Results from the Australian PITCH study: a national stepped‐wedge cluster RCT evaluating a dementia training program for home care workers

Abstract

AbstractBackgroundThe NHMRC‐funded Promoting Independence Through quality Care at Home (PITCH) project aimed to improve outcomes for people living with dementia and their paid and family carers via an evidence‐based dementia specialist training program for home care workers (HCWs). PITCH training was co‐designed with HCWs, family carers and people with dementia, consisting of 2×3.5 hour sessions, delivered face to face (F2F) or on‐line.MethodsStepped‐wedge cluster RCT including 18 home care services in rural and urban VIC, NSW, and SA cluster‐randomised into one of two arms. Data collection from 18 July 2019 to 12 May 2022. Analyses included linear mixed models with intention to treat.ResultsN = 213 HCWs completed baseline measures, N = 144 completed 6‐month follow‐ups, and N = 120 completed 12‐month follow‐ups. 172 HCWs completed the training program. N = 148 (86%) completed all training sessions; N = 81 F2F and 67 online.Primary outcome measureHCWs' Sense of Competency in Dementia Care Staff (SCIDS) was higher after training (p = 0.04). This was driven by F2F training: SCIDS for HCWs completing F2F training was higher vs no training (p = 0.003) and online training (p = 0.015). There was no difference between online training and no training (control condition).Secondary outcome measuresOverall, HCW scores on the Dementia Attitudes Scale (DAS) showed no difference between training and no training. However, F2F training was associated with higher DAS compared to no training (p = 0.05) and online training (p = 0.05).Training improved scores on the Dementia Knowledge Assessment Scale (DKAS, p = 0.03). This was also driven by F2F training (F2F vs no training p = 0.024; F2F vs online p = 0.026).There was no difference between online training and no training for DAS and DKAS. Training had no effect on Strain in Dementia Care Scale (SDCS) scores.Discussion/ConclusionReceiving F2F PITCH training improved dementia attitudes, dementia knowledge, and sense of competence in delivering dementia care for HCWs versus no training and online training.The HCW workforce has unique challenges to accessing and completing training and education to deliver evidence‐based dementia care. Minimising these challenges is critical to the delivery of quality home care. PITCH training now has evidence for its efficacy but only when delivered face‐to‐face.