Prevention of Weight Loss in Long Term Care Veterans
1 other identifier
interventional
222
1 country
1
Brief Summary
Background: Numerous studies have shown that many LTC residents receive inadequate staff assistance with eating, which places them at risk for under-nutrition, dehydration and weight loss. Moreover, improvements in feeding assistance care have been shown to improve residents' daily food and fluid consumption and weight loss outcomes. Objectives: The purpose of this program evaluation project is to train indigenous LTC staff how to improve nutritional care within the constraints of existing staffing resources. Methods: A multiple baseline design was used to evaluate the effectiveness of the program in one federal and one state VA LTC facility. Research staff collected baseline measures related to nutritional care processes and resident outcomes. All LTC units in each of the two sites were divided into two groups for program implementation. The program was implemented with staff and residents on the units in the immediate intervention group; while, the delayed intervention group remained in usual care and continued to be monitored monthly for all care process and resident outcome measures. Status: This project ended 10/1/13. Five published papers resulted from this study.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Feb 2009
Longer than P75 for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
February 1, 2009
CompletedFirst Submitted
Initial submission to the registry
February 9, 2009
CompletedFirst Posted
Study publicly available on registry
February 11, 2009
CompletedPrimary Completion
Last participant's last visit for primary outcome
October 1, 2011
CompletedStudy Completion
Last participant's last visit for all outcomes
September 1, 2013
CompletedResults Posted
Study results publicly available
November 10, 2014
CompletedApril 27, 2015
October 1, 2014
2.7 years
February 9, 2009
October 28, 2014
April 6, 2015
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Quality of Feeding Assistance Care Processes
Research staff observed each participant during six meals per study phase. Research staff documented the total amount of staff time spent providing feeding assistance and each type of assistance per resident per meal. These data were used to construct standardized "feeding assistance care quality indicators" wherein the number of resident meal observations was variable. For example, one indicator was defined as: Percentage of meals during which resident intake was below 50% and staff offered and alternative to the served meal". Thus, the denominator for total number of observed meals scored varied by indicator. There were multiple indicators; thus, there is inadequate space to provide an adequate description of each measure and the corresponding scoring rules here. Please refer to published papers for a complete description of all outcome measures.
3 month intervention and 3 month follow up periods
Study Arms (2)
Immediate Intervention Group
EXPERIMENTALImmediate Intervention: Long term care units assigned to the Immediate Intervention group were first to receive the staff training and management intervention to improve nutritional care processes.
Delayed Intervention Group
ACTIVE COMPARATORDelayed Intervention: Long term care units assigned to the Delayed Intervention group were monitored under usual care conditions to serve as a control for the Immediate Intervention group. Then, these units received the staff training and management intervention at a later date.
Interventions
Unit staff received weekly training and feedback for 12-weeks to improve daily nutritional care processes.
Research staff monitored this group under usual care conditions, then these units crossed over into intervention.
Eligibility Criteria
You may qualify if:
- Long-stay,
- free of feeding tube,
- not receiving hospice care,
- not on a planned weight loss diet,
- able to speak English
You may not qualify if:
- short stay/rehab only
- feeding tube
- hospice
- planned weight loss diet
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Tennessee Valley Healthcare System Nashville Campus, Nashville, TN
Nashville, Tennessee, 37212-2637, United States
Related Publications (5)
Simmons SF, Durkin DW, Shotwell MS, Erwin S, Schnelle JF. A staff training and management intervention in VA long-term care: impact on feeding assistance care quality. Transl Behav Med. 2013 Jun;3(2):189-99. doi: 10.1007/s13142-013-0194-3.
PMID: 24073169RESULTSimmons SF, Sims N, Durkin DW, Shotwell MS, Erwin S, Schnelle JF. The quality of feeding assistance care practices for long-term care veterans: implications for quality improvement efforts. J Appl Gerontol. 2013 Sep;32(6):669-86. doi: 10.1177/0733464811433487. Epub 2012 Mar 22.
PMID: 25474793RESULTDurkin DW, Shotwell MS, Simmons SF. The impact of family visitation on feeding assistance quality in nursing homes. J Appl Gerontol. 2014 Aug;33(5):586-602. doi: 10.1177/0733464814522126. Epub 2014 Feb 18.
PMID: 24652932RESULTDurkin DW, Umayam SP, Sims N, Cleeton P, Simmons SF. Whom do veteran nursing home residents prefer to talk to about satisfaction with care?: implications for nursing staff. J Gerontol Nurs. 2012 Dec;38(12):38-45. doi: 10.3928/00989134-20121109-01.
PMID: 23189996RESULTSimmons SF, Durkin DW, Rahman AN, Schnelle JF, Beuscher LM. The value of resident choice during daily care: do staff and families differ? J Appl Gerontol. 2014 Sep;33(6):655-71. doi: 10.1177/0733464812454010. Epub 2012 Aug 1.
PMID: 25143465RESULT
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Limitations and Caveats
This study was conducted in only two VA facilities in one geographic region with predominately White, male residents. All study results have been published in a series of papers.
Results Point of Contact
- Title
- Sandra F. Simmons, PhD, Associate Professor of Medicine
- Organization
- Tennessee Valley Healthcare System, GRECC and Vanderbilt University, School of Medicine, Division of Geriatrics, Center for Quality Aging
Study Officials
- PRINCIPAL INVESTIGATOR
Sandra F Simmons, BA MA PhD
Tennessee Valley Healthcare System Nashville Campus, Nashville, TN
Publication Agreements
- PI is Sponsor Employee
- Yes
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- CROSSOVER
- Sponsor Type
- FED
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
February 9, 2009
First Posted
February 11, 2009
Study Start
February 1, 2009
Primary Completion
October 1, 2011
Study Completion
September 1, 2013
Last Updated
April 27, 2015
Results First Posted
November 10, 2014
Record last verified: 2014-10