Dementia, Primary Health Care Providers
Conditions
Keywords
dementia, primary health care providers, dementia management, training, cluster randomized controlled trial, RE-AIM, implementation science, primary care
Brief summary
This study aims to evaluate the effectiveness and implementation outcomes of a dementia management competency training program for primary healthcare workers. A cluster randomized controlled trial will be conducted among primary healthcare institutions in Nanping, Fujian Province, China. Eligible primary health care providers will be recruited from community health service centers and township health centers.Participating institutions will be randomized in a 1:1 ratio to either a structured dementia management training group or a self-directed learning control group. The intervention group will receive a 12-week blended training program, including online learning, an in-person skills workshop, and case-based practice supervision. The control group will receive self-directed online learning materials. Outcomes will be assessed at baseline, immediately after the intervention, and 3 months after the intervention. The primary outcome is the change in dementia knowledge, measured using the Dementia Knowledge Assessment Scale. Secondary outcomes include dementia-related attitudes, dementia management practice competency, self-reported dementia management behaviors, objective screening and referral-related indicators, and implementation outcomes based on the RE-AIM framework.
Detailed description
This study uses a hybrid effectiveness-implementation design integrating a cluster randomized controlled trial and implementation evaluation. The trial will assess the effectiveness of a dementia management competency training program for primary health care providers at both the individual and organizational levels. At the individual level, the study will evaluate the effects of the training on dementia knowledge, attitudes, practice competency, and dementia management-related clinical behaviors. At the organizational level, the study will examine reach, adoption, implementation quality, and maintenance of the training program in real-world primary healthcare settings.The study will be conducted in community health service centers and township health centers in Nanping, Fujian Province, China. Primary healthcare institutions will serve as clusters. Approximately 16 institutions will be recruited and randomized to the intervention or control group at a 1:1 ratio, with approximately 20 primary health care providers recruited from each institution.The intervention group will receive a 12-week structured blended training program named "Hand in Hand Along the Memory Path". During weeks 1-4, participants will complete seven online learning modules, with a total learning duration of approximately 3 hours. At the end of week 4, participants will attend an in-person skills workshop of approximately 2 hours, focusing on standardized use of cognitive screening and assessment tools. During weeks 5-12, participants will take part in online case-based supervision every two weeks and complete practice tasks related to cognitive screening and dementia management.The control group will receive self-directed online learning materials, including the same knowledge module videos and text-based materials. However, the control group will not receive structured learning tasks, case analysis, knowledge tests, demonstration videos, forum-based support, learning reminders, expert support, toolkits, in-person workshops, or case-based supervision.Quantitative data will be collected at baseline, immediately after the intervention, and 3 months after the intervention. Semi-structured interviews will be conducted 3 months after the intervention to explore participants' experiences, implementation barriers and facilitators, and factors affecting maintenance. Quantitative and qualitative findings will be integrated according to the RE-AIM framework.
Interventions
GENETICStructured Dementia Management Competency Training Program
The intervention is a 12-week blended training program. During weeks 1-4, participants will complete seven online modules with a total learning duration of approximately 3 hours. At the end of week 4, participants will attend a 2-hour in-person skills workshop focusing on standardized cognitive screening and assessment. During weeks 5-12, participants will participate in online case-based supervision every two weeks and complete practice tasks, including cognitive screening records and dementia management case records.
BEHAVIORALSelf-directed Dementia Learning
Participants will be provided with online dementia-related learning materials and will arrange their own learning time and place. No structured completion requirements, assessments, in-person activities, or expert supervision will be provided.
Sponsors
Fujian Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Masking description
Participants are blinded to group allocation. All participants are aware that both groups receive training, but do not know whether they are assigned to the intervention or control group. Outcome data are primarily collected via self-administered questionnaires. Personnel responsible for questionnaire distribution and data entry (outcomes assessors) are blinded to group allocation. The primary quantitative analysis is performed independently by a blinded analyst who has no access to qualitative data. Additionally, a semi-structured interview is conducted only with the intervention group for exploratory mixed-methods analysis. The integration of interview findings with quantitative data is performed separately by another individual who is not among the blinded roles described above. Therefore, the mixed-methods analysis does not compromise the blinding of the primary quantitative outcome assessment or analysis. Care providers are not blinded because they are aware of the differences bet
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Primary healthcare workers aged 18 years or older Registered healthcare professionals holding a formal license issued by the national health authority At least 1 year of work experience Able to access the internet using a computer, tablet, or mobile phone Currently working in a participating community health service center or township health center Willing to participate in the study and provide written informed consent
Exclusion criteria
Personnel who do not directly participate in patient disease management, including logistics or auxiliary staff Interns, trainees, or students Individuals currently participating in other similar dementia training interventions Individuals planning to leave their current institution within the next 12 months Individuals who refuse to participate in the study or decline to provide written informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in dementia knowledge score | Baseline, immediately after the intervention, and 3 months after the intervention | Dementia knowledge will be measured using the Dementia Knowledge Assessment Scale. The primary outcome is the change in total DKAS score from baseline to immediately after the 12-week intervention. Higher scores indicate greater dementia knowledge. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in dementia-related attitudes and confidence | Baseline, immediately after the intervention, and 3 months after the intervention | Dementia-related attitudes and confidence will be measured using the General Practitioners' Attitudes and Confidence Scale for Dementia. Higher scores indicate more positive attitudes and greater confidence. |
| Change in dementia management practice competency | Baseline, immediately after the intervention, and 3 months after the intervention | Dementia management practice competency was measured using the Dementia Management Practice Competency Scale for Primary Care, which was developed by the research team. Higher scores on the scale indicate greater dementia management practice competency. |
| Change in self-reported dementia management-related behaviors | Baseline, immediately after the intervention, and 3 months after the intervention | Participants will report the frequency of dementia management-related behaviors during the past month, including cognitive screening, identification of suspected cognitive impairment, referral recommendation, communication with patients or family members, and dementia-related health education. |
| Cognitive screening implementation rate | Baseline, immediately after the intervention, and 3 months after the intervention | The cognitive screening implementation rate will be calculated as the number of patients aged 65 years or older who received cognitive screening divided by the total number of patients aged 65 years or older seen during the same period, multiplied by 100%. |
| Referral recommendation documentation rate | Baseline, immediately after the intervention, and 3 months after the intervention | The referral recommendation documentation rate will be calculated as the number of screen-positive patients with documented referral recommendations divided by the total number of screen-positive patients, multiplied by 100%. |
Contacts
CONTACTXinying Lin
Outcome results
None listed