A Training and Fidelity Model to Move and Scale Evidence-based Dementia Care and Caregiver Support Programs into Practice: The Case for COPE in PACE service settings

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This NIA Stage I study is designed to address two leading barriers to implementation of evidence-based dementia care and caregiver support programs into long-term care settings: (1) lack of streamlined, user-friendly, and tested training modalities, and (2) lack of scalable, practical processes to accurately measure fidelity in “real world” settings. The aims of the study are to determine whether an online training program is the same or better in improving interventionist fidelity to an evidence based dementia program (COPE) and dementia patient outcomes when compared to a high intensity face-to-face traditional form of training. To accomplish these aims we will develop an online, principle-driven approach using state-of-the- science simulation and best practices and a scalable approach to assess fidelity to COPE by applying computational linguistics techniques. We will then conduct a noninferiority trial in Programs for All Inclusive Care for Elders (PACE) organizations randomly assigned to the training conditions. PACE staff will be evaluated post training on their fidelity outcomes. Dyads of persons with dementia and their caregivers will be evaluated at 4 months post COPE implementation on function, neuropsychiatric symptoms, quality of life, and caregiver burden. The findings from this project will lay the essential groundwork for a large scale, Stage III-IV, pragmatic trial of COPE in PACE settings throughout the US. Findings will also serve as a model for guiding the development of practical, scalable processes for training and fidelity monitoring in other long-term care settings and for other evidence-based support programs.