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Sustaining Transfers through Affordable Research Translation (START): study protocol to assess knowledge translation interventions in continuing care settings.

Slaughter SE, Estabrooks CA, Jones CA, Wagg AS, Eliasziw M - Trials (2013)

Bottom Line: We will examine how the reminders are implemented and perceived by health care aides and licensed practical nurses, as well as how health care aides providing peer reminders are identified, received by their peers, and supported by their supervisors.The project's reach extends to both supportive living and long-term care settings.By identifying the optimal frequency and intensity of knowledge translation interventions, we hope to enable continuing care organizations to efficiently integrate care innovations into the day-to-day care of residents.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB T6G 1C9, Canada. susan.slaughter@ualberta.ca.

ABSTRACT

Background: Bridging the research-practice gap is an important research focus in continuing care facilities, because the population of older adults (aged 65 years and over) requiring continuing care services is the fastest growing demographic among countries in the Organisation for Economic Co-operation and Development (OECD). Unlicensed practitioners, known as health care aides, provide the majority of care for residents living in continuing care facilities. However, little research examines how to sustain health care aide behavior change following initial adoption of current research evidence.

Methods/design: We will conduct a phase III, multicentre, cluster randomized controlled trial (RCT) using a stratified 2 × 2 additive factorial design, including an embedded process evaluation, in 24 supportive living facilities within the health zone of Edmonton, AB, Canada. We will determine which combination of frequency and intensity of reminders most effectively sustains the completion of the sit-to-stand activity by health care aides with residents. Frequency refers to how often a reminder is implemented; intensity refers to whether a reminder is social or paper-based. We will compare monthly reminders with reminders implemented every 3 months, and we will compare low intensity, paper-based reminders and high intensity reminders provided by a health care aide peer.Using interviews, questionnaires, and observations, Sustaining Transfers through Affordable Research Translation (START) will evaluate the processes that inhibit or promote the mobility innovation's sustainability among health care aides in daily practice. We will examine how the reminders are implemented and perceived by health care aides and licensed practical nurses, as well as how health care aides providing peer reminders are identified, received by their peers, and supported by their supervisors.

Discussion: START will connect up-to-date innovation research with the practice of health care aides providing direct care to a growing population of older Albertans. The project's reach extends to both supportive living and long-term care settings. Furthermore, START has the potential to introduce and sustain a broad range of innovations in various care areas, such as dementia care, wound care, and pain management - domains where the uptake and sustainability of innovations also encounter significant challenges. By identifying the optimal frequency and intensity of knowledge translation interventions, we hope to enable continuing care organizations to efficiently integrate care innovations into the day-to-day care of residents.

Trial registration: ClinicalTrials.gov, NCT01746459.

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Related in: MedlinePlus

Sample size assumptions.
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Figure 3: Sample size assumptions.

Mentions: The required sample size for the trial is 24 facilities, each with an average of 15 health care aides assigned to two clients. Each aide is expected to have 1,440 (2 × 2 × 30 × 12) possible uptake occasions with each client, for an expected total of 43,200 (15 × 2 × 1,440) aide-occasions per facility over the trial’s duration. The sample size calculation, based upon previous results from four facilities consisting of 44 aides [7,50], yielded an estimated non-interventional uptake rate of 22.6% with a coefficient of variation (CV) of 0.54 among facilities. The CV plays the role of the between-facility clustering parameter in the sample size formula for rates [51]. For the purpose of sample size calculations, we assume the low-low arm to have an uptake rate of 20%, the single-high arms to have an uptake rate of 55%, and the double-high arm to have an uptake rate of 90%. The additive trial design has 80% power at a 5% two-sided level of significance to detect a 93.3% relative increase in the marginal rates of uptake (72.5% versus 37.5%) between high and low (Figure 3).


Sustaining Transfers through Affordable Research Translation (START): study protocol to assess knowledge translation interventions in continuing care settings.

Slaughter SE, Estabrooks CA, Jones CA, Wagg AS, Eliasziw M - Trials (2013)

Sample size assumptions.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231466&req=5

Figure 3: Sample size assumptions.
Mentions: The required sample size for the trial is 24 facilities, each with an average of 15 health care aides assigned to two clients. Each aide is expected to have 1,440 (2 × 2 × 30 × 12) possible uptake occasions with each client, for an expected total of 43,200 (15 × 2 × 1,440) aide-occasions per facility over the trial’s duration. The sample size calculation, based upon previous results from four facilities consisting of 44 aides [7,50], yielded an estimated non-interventional uptake rate of 22.6% with a coefficient of variation (CV) of 0.54 among facilities. The CV plays the role of the between-facility clustering parameter in the sample size formula for rates [51]. For the purpose of sample size calculations, we assume the low-low arm to have an uptake rate of 20%, the single-high arms to have an uptake rate of 55%, and the double-high arm to have an uptake rate of 90%. The additive trial design has 80% power at a 5% two-sided level of significance to detect a 93.3% relative increase in the marginal rates of uptake (72.5% versus 37.5%) between high and low (Figure 3).

Bottom Line: We will examine how the reminders are implemented and perceived by health care aides and licensed practical nurses, as well as how health care aides providing peer reminders are identified, received by their peers, and supported by their supervisors.The project's reach extends to both supportive living and long-term care settings.By identifying the optimal frequency and intensity of knowledge translation interventions, we hope to enable continuing care organizations to efficiently integrate care innovations into the day-to-day care of residents.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB T6G 1C9, Canada. susan.slaughter@ualberta.ca.

ABSTRACT

Background: Bridging the research-practice gap is an important research focus in continuing care facilities, because the population of older adults (aged 65 years and over) requiring continuing care services is the fastest growing demographic among countries in the Organisation for Economic Co-operation and Development (OECD). Unlicensed practitioners, known as health care aides, provide the majority of care for residents living in continuing care facilities. However, little research examines how to sustain health care aide behavior change following initial adoption of current research evidence.

Methods/design: We will conduct a phase III, multicentre, cluster randomized controlled trial (RCT) using a stratified 2 × 2 additive factorial design, including an embedded process evaluation, in 24 supportive living facilities within the health zone of Edmonton, AB, Canada. We will determine which combination of frequency and intensity of reminders most effectively sustains the completion of the sit-to-stand activity by health care aides with residents. Frequency refers to how often a reminder is implemented; intensity refers to whether a reminder is social or paper-based. We will compare monthly reminders with reminders implemented every 3 months, and we will compare low intensity, paper-based reminders and high intensity reminders provided by a health care aide peer.Using interviews, questionnaires, and observations, Sustaining Transfers through Affordable Research Translation (START) will evaluate the processes that inhibit or promote the mobility innovation's sustainability among health care aides in daily practice. We will examine how the reminders are implemented and perceived by health care aides and licensed practical nurses, as well as how health care aides providing peer reminders are identified, received by their peers, and supported by their supervisors.

Discussion: START will connect up-to-date innovation research with the practice of health care aides providing direct care to a growing population of older Albertans. The project's reach extends to both supportive living and long-term care settings. Furthermore, START has the potential to introduce and sustain a broad range of innovations in various care areas, such as dementia care, wound care, and pain management - domains where the uptake and sustainability of innovations also encounter significant challenges. By identifying the optimal frequency and intensity of knowledge translation interventions, we hope to enable continuing care organizations to efficiently integrate care innovations into the day-to-day care of residents.

Trial registration: ClinicalTrials.gov, NCT01746459.

Show MeSH
Related in: MedlinePlus