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Related Experiment Videos

Developing rehabilitative behavioral interventions for long-term care: technology transfer, acceptance, and

J F Schnelle1, P A Cruise, A Rahman

  • 1Borun Center for Gerontological Research, UCLA School of Medicine, Reseda, California 91335, USA.

Journal of the American Geriatrics Society
|June 13, 1998
PubMed
Summary

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Effective rehabilitative interventions for nursing home residents are often not implemented. A new research model evaluating implementation in long-term care (LTC) facilities is proposed to bridge this gap.

Area of Science:

  • Gerontology
  • Health Services Research
  • Behavioral Interventions

Background:

  • Rehabilitative behavioral interventions show promise for improving nursing home resident outcomes.
  • Despite documented efficacy and practice guideline recommendations, these interventions are rarely adopted in daily long-term care (LTC) settings.
  • A significant gap exists between the efficacy of interventions in clinical trials and their effectiveness in real-world practice.

Purpose of the Study:

  • To propose a research model that addresses the gap between intervention efficacy and practice effectiveness in LTC facilities.
  • To identify critical issues in intervention and implementation that hinder the adoption of evidence-based practices in LTC.
  • To suggest modifications in clinical trial design to enhance the probability of successful intervention implementation.

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Main Methods:

  • Discussion of critical intervention and implementation issues, including targeting, advocacy, cost-effectiveness, training, and quality control.
  • Proposal of a supplementary research model integrating traditional clinical research with implementation science methodology.
  • Description of staged clinical trial designs to facilitate practical application in LTC settings.

Main Results:

  • Failure to evaluate implementation factors beyond clinical efficacy contributes to the efficacy-practice gap.
  • Addressing issues such as cost-effectiveness, training, and quality control is crucial for successful adoption.
  • A tailored research model can improve the translation of effective interventions into daily LTC.

Conclusions:

  • A research model incorporating implementation evaluation is essential for bridging the efficacy-effectiveness gap in LTC.
  • Optimizing intervention design and trial staging can increase the likelihood of successful adoption in nursing homes.
  • This approach supports the consistent delivery of evidence-based care to frail older adults in long-term care.