Journal article
Implementing a Reablement Intervention, “Care of People With Dementia in Their Environments (COPE)”: A Hybrid Implementation-Effectiveness Study
The Gerontologist, v 61(6), pp 965-976
01 Sep 2021
PMID: 32803248
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Abstract
Background and Objectives
The translation of reablement programs into practice is lagging despite strong evidence for interventions that maintain function for the person living with dementia as well as improve carer well-being. The aim was to evaluate the implementation of an evidence-based program, Care of People with Dementia in Their Environments (COPE), into health services.
Research Design and Methods
An implementation-effectiveness hybrid design was used to evaluate implementation outcomes while simultaneously involving a pragmatic pre–post evaluation of outcomes for people with dementia. We report uptake, fidelity to intervention, outcomes for people living with dementia and carers, and beliefs and behaviors of interventionists contributing to successful implementation.
Results
Seventeen organizations in Australia across 3 health contexts, 38 occupational therapists, and 17 nurses participated in training and implementation. While there were challenges and delays in implementation, most organizations were able to offer the program and utilized different models of funding. Overall, we found there was moderate fidelity to components of the program. Pre–post outcomes for carer well-being and coping (Perceived Change Index, p < .001) and activity engagement of the person living with dementia (p = .002) were significantly increased, replicating previous trial results. What contributed most to therapists implementing the program (Determinants of Implementation Behaviour Questionnaire) was a stronger intent to deliver (p < .001), higher confidence (p < .001), a sense of control in delivery (p = .004), and a belief the program was very useful to their clients (p = .002).
Discussion and Implications
This study demonstrated that implementation is possible in multiple health systems and beneficial to individuals and their families.
Metrics
Details
- Title
- Implementing a Reablement Intervention, “Care of People With Dementia in Their Environments (COPE)”: A Hybrid Implementation-Effectiveness Study
- Creators
- Lindy Clemson - University of SydneyKate Laver - Flinders UniversityMiia Rahja - Flinders UniversityJennifer Culph - University of SydneyJustin N Scanlan - University of SydneySally Day - University of SydneyTracy Comans - University of QueenslandYun-Hee Jeon - Faculty of Medicine & Health, The University of Sydney, New South Wales, AustraliaLee-Fay Low - University of SydneyMaria Crotty - Flinders UniversitySue Kurrle - Faculty of Medicine & Health, The University of Sydney, New South Wales, AustraliaMonica Cations - Flinders UniversityCathy V Piersol - Thomas Jefferson UniversityLaura N Gitlin - Drexel University
- Publication Details
- The Gerontologist, v 61(6), pp 965-976
- Publisher
- Oxford University Press
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Nursing and Health Professions
- Web of Science ID
- WOS:000692622100021
- Scopus ID
- 2-s2.0-85100207151
- Other Identifier
- 991019168765104721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Gerontology