Developing and Testing Remote Implementation for the Changing Talk Online (CHATO) Communication Intervention for...

Area of Science:

• Gerontology
• Nursing Home Care
• Dementia Care

Background:

• Elderspeak and behavioral challenges are significant issues in dementia care within nursing homes.
• The Changing Talk (CHAT) communication training has previously shown effectiveness in reducing these challenges.
• A pilot pragmatic clinical trial was conducted to test Changing Talk: Online Training (CHATO), a novel online version.

Purpose of the Study:

• To develop and test a remote implementation design for the CHATO program.
• To capture contextual factors influencing implementation.
• To determine effective implementation strategies for the CHATO program in nursing homes.

Main Methods:

• A 2-phase approach informed by the Expert Recommendation for Implementing Change guide.
• Developmental phase guided by an Advisory Board.
• Pilot testing utilized a cluster-randomized design with process evaluation.

Main Results:

• Seven nursing homes participated; five were nonprofit with high quality ratings.
• 237 staff members participated, predominantly female nursing assistants.
• Key implementation strategies associated with improved outcomes included assigning champions, involving social workers, using multiple reminder mediums, offering rewards, and supporting discussions.

Conclusions:

• Active leadership engagement, multi-team involvement, and varied implementation strategies correlated with better outcomes.
• Staff participation ranged from 20% to 76%, with over 63% completing the training and 87% passing the posttest.
• Leadership evaluations indicated staff applied CHATO concepts, fostering a better communication culture.