Weaving Evidence into Action for Veterans with dementia (WEAVE): Codesigning the implementation of nonpharmacological interventions for programme fidelity and sustainability

Author:

Meyer Claudia1234ORCID,Golenko Xanthe56,Cyarto Elizabeth V.78,O'Keefe Fleur9,Cooley Josh10,Bonney Gwen11,Min Mina11,Lowthian Judy1812

Affiliation:

1. Bolton Clarke Research Institute Melbourne Victoria Australia

2. Centre for Health Communication and Participation La Trobe University Melbourne Victoria Australia

3. Rehabilitation, Ageing and Independent Living Research Centre Monash University Melbourne Victoria Australia

4. College of Nursing and Health Sciences Flinders University Adelaide South Australia Australia

5. Bolton Clarke Research Institute Brisbane Queensland Australia

6. Department of Business Innovation and Strategy, Griffith Business School Griffith University Brisbane Queensland Australia

7. Faculty of Health University of Technology Brisbane Queensland Australia

8. Faculty of Health and Behavioural Sciences The University of Queensland Brisbane Queensland Australia

9. Bolton Clarke Melbourne Victoria Australia

10. School of Medicine and Dentistry Griffith University Melbourne Victoria Australia

11. Bolton Clarke Galleon Gardens Care Home Gold Coast Brisbane Australia

12. School of Public Health and Preventive Medicine, Alfred Hospital Monash University Melbourne Victoria Australia

Abstract

AbstractRationaleChallenges associated with translating evidence into practice are well recognised and calls for effective strategies to reduce the time lag and successfully embed evidence‐based practices into usual care are loud and clear. While a plethora of nonpharmacological interventions for people with dementia exist; few are based on strong evidence and there is little consideration for programme operationalisation in the complex environment of long‐term care.Aims and ObjectivesThis paper describes the preparation for the implementation of the Weaving Evidence into Action for Veterans with dementia project, incorporating the codesign of delivery of four evidence‐based, nonpharmacological interventions.MethodImplementation preparation for this type 2 hybrid effectiveness‐implementation project was underpinned by the Implementation Framework for Aged Care (IFAC). A sociocultural–political contextual scan was undertaken, and reflection on the IFAC question ‘why change?’ with key stakeholders. Delivery of the four interventions of music therapy, exercise, reminiscence therapy and sensory modulation was explored using codesign methodology. Preparation of both intervention delivery personnel and recipients was via training, establishment of a change team and promotional/awareness‐raising strategies.ResultsThe contextual scan revealed Australian government reforms and organisational imperatives facing long‐term care services, while reflections on ‘why change’ flagged best practice dementia care at the local care home level. Several codesign sessions involved veterans with dementia, family members, care home staff members and volunteers to ensure programme alignment with needs and preferences, accounting for existing activities. Training was designed and delivered before programme commencement. A change team was established and strategies to support behaviour change instigated. Implementation evaluation is reported elsewhere.ConclusionThe extended preparatory period for implementation, afforded by the COVID‐19 pandemic on programme commencement, enabled time for widespread understanding of the programme and necessary upskill of staff. Comprehensive codesign with all stakeholders of programme components identified core and flexible elements necessary for fidelity of implementation.

Publisher

Wiley

Subject

Public Health, Environmental and Occupational Health,Health Policy

Reference40 articles.

1. World Health Organization.Dementia key facts.2020.

2. Department of Veterans' Affairs. “Our purpose.”2022.

3. U.S. Department of Veterans Affairs. “About VA.”2022.

4. Australian Institute of Health and Welfare.A profile of Australia's veterans.2018. Cat. no. PHE 235. Canberra AIHW.

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