Grip on challenging behavior: process evaluation of the implementation of a care program

Area of Science:

• Gerontology
• Healthcare Management
• Behavioral Science

Background:

• The Grip on Challenging Behavior program was implemented in 17 Dutch nursing homes to manage challenging behaviors in dementia special care units.
• A process evaluation assessed implementation quality and identified lessons for future endeavors.
• The study was registered under NTR2141, with randomization in November 2010 and intervention commencement in February 2011.

Purpose of the Study:

• To evaluate the implementation process of the Grip on Challenging Behavior care program.
• To determine the quality of implementation and identify barriers and facilitators.
• To provide insights for future implementation of similar care programs.

Main Methods:

• A stepped wedge design was employed for program implementation.
• First-order data (recruitment, reach, relevance, feasibility) and second-order data (intervention quality, barriers, facilitators) were collected.
• Data were gathered through structured questionnaires for care staff and key stakeholders, and semi-structured interviews.

Main Results:

• High resident participation (>95%) and training session attendance (82%) were achieved.
• The care program was perceived as relevant and feasible by respondents.
• Implementation quality was suboptimal, with barriers identified in organizational aspects, unit culture, and program specifics.

Conclusions:

• Recruitment, reach, relevance, and feasibility support analysis and generalization of program effects.
• The degree of implementation is a critical factor for further analysis.
• Future implementations should consider organizational and cultural contexts for better adaptation and success.