Evaluating a specialist dementia training program for home care workers

INTERVENTION: The study aims to evaluate the impact of a dementia‐specific training program (PITCH) delivered to home care workers who provide services to clients with dementia. INTERVENTION The PITCH program is a face‐to‐face training program for home care workers, specifically tailored in content for relevance to paid carers who service clients with dementia. The PITCH training program includes participant training materials and workbook with content on dementia and its impact/symptoms, person‐centered care, effective communication, values, understanding triggers for behaviours and effective response, and resources for further reading. Program delivery includes case studies, role modelling and group discussions designed to provide experiential learning. The PITCH program is delivered face‐to‐face by an experienced trainer at two half‐day sessions. DESIGN Approximately 120 people living with dementia at home and receiving a home care service will participate in the trial, as well as their family carers and paid home care staff. Over 200 home care workers will be trained in the PITCH program. The RCT will evaluate PITCH related outcomes for up to 12 months. All participants will be controls at baseline (0 months), with home care workers randomised to receive the intervention (PITCH) at one of two time‐points during the RCT, and with all participants in the intervention receiving training by the end of the RCT. RECRUITMENT We will recruit from amongst our partner aged care service providers who provide home care services in Australia. We will recruit clients, their family carers (or non‐relative carers), and home care workers. CONSENT Five Participant Information Sheet/Consent Forms have been developed to meet the needs of different participant groups: person with dementia, person responsible, family carer, non‐relative carer and home care worker. Client: Research staff will assess the potential participant's capacity to consent CONDITION: Dementia; ; Dementia Neurological ‐ Dementias Public Health ‐ Health service research PRIMARY OUTCOME: Home care worker self‐reported capacity and effectiveness in caring for a person with dementia (Sense of Competency in Dementia Care Staff, SCIDS)[Baseline, 6 months (primary timepoint) and 12 months post] SECONDARY OUTCOME: Client experience receiving home care (Consumer Experience Report Pilot Draft, CER‐Draft)[Baseline, 6 months, 12 months.] Client functional disability (Disability Assessment for Dementia Scale, DAD).[Baseline, 6 months and 12 months post] Client health‐related quality of life (DEMQOL)[Baseline, 6 months and 12 months post] Client neuropsychiatric symptomatology (Neuropsychiatric Inventory, NPI).[Baseline, 6 months and 12 months post] Client quality of life (Adult Social Care Outcomes Toolkit SCT4, ASCOT)[Baseline, 6 months and 12 months post] Economic measure: EuroQol 5 Dimensions 5 Levels (EQ‐5D‐5L) ; ; The EQ‐5D‐5L or EQ‐5D‐5L Proxy Version measures quality of life and has either self‐report or proxy versions. The scale will be administered to the client and family carer (as a proxy). ; ; A prospective economic evaluation will be used to inform the cost‐effectiveness of the PITCH program. Incremental costs will be estimated relative to the controls. In regards to outcomes, quality of life measures will be used to estimate a Quality Adjusted Life Year (QALY) profile for participants. This will be used to estimate the cost per QALY. Statistical uncertainty and sensitivity analyses will be attached to all results. ; ; ; ; The ICECAP‐O is a health and wellbeing‐related quality of life measurement instrument important for older people. This scale will be administered to the client and family carer (as a proxy). ; Home care workers: Adult employed by a home care provider and are the front‐line service worker for clients. Have capacity to provide informed consent to participate in research. ; Costs associated with the training and support provided to home care workers, and additional costs from clients and their families, will be captured. Health care service costs will be obtained from Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data. This will include costs to participants and their use of other support services.[Baseline, 6 months and 12 months post] Economic measure: ICEpop CAPability measure for Older people (ICECAP‐O) ; Costs associated with the training and support provided to home care workers, and additional costs from clients and their families, will be captured. Health care service costs will be obtained from Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data. This will include costs to participants and their use of other support services. ; A prospective economic evaluation will be used to inform the cost‐effectiveness of the PITCH program. Incremental costs will be estimated relative to the controls. In regards to outcomes, quality of life measures will be used to estimate a Quality Adjusted Life Year (QALY) profile for participants. This will be used to estimate the cost per QALY. Statistical uncertainty and sensitivity analyses will be attached to all results. [Baseline, 6 months and 12 months post] Family Carer personal strain and role strain providing care to another person (Zarit Burden Interview, ZBI)[Baseline, 6 months and 12 months post] Home care worker attitude towards people with dementia (Dementia Attitudes Scale, DAS)[Baseline, 6 months and 12 months post] Home care worker knowledge of dementia (Dementia Knowledge Assessment Scale, DKAS)[Baseline, 6 months and 12 months post] Home care worker stress related to the caring of people with dementia (Strain in Dementia Care Scale, SDCS)[Baseline, 6 months and 12 months post] INCLUSION CRITERIA: Clients: Adult with a likelihood of/diagnosis of any dementia and receiving a home care service. No age restrictions. May or may not have capacity to provide informed consent to participate in research. Family carers: Adult relative or someone who knows the client well (non‐relative carer). Aged at least 18 years. Either living with the client or significantly close by, as to be ‘on call’. Spend a minimum of six hours with the client each week. Have capacity to provide informed consent to participate in research.