (Excel). The review was registered on PROSPERO and followed RAMESES guidance and publication standards. Result Of the 2036 articles initially found, data extraction was completed from 64, following sorting for relevance and rigour (Figure 1). An initial programme theory involving 11 context‐mechanism‐outcome configurations (CMOc) is presented (Table 1) at different socio‐ecological levels of interaction needed to underpin a personalised exercise programme for PwD. Consideration of the individual’s identity, preference, preserved/embodied abilities, vulnerabilities, motivations (behaviour change), and their care‐giver should be acknowledged at an inter/intra‐personal level. Staff implementing the exercise programmes should have a person‐centered care approach, acknowledging concepts of personhood and using shared decision‐making. Finally, the cultural norms and expectations of the society within which the exercise programme is being conducted, and the PwD is situated within, should be considered to promote social connections rather than stigmatisation. Conclusion The initial programme theory explains personalisation and illustrates a novel foundation upon which to develop and refine a programme of exercise adapted specifically for PwD. Results from this review will inform data collection in the subsequent realist evaluation (e.g., interview questions).