Promoting Independence Through quality dementia Care at Home (PITCH): a research protocol for a stepped-wedge cluster-randomised controlled trial

Steven Savvas,Erica H Wise ,Anita Panayiotou,Meg Polacsek,Nadia Chau,Jason Burton,Samantha M Loi ,Sue Malta,Margaret Winbolt,David Ames,Fenny Muliadi,Colleen Doyle,Samuel Scherer,Lee‐Fay Low ,Frances Batchelor,Tanara Vieira Sousa ,Anita M Y Goh ,Philip Clarke ,Esther Tan,Jay Stiles,Anne Fairhall,Briony Dow

doi:10.1186/s13063-021-05906-1

Abstract

BackgroundHome care service providers are increasingly supporting clients living with dementia. Targeted and comprehensive dementia-specific training for home care staff is necessary to meet this need. This study evaluates a training programme delivered to care staff (paid personal carers) of clients living with dementia at home.MethodsThis study is a pragmatic stepped-wedge cluster-randomised controlled trial (SW-CRT). Home care workers (HCWs) from seven home care service providers are grouped into 18 geographical clusters. Clusters are randomly assigned to intervention or control groups. The intervention group receives 7 h of a dementia education and upskilling programme (Promoting Independence Through quality dementia Care at Home [PITCH]) after baseline measures. The control group receives PITCH training 6 months after baseline measures. This approach will ensure that all participants are offered the program. Home care clients living with dementia are also invited to participate, as well as their family carers. The primary outcome measure is HCWs’ sense of competence in dementia care provision.DiscussionUpskilling home care staff is needed to support the increasing numbers of people living with dementia who choose to remain at home. This study uses a stepped-wedge cluster-randomised trial to evaluate a training programme (PITCH) for dementia care that is delivered to front-line HCWs.Trial registrationanzctr.org.au; ACTRN12619000251123. Registered on 20 February 2019.

Highlights

Home care service providers are increasingly supporting clients living with dementia
This workforce is often not provided with the necessary specialist dementia training and education, with a recent systematic review demonstrating a dearth of evidence surrounding interventions aimed at improving the quality of home care for people living with dementia [6]
The aim of the trial is to determine the efficacy and feasibility of implementing the specialist dementia training programme to Home care workers (HCW) to improve their confidence and knowledge when servicing clients living with dementia, as well as evaluate clinical and health outcomes for clients and family carers

Summary

Methods

This study is a pragmatic stepped-wedge cluster-randomised controlled trial (SW-CRT). Home care workers (HCWs) from seven home care service providers are grouped into 18 geographical clusters. Clusters are randomly assigned to intervention or control groups. The intervention group receives 7 h of a dementia education and upskilling programme (Promoting Independence Through quality dementia Care at Home [PITCH]) after baseline measures. The control group receives PITCH training 6 months after baseline measures. This approach will ensure that all participants are offered the program. Home care clients living with dementia are invited to participate, as well as their family carers. The primary outcome measure is HCWs’ sense of competence in dementia care provision

Discussion

Background

Methods/design

Findings