The Changing Talk: Online training (CHATO) — Developing and testing an implementation strategy for a national randomized control trial Developing topics

• Published in: Alzheimer's & dementia Vol. 16; no. S8
• Main Authors: Coleman, Carissa K, Williams, Kristine N, Hein, Maria, Perkhounkova, Yelena, Beachy, Tim, Berkley, Amy, Shaw, Clarissa
• Format: Journal Article
• Language: English
• Published: 01.12.2020
• ISSN: 1552-5260; 1552-5279
• DOI: 10.1002/alz.047450

Abstract Background The Changing Talk (CHAT) training effectively reduces elderspeak and subsequent behavioral challenges in residents with dementia in nursing homes. The Changing Talk: Online (CHATO) training was developed to increase staff access to education using a new online format. In order to test the online training using a national nursing home (NH) sample, an implementation strategy and process evaluation were necessary to capture organizational factors, ensure consistent application across NHs, and test the most effective and efficient implementation strategies. Methods A planning grant was used to design an implementation strategy using an advisory board. The board consisted of NH Administrators, Directors of Nursing, Nurse Training Specialists, and a marketing consultant. Multiple products were designed including a website, implementation toolkit, training manual, posters, implementation checklist, surveys, and leadership interviews. A pilot test was then conducted to confirm the strategy in 8 nursing homes with a 90‐day implementation timeline. At the initial meeting, an implementation lead was identified. During planning phase, strategies were tailored to the organizational culture and current practices. During the training phase, weekly participation and completion rates were shared. After the training closed, surveys and interviews were conducted. Results An initial feasibility NH (NH0) and seven NHs (NH1‐7) were tested. The mean total implementation time was 70.3 days (SD = 9.3) with a mean planning phase of 20.1 days (SD = 6.7) and a mean training phase of 50 days (SD = 7.6). The implementation strategies varied across NHs (Table 1). The best outcomes were associated with champions, four mediums for weekly reminders, and a group reward. Leadership evaluation was positive (Tables 2 and 3). Differences between leadership perspectives will be used to make improvements prior to the national trial. Conclusions NH homes utilized the website and implementation toolkit to create a method of implementation tailored for their NH. Process evaluation methods were able to capture strategies used, compatibility, and NH goals for using CHATO. Evaluation of CHATO from both administration and direct care leadership provided multiple perspectives. The implementation strategy will be used to scale up the intervention and test the impact of implementation on CHATO’s primary outcomes.