Evaluating a National Person-Centered Training Program to Strengthen the Dementia Care Workforce

评估以人为本的国家培训计划，以加强痴呆症护理人员队伍

• 批准号: 10679067
• 负责人: Sheryl Zimmerman
• 金额: $ 74.99万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10679067
• 关键词: Adoption; Age Years; Alzheimer' s Disease; Alzheimer' s disease related dementia; Area; Assisted Living Facilities; Attitude; Beds; Behavior; Caring; Case Mixes; Certification; Characteristics; Cluster randomized trial; Communities; Community Healthcare; Community Participation; Competence; Computers; Country; Data; Dementia; Development; Discipline of Nursing; Education; Educational process of instructing; Effectiveness; Family; Family member; Feeling; Hour; Impaired cognition; Individual; Injury; Intention; Knowledge; Learning; Licensing; Long-Term Care; Minority; Modeling; National Institute on Aging; Occupations; Outcome; Perception; Personal Satisfaction; Persons; Preparation; Procedures; Provider; Psychological reinforcement; Quality of life; Randomized; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Reaction; Reporting; Residential Treatment; Self Care; Severities; Tablet Computer; Testing; Training; Training Programs; Waiting Lists; Workplace; arm; behavior change; burnout; care outcomes; care providers; community living; cost; dementia care; effectiveness evaluation; effectiveness/implementation hybrid; evidence base; expectation; experience; handheld mobile device; high school; improved; improved outcome; interest; peer support; person centered; programs; recruit; residential care facility; response; skills; skills training; virtual

Project Summary/Abstract More than 75% of persons living with Alzheimer's disease and related dementias who reach 80 years of age require residential long-term care, which is increasingly provided in assisted living (AL). Across the country, almost 29,000 AL communities with more than 996,000 beds have become the primary residential care provider for persons with dementia: 90% of AL residents have cognitive impairment and 42% have recorded moderate or severe dementia, with actual rates being higher. AL provides supportive but not nursing services; consequently, virtually all care is provided by direct care workers (nursing assistants and personal care aides). Unfortunately, direct care workers are undervalued and undertrained, leading to poor care, workplace injury, dissatisfaction, and high turnover. AL is state-regulated, and only 17 states stipulate minimum training hours (some being as low as one hour), meaning that two-thirds of states are silent on training. Fewer than 40% of staff have education beyond high school, and so it is not surprising that a minority report sufficient knowledge to care for persons with dementia. In striving to fill this gap, training for direct care workers must be accessible and have efficacy in benefitting the staff, organization, and persons with dementia. Online training is an especially promising option due to its low cost, wide availability, and potential for self- pacing, automated skills tests, and certification. The Alzheimer's Association is the national leader in dementia care training, and in 2021 developed essentiALZTM (pronounced “essentials”), an online program teaching evidence-based, person-centered care, which can be accessed from a computer, tablet, or mobile device. Already more than 1,500 staff have essentiALZ certification, but as is true of the majority of training programs, evidence as to its ability to improve care and outcomes is lacking. It is possible that essentiALZ is effective in changing care and outcomes, but it may also be that additional supports are necessary to do so. A timely model of support is Project ECHO, which has flooded the field of long-term care as a proven way to provide expert guidance and peer support via a remote, online approach. Adding ECHO to online dementia training might provide a necessary boost to achieve care change and improved outcomes. The proposed project responds to the NIA Notice of Special Interest that calls for strengthening the workforce through enhancing and supporting skills training. It will conduct a hybrid implementation/effectiveness cluster- randomized trial in 126 AL communities across six states, comparing essentiALZ alone, essentiALZ + ECHO enhancement, and a waitlist control. Outcomes grounded in the RE-AIM model and the Kirkpatrick training effectiveness model will be examined over six months, comparing the arms in terms of (1) implementation and (2) effectiveness, and (3) examining the extent to which implementation and effectiveness differ based on characteristics of the AL community, staff, residents, and family members. Results will inform next steps in dementia care training for the AL and broader long-term care workforce.

项目总结/文摘