Catherine Houghton

Background: Dementia is a priority public health issue globally. Behavioral and psychological symptoms of dementia (BPSD) lead to low quality of life (QoL) for people living with dementia and can also cause distress amongst their caregivers. To date, the effectiveness of pharmacological treatments for dementia have had limited. Animal assisted intervention (AAI) has become a popular non-pharmacological therapy and psychosocial intervention, and can have positive effects on mood, social behavior, physical activity and QoL of people living with dementia. The factors influencing the delivery of AAI remain underexplored. The aim of this review is to synthesize qualitative research regarding stakeholders’ perceptions and experiences of AAI for people living with dementia in community settings. Methods: We will systematically search nine databases/platforms. Two reviewers will independently screen the titles, abstracts and full texts; the process will be reported following PRISMA guidance. Data from included studies will be extracted according to a specifically designed form. Three reviewers will independently appraise the methodological quality of studies using the Critical Appraisal Skills Program qualitative checklist. We will analyze data following thematic synthesis. GRADE-CERQual will be applied to assess confidence in the findings. The research team will engage in reflexivity throughout all review stages of process through regular meetings/discussions. A Public and Patient Involvement (PPI) contributor will be included to oversee and provide advice on the QES process. Discussion: AAI is a potentially valuable for improving mood and reducing BPSD for people living with dementia. However, the perceptions and experiences of stakeholders and factors influencing the implementation of AAI for people living with dementia are not clear. This qualitative evidence synthesis will significantly contribute to the evidence base. It will identify factors and recommendations for AAI guidance, and have clinical and social implications of improving the well-being of people living with dementia and their caregivers.