Sexual and gender-based violence can have long-term impacts on the physical and mental health of survivors, with demonstrated impairments to immune, endocrine and nervous systems, and increased risk of chronic conditions such as cardiovascular disease, depression and post-traumatic stress. Moreover, survivors commonly experience low self-efficacy and lack of perceived control over their lives. Creating space for survivors to feel empowered through a multidimensional approach to health promotion, considering both physical and psychological influences on health, is necessary to reduce chronic disease.

In this type II hybrid effectiveness-implementation cluster randomised controlled trial, we evaluate a novel peer-led intervention that combines expressive writing and trauma-informed boxing, Left Write Hook, against trauma-informed boxing alone—an intervention approach that is currently accessible in the community and has been shown to improve both mental and physical health. 20 clusters of 8–10 adults (n=150) with a self-reported history of child sexual abuse or other gender-based violence will be recruited in Melbourne, Australia, through health services and the community. Clusters will be randomly assigned to complete either 8x weekly group sessions of Left Write Hook (intervention) involving both expressive writing and trauma-informed boxing led by a trained peer facilitator, or 8x weekly group boxing sessions led by a trauma-informed boxing facilitator (control). Implementation will be evaluated against the PRISM Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. The primary effectiveness outcome is change in self-efficacy from preintervention to postintervention (8 weeks). Secondary effectiveness outcomes are changes in symptoms of complex post-traumatic stress disorder, trauma-related cognition and indicators of physical fitness (strength, flexibility, aerobic fitness and balance). Assessment will be completed online or over the phone with a member of the research team at preintervention (0 weeks), postintervention (8 weeks) and at 1 month following completion of the intervention (12 weeks). The primary implementation outcome is the fidelity of the train-the-champion implementation strategy for intervention training and delivery, and the secondary implementation outcome is adoption of the intervention and training delivery.

Ethical approval was received from the Human Research Ethics Committee of The University of Melbourne (2024-28998-60131-11) and the Alfred Hospital Ethics Committee (110810). Results will be disseminated via publication in a peer-reviewed journal, and data will be made available via Open Science Framework at the conclusion of the trial.

ACTRN12624000862549.

Point-of-care lung ultrasound (LUS) can assist in diagnosing acute respiratory diseases for its high accuracy and immediate availability at the bedside, including older patients with frailty. Delirium represents a frequent complication of hospitalisation in this setting, frequently triggered by acute respiratory diseases. LUS may therefore help identify individuals at risk of delirium, but the association between LUS abnormalities and delirium remains unexplored.

This study is a prospective, observational, multicentre study, with the main objective of assessing the correlation between LUS abnormalities and incident delirium during hospitalisation (primary outcome). The secondary objectives are to assess correlations between lung and diaphragm ultrasound parameters and clinical outcomes including duration of delirium, severity of respiratory failure and mortality. 480 patients aged ≥65 years old, urgently hospitalised after an emergency department visit for acute respiratory complaints, will be recruited in eleven acute geriatric wards located in eight teaching hospitals across Italy. LUS examinations will be performed by skilled clinicians prior to treatment whenever feasible, and in any case within 48 hours from admission. They will also undergo comprehensive geriatric assessment, and daily delirium assessment through the 4-AT tool. The association between LUS abnormalities, related parameters (LUS score, Pleural Effusion Score) and outcomes will be assessed by linear and logistic regression models.

Ethics Committee approval of the coordinating centre (Comitato Etico Territoriale Lombardia 3, reference ID 4369_20.03.2024_M) and collaborative centres has been obtained. All participants will provide written informed consent. Study results will be publicly available following peer-reviewed publication in international scientific journals.

NCT06670118.