Identifying Person-Centered Outcome Measures for Use in Adult Day Services: An E-Delphi Consensus Study

Researchers and advocates recognize that adult day services (ADS) play a key role in delivering person-centered care to individuals living with Alzheimer's Disease and related dementias (ADRD). However, few ADS centers are routinely measuring person-centered outcomes, thereby limiting our ability to understand the impact of ADS on these key indicators of well-being. Guided by Kitwood's framework of person-centered dementia care, this study aimed to identify valid, reliable, and practical person-centered outcome measures that reflect ADRD quality-of-life domains. Twenty-two ADS practitioners and researchers (N = 22) participated in a two-round e-Delphi review to evaluate 10 potential outcome measures across four person-centered domains: meaning and purpose; engagement; social networks; and sense of belonging. Based upon scores on select characteristics in Round 1 of the e-Delphi review (e.g., ease of administration, relevance to population), consensus was reached in Round 2 (66.67% supermajority) on the following measures: the PROMIS Meaning and Purpose in Life Scale (76%); the Friendship Scale (76%); and the General Belongingness Scale (67%). Panelists could not reach consensus on the Life Engagement Test (52%) and the Engagement in Meaningful Activities Scale (48%), so both were retained for future evaluation. The scales identified in this e-Delphi review will now be incorporated into real-world data collection beta-testing to evaluate feasibility, practicality and impact of ADS on these person-centered outcomes.