Cotton Quinton D, Bailey Dionne, Albers Elle, Ingvalson Steph, Bloomquist Emily, Marx Katie, Anderson Keith, Dabelko-Schoeny Holly, Parker Lauren, Gitlin Laura N, Gaugler Joseph E
School of Social Work, University of Pittsburgh, Pittsburgh, USA.
School of Public Health, University of Minnesota, Minneapolis, USA.
BMC Geriatr. 2025 Feb 13;25(1):95. doi: 10.1186/s12877-025-05757-4.
Among the available evidence-based interventions targeting dementia family caregivers, there is limited evidence on implementation processes that produce desired outcomes (i.e., reductions in depression and burden) for caregivers, people living with dementia (PLWD), and community-based programs themselves. In a national multi-site hybrid effectiveness trial, we investigated the implementation success and challenges of embedding an evidence-based intervention (ADS Plus) targeting dementia family caregivers whose PLWD was enrolled in an adult day service (ADS).
Informed by the Consolidated Framework for Implementation Research, we conducted a directed qualitative content analysis to understand caregiver (n = 15) and staff (n = 14) perceptions of facilitators of and potential barriers to implementation of ADS Plus in nine ADS programs to guide future dissemination efforts.
Results demonstrated that successful delivery of ADS Plus was achieved through intervention adaptability, personalization, and structure (innovation); responsiveness of ADS Plus to external changes and intervention marketability (outer domain); presence of aligned goals and familiarity (inner setting); involvement of research staff, connections among practitioners, and meeting caregiver needs (individual domain); and understanding caregivers' needs and addressing staff capacity to take action (implementation process). This adaptability reassures us of the potential to implement ADS Plus in heterogeneous programmatic settings.
Globally, our results demonstrate that ADS Plus offers a viable community-based solution for supporting dementia family caregivers with high implementation potential for diverse ADS settings.
ClinicalTrials.gov ID: NCT02927821 (Registration Date 10/7/2016).
在针对痴呆症家庭照顾者的现有循证干预措施中，关于能为照顾者、痴呆症患者以及社区项目本身带来预期效果（即减轻抑郁和负担）的实施过程的证据有限。在一项全国多地点混合效果试验中，我们调查了针对痴呆症家庭照顾者（其照顾的痴呆症患者已参加成人日间服务项目）实施循证干预措施（强化成人日间服务项目，ADS Plus）的实施成功经验和挑战。
依据实施研究整合框架，我们进行了定向定性内容分析，以了解九个成人日间服务项目中照顾者（n = 15）和工作人员（n = 14）对强化成人日间服务项目实施的促进因素和潜在障碍的看法，为未来的推广工作提供指导。
结果表明，通过干预的适应性、个性化和结构化（创新）；强化成人日间服务项目对外部变化的响应能力和干预的市场适应性（外部领域）；目标一致和熟悉程度（内部环境）；研究人员的参与、从业者之间的联系以及满足照顾者需求（个体领域）；以及了解照顾者需求并提升工作人员采取行动的能力（实施过程），成功实现了强化成人日间服务项目的交付。这种适应性让我们确信在不同的项目环境中实施强化成人日间服务项目的潜力。
在全球范围内，我们的结果表明，强化成人日间服务项目为支持痴呆症家庭照顾者提供了一个可行的基于社区的解决方案，在不同的成人日间服务环境中具有很高的实施潜力。
ClinicalTrials.gov标识符：NCT02927821（注册日期：2016年10月7日）。
