Miami University
Effectiveness of the Individualized Positive Psychosocial Interaction (IPPI) Program to Reduce Distress in Nursing Home Residents with Dementia
Health Care System Partner
Miami University
Dr. Abbott is a professor of gerontology and executive director of the Scripps Gerontology Center at Miami University. She is an applied researcher focused on preference-based, person-centered dementia care, and non-pharmacological interventions for older adults in long-term care settings. Dr. Abbott’s research emphasizes the development, testing, and pragmatic implementation of evidence-based programs that enhance resident well-being and strengthen direct care worker confidence and skills. This award will provide the opportunity to complete a Stage IV cluster randomized embedded pragmatic clinical trial testing the pragmatic effectiveness and implementation of the Individualized Positive Psychosocial Interaction (IPPI) program across 26 nursing homes.
RATIONALE: Up to 82% of residents with dementia living in nursing homes experience psychological and behavioral distress, which negatively impacts their quality of life and increases the stress of staff caring for these residents. While non-pharmacological interventions exist, there remains a critical gap in translating these approaches into scalable, evidence-based programs that can be easily integrated into daily routine care within nursing home memory care units.
OBJECTIVE: To conduct a cluster randomized embedded pragmatic clinical trial (ePCT) comparing the IPPI program to usual care to evaluate its effectiveness to reduce resident distress, enhancing staff care partner self-efficacy and competence, and evaluating implementation success.
SETTING: 26 nursing homes with designated Dementia Special Care or Memory Care Neighborhoods participating in the Long-Term Care Data Cooperative (LTCDC).
POPULATION: Nursing home residents with dementia who have a Brief Interview for Mental Status (BIMS) score of 0–12 and at least one documented symptom of psychological or behavioral distress.
INTERVENTION: The IPPI program involves staff attending an online, self-paced emotion-focused communication training, after which the staff deliver 10-minute preference-matched positive interactions to residents with dementia twice weekly for 6 months.
OUTCOMES: The primary clinical outcome is the change in psychological and/or behavioral symptoms of distress ascertained using items from the Minimum Dataset from baseline to 3-months and 6-months. The secondary clinical outcome is the Sense of Competence in Dementia Care Staff (SCIDS) scale collected from the staff care partner at baseline, 3-months, and 6-months.
IMPACT: This ePCT has the potential to demonstrate the effectiveness of the IPPI programs to reduce the distress and behavior symptoms of nursing residents with dementia and improve the self-efficacy of the staff caring for these residents.