Let's CHAT (Community Health Approaches To) Dementia in Aboriginal and Torres Strait Islander Communities.

This is a stepped wedge cluster randomised control trial of 12 clusters in 4 states. Each cluster will experience the intervention with four clusters commencing participation at each of three time points - within 6 months, within 12 months and within 18 months of commencement of data collection (NOTE: the timeline of the study has been disrupted due to the pandemic. The services will still enter the intervention phase at three time points, however there is now a hiatus period corresponding to societal lockdown, between when the second and third cluster enter the intervention phase). The main intervention includes training and support to staff within Aboriginal Community Controlled Health Services (ACCHS) that offer primary care with the aim of strengthening capacity to diagnose and manage older Aboriginal and Torres Strait Islander People with dementia. The training and support will include: • a Best Practice Guide for cognitive impairment and dementia care in the primary care setting, • Decision Support Tools, including: cognitive screenings and assessments that can be incorporated into the Aboriginal and Torres Strait Islander 715 assessment, or designed as stand-alone tools; culturally tailored cognitive impairment/dementia care pathways. • A package of resources developed in collaboration with each health service specifically for this study, and tailored for use in each health service. It will include both online/web-enabled and face-to-face options. • Professional Development/Training and organisational development as part of a Continuous Quality Improvement (CQI) process. Once each health service enters the implementation phase, regular training and support will be provided by experienced health professionals and educators with specific knowledge about Best Practice Dementia care. The training will be conducted face-to-face in the health services, or via videoconference if this is not possible due to pandemic restrictions. Training and support from the available package of resources will be tailored where possible to the identified needs of each agency and scheduled as requested by each health service. In accordance with the stepped-wedge design (see attachment), health services will enter the training and support phase of the study in a staggered, six-monthly interval sequence. By mid-2021 all health services will be receiving the implementation. The training and support phase will end in Early 2023.