Table 2 Description of the PromeTheus intervention using the TIDieR checklist [41]

1. Brief name

Prevention for more participation in old age (PromeTheus)

2. Why

Multifactorial, interdisciplinary interventions with physical exercise as the main component, supplemented by additional nutritional, environmental, functional, and psychosocial components, have been shown to be effective in frailty management. Evidence on the (cost-)effectiveness and the successful implementation of such interventions in routine practice via available healthcare structures is limited.

3. What: Materials

WEBB: German WEBB program manual (general training principles; pictorial and written exercise descriptions; exercise frequency, volume, duration, intensity, and progression; Borg Rating of Perceived Exertion scale, precautions and safety issues), workbook (training sheets with individual exercise prescriptions and training goals, training diaries, DEMMI progress chart, EARS, contact information of physiotherapists), training materials (weight vest, balance pad, anti-slip mat, objects to step over [e.g., book] and to grasp [e.g., water bottle], adhesive tape to make marks on the floor, cushion, table, chair)

Counseling on person-environment-fit: 25-item checklist, information materials on local consulting sites of service providers (e.g., healthcare supply stores), pre-formulated cover letter to GP

Counseling on coping with everyday life: 10-item screening tool, referral document to the social worker

Nutritional counseling: MNA-SF, SNAQ, referral document to the nutritionist, 7-day nutritional protocol, brochure on malnutrition in old age

Group component: information materials about local counseling sites on group offers for older people, information letter to the relatives with this information and a request for support in finding and referring participants to appropriate group programs

The trainer manual with all information is also included in the participants’ WEBB program manual and workbook, with additional content and task descriptions of all 10 home visits and 5 phone calls, instructions for goal setting, motivational interviewing, and feedback provision on training progress.

4. What: Procedures

10 home visits and 5 phone calls by one physiotherapist

Home visit 1: The PromeTheus program is introduced, all documents (WEBB program manual, workbook) and training materials are handed over and reviewed with the participants, participants’ physical capacity is assessed (DEMMI), an adequate training location in the home is identified, and a training plan with first exercises is worked out. Home visit 2: The exercises that were not yet introduced in home visit 1 are added to the training plan, existing exercises are adapted to increase the training stimulus, if necessary, and 2–4 training goals are defined. Subsequent home visits and phone calls: Training plans, exercise prescriptions and attainment of training goals are evaluated and adapted to the participants’ training progress. DEMMI is assessed at home visits 6 and 10. Home visits 3–5: Needs assessments for facultative individual intervention components (person-environment-fit, coping with everyday life, nutrition) are performed. 2nd intervention quarter: Needs assessments for the facultative group component. If there is a need and willingness for counseling, information materials on local consulting sites of service providers are provided (counseling on person-environment-fit), relatives are involved for support (referral to group activities), GP visit is encouraged (prescription of assistive devices), or participants are referred to the social workers (counseling on coping with everyday life) or nutritionists (nutritional counseling).

5. Who provided

Physiotherapists (WEBB), service providers at the local sites (counseling on person-environment-fit), AOK social workers with qualification as a care consultant (counseling on coping with everyday life), AOK nutritionists (nutritional counseling)

6. How

Intervention is provided in one-on-one situations in participants’ homes (WEBB, counseling on coping with everyday life), at the AOK facilities (nutritional counseling), or via phone (WEBB, counseling on coping with everyday life, nutritional counseling)

7. Where

Three study sites: Stuttgart, Heidelberg, and Ulm (Baden-Wuerttemberg, Germany)

Primarily delivered in participants’ homes (WEBB, counseling on person-environment-fit and coping with everyday life), additional out-of-home appointments offered if needed and willing to (nutritional counseling at the AOK facilities in the city centers, group activities in the participants’ local area)

8. When and how much

WEBB: 10 home visits (week 1, 2, 4, 6, 10, 14, 18, 26, 34, 42) à 30–60 min, 5 phone calls (week 5, 7, 22, 38, 50) à 20 min, overall exercise prescription: 3–5 ×/week à 20–30 min

Counseling on person-environment-fit (after week 3) and coping with everyday life (after week 4 or 5), group activities (start: 2nd intervention quartal), if needed and willing to: frequency, schedule, duration, etc. individually tailored to the participants’ needs/interests

Nutritional counseling (after week 4 or 5), if needed and willing to: 3 sessions à 45–60 min within ≤6 weeks

9. Tailoring

WEBB: Individual tailoring of the exercise prescription (e.g., training frequency, intensity, volume) and training goals is constantly given at each home visit and a phone call by the physiotherapist.

Facultative components (counseling on person-environment-fit, coping with everyday life, nutrition, and group activities) are provided based on individual participant needs.

10. Modifications

N/A

11. How well:Planned

Training adherence is assessed using self-reported training diaries and the EARS filled out by the participants after home visits 3, 6 and 8.

Training diaries contain sheets with (1) check boxes for each day that participants mark differently for different types of exercises completed, and (2) blank spaces for each exercise in which participants document the execution, sets, repetitions, weight, and/or duration for each exercise

Motivational and volitional techniques of behavior change are used to increase training adherence: provision of training information (WEBB program manual), regular home visits/phone calls for setting, reviewing and adapting individual training goals, barrier identification and problem-solving, self-monitoring by training diaries, motivational interviewing, provision of feedback on training progress.

12. How well: Actual

N/A