The virtual adaptation of Innovations in Dementia Empowerment and Action – IDEA

Abstract

AbstractBackgroundIn contrast to their counterparts in the general population, sexual and gender minority (SGM) older adults and their care partners, have distinct susceptibilities that complicate living with dementia, including significant disparities in comorbid chronic conditions, social isolation, and systemic marginalization, such as discrimination and limited access to health services and supports. We developed a culturally responsive, psychosocial behavioral intervention for SGM older adults living with dementia and their care partners, the first‐ever randomized controlled clinical trial (RCT), Innovations in Dementia Empowerment and Action (IDEA). Initially designed to be delivered (and initially delivered) in‐person and in‐home, challenges associated with COVID‐19 (e.g., quarantining, socially isolating) also provided a unique opportunity to adapt and recalibrate IDEA to be fully delivered via virtual technologies.MethodWe were guided by principles of accessibility, quality, ease of delivery, and sustainability to ensure rigor during the adaptation process. Implementation needs included identifying a HIPPA‐compliant online virtual platform that was easy to use; adapting elements and materials in the intervention manual as needed; providing training for intervention coaches in best practices for virtual delivery; and training participants in the use of virtual technologies.ResultPreliminary findings suggest intervention coaches and most participants deemed the adapted intervention and virtual delivery to be acceptable. of IDEA. Only two of 22 dyads expressed discomfort with the virtual delivery to the degree they chose not to participate. Regarding difficulty in delivering the intervention virtually, 87% of coaches indicated that it was not at all or only a little difficult;12% somewhat difficult; and only 1% difficult. Virtual delivery also allowed us to expand beyond our initial 3‐site catchment area to 28 states, which also greatly increased access for rural and isolated SGM.ConclusionDelivering the adapted IDEA intervention virtually provided preliminary, potentially beneficial evidence to advance dementia interventions to address the growing, diverse population of people living with dementia and their care partners. Further systematic research is required to fully evaluate the benefits and limitations of virtual dementia interventions, including whether specific subgroups are better served by differing delivery modalities.