Noninferiority of Online Versus In-Person Training for Health Professionals Delivering the COPE Dementia Care Program...

This study evaluates the equivalency (noninferiority) of two approaches to training clinicians in the delivery of an evidence-based dementia caregiving program in PACE (Programs of All-Inclusive Care of the Elderly) settings. Considered are clinician outcomes following each training method and PACE participant-caregiver outcomes following COPE receipt after 4 months.

11 PACE settings were randomized to have clinicians trained in-person (n = 7) or online (n = 4) to deliver COPE to caregivers of patients with dementia.

PACE provides long-term care services and support to dually eligible older adults (PACE participants), most of whom have dementia diagnoses, to age in place at home.

The study included occupational therapists (n = 14) and registered nurses (n = 8) employed at participating PACE sites. Caregivers (n = 17) and PACE participants (n = 17) with dementia were enrolled as dyads to receive COPE.

Primary outcomes included changes in clinician knowledge and training satisfaction via the Knowledge and Skills Survey and implementation competence via the Normalization Process Theory (NoMad) survey. For dyad outcomes, caregivers identified priority areas using validated assessments, selected up to four "target behaviors" and rated confidence in managing each.

No significant differences were found between training groups in clinician or dyad characteristics. Training modalities showed similar impacts on clinician knowledge and skills, with no statistically significant differences between groups in change scores across NoMad domains (all p >0.3). After COPE, all caregivers reported significant improvement in the Perceived Change Index (p = 0.0034) and increased confidence in managing target behaviors.

Online training in COPE was noninferior to in-person training for clinician competence and PACE participant-caregiver outcomes. These findings support online training as a scalable approach for disseminating evidence-based dementia care programs without compromising effectiveness.