An implementation evaluation of the Driving and Dementia Roadmap (DDR) in Alzheimer Society organizations

Abstract

AbstractBackgroundIn response to the immense challenges that people with dementia (PWD) and family/friend carers (FCs) face in the driving cessation process, we developed the Driving and Dementia Roadmap (DDR). The DDR is a web‐based resource comprised of information and tools to support PWD, FCs and healthcare providers in the decision‐making and transition to non‐driving. To understand the factors (i.e., barriers and facilitators) that influenced the DDR’s implementation in Alzheimer Society (AS) settings, we conducted an implementation evaluation.MethodThe DDR was implemented by AS staff in six organizations in four Canadian provinces. Nineteen AS staff were interviewed after a three to six month period of delivering the DDR to their clients. Participants also recorded details about each interaction involving the DDR (e.g., setting, mode and rationale). Data were examined using a thematic analysis approach guided by the Consolidated Framework for Implementation Research (CFIR), which is a meta‐theoretical framework comprised of constructs organized into five domains (e.g., user characteristics, intervention characteristics and process).ResultThe DDR was implemented mainly via individual consultations by telephone/email to FCs who expressed concern about driving issues. Main factors that facilitated the DDR’s implementation were related to the characteristics of the DDR, such as its perceived evidence strength (e.g., research‐based) and quality (e.g., variety of tools, association with reputable organizations), superiority to other resources (e.g., more in‐depth, comprehensive and user friendly) and its ease of delivery (e.g., via telephone/email with minimal instruction required by clients). AS staff characteristics’ that facilitated implementation included their enthusiastic and favorable views about the DRR’s potential to be an empowering resource that could facilitate conversations and early planning for driving cessation. Barriers to implementation included clients’ lack of computer skills as well as competing priorities for AS staff such as other projects and tasks, and attending to issues related to the COVID‐19 pandemic (e.g., isolation, caregiver burnout, staying safe).ConclusionThis study highlights how the perceived strengths of the DDR resource itself and AS staff’s favourable beliefs about the DDR facilitated its successful implementation in AS settings. Strategies to address implementation barriers include offering a print‐based version of the DDR.