N/A
Completed N=219
Changing Talk Online (CHATO) Study
Staff Attitude · Dementia
Source: ClinicalTrials.gov NCT03849937 ↗
Enrolled (actual)
219
Serious AEs
0.0%
Results posted
Aug 2021
Primary outcomePrimary: Knowledge Gain Scores for CHATO Training Participants — 63.0; 58.7; 83.8; 63.0 score on a scale — p=<.001
Summary
Objectives AIM 1. Establish acceptability and preliminary efficacy of online CHATO modules through pilot testing with NH staff.
AIM 2. Develop and pilot test the data collection tool with consultant and advisory panel input. Interviews of NH administrators and staff who participate in the pilot testing of CHATO and a process evaluation will be used to identify and develop supports for implementation and sustainability in preparation for future CHATO testing.
Design and Outcomes The R61 will prepare for the R01 pragmatic trial by establishing feasibility of online modules and preliminary efficacy of CHATO with NH staff. The research design is a randomized clinical trial. One NH will provide initial feasibility testing. Any modifications to the modules will be made. Then six nursing homes (estimated N=150 staff) will be randomly assigned to intervention or wait-list control groups. The primary outcome will be knowledge gain for staff completing CHATO training. Additional outcomes include resident quality measures related to behavioral and psychological symptoms of dementia (BPSD) on both resident and facility levels and facility level data related to inappropriate use of psychotropic medications to control BPSD. Implementation strategies will be assessed by survey and leadership interviews completed by an external evaluator.
Interventions and Duration Changing Talk Online (CHATO) training is a course is to increase awareness of the importance of effective communication with older adults and to use evidence-based person-centered communication during interactions with older adults in nursing homes and other health care settings. The total program is approximately 3 hours, split into 3 modules. Each module is approximately an hour, depending on the individual user. Each NH will work with the research team for three months to plan, implement, and collect data.
Sample Size and Population This course is designed for staff in nursing homes, independent and assisted living, and health care settings in the community that include registered nurses, nursing assistants, nursing home dieticians, direct care professionals, other administrations and support employees. All the employees at all seven nursing homes will be asked to participate. Assignment of NHs to intervention and wait-list control groups will be at random. A sample of 150 training participants are estimated.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Knowledge Gain Scores for CHATO Training Participants |
63.0; 58.7; 83.8; 63.0; NA; 86.8 | <.001 sig |
| PRIMARY Communication Rating Scores for CHATO Training Participants |
2.7; 2.1; 3.1; 2.2; 0.6; 0.7 | <.001 sig |
| PRIMARY BPSD Reports for the One-month Period Before Baseline Data Collection and One Month After Will be Compared Between the Intervention and Wait-list Control Groups and Within Nursing Homes Before and After the CHATO Training. |
— | — |
| PRIMARY Psychotropic Medication Reports for the One-month Period Before Baseline Data Collection and One Month After Will be Compared Between the Intervention and Wait-list Control Groups and Within Nursing Homes Before and After the CHATO Training. |
— | — |
| SECONDARY Number of Implementation Strategies Used in Each Nursing Home (Nursing Home Level Data) |
7; 7; 11; 3; 11; 7 | — |
| SECONDARY Artifacts of Culture Change Scores Per Nursing Home to Assess Nursing Home Practices, Environment, and Staffing (Nursing Home Level Training) |
45.3; 64.7; 66.9; 70.2; 80.5; 36.0 | — |
| SECONDARY Nursing Home Implementation Strategies Assessed by Interviews Will be Described, Categorized, and Correlated With Participation Rates. |
— | — |
| SECONDARY The Cost Associated With Hypothesized BPSD Reductions After the CHATO Training Will be Calculated Using Primary Outcomes and Wage Data. |
— | — |
Eligibility Criteria
Inclusion Criteria
- Nursing Homes that serve people with dementia.
- Nursing Homes that have internet available for staff to complete the CHATO training.
- Nursing Homes that are willing to complete leadership interviews and surveys.
- CNAs and nurses who are permanent employees and who provide direct care at least 8 hours weekly will be invited to complete the CHATO training, available by URL link.
- Other personnel, such as housekeeping, dietary, and administrators may also participate. Participation by as many staff as possible is desired to achieve facility-wide communication change.
- Aggregate, deidentified data for residents with Alzheimer's disease or non-Alzheimer's dementia documented on the MDS Active Diagnoses list.
Exclusion Criteria
- Assisted Living facilities or other types of facilities are excluded due to lack of MDS data as well as NHs that previously participated in the CHAT study.
Data sourced from ClinicalTrials.gov (NCT03849937). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.