Changing Talk Online (CHATO) Study
Changing Talk Online (CHATO): A Pragmatic Trial to Reduce Behavioral Symptoms in Dementia Care
1 other identifier
interventional
219
1 country
2
Brief Summary
Objectives AIM 1. Establish acceptability and preliminary efficacy of online CHATO modules through pilot testing with NH staff. AIM 2. Develop and pilot test the data collection tool with consultant and advisory panel input. Interviews of NH administrators and staff who participate in the pilot testing of CHATO and a process evaluation will be used to identify and develop supports for implementation and sustainability in preparation for future CHATO testing. Design and Outcomes The R61 will prepare for the R01 pragmatic trial by establishing feasibility of online modules and preliminary efficacy of CHATO with NH staff. The research design is a randomized clinical trial. One NH will provide initial feasibility testing. Any modifications to the modules will be made. Then six nursing homes (estimated N=150 staff) will be randomly assigned to intervention or wait-list control groups. The primary outcome will be knowledge gain for staff completing CHATO training. Additional outcomes include resident quality measures related to behavioral and psychological symptoms of dementia (BPSD) on both resident and facility levels and facility level data related to inappropriate use of psychotropic medications to control BPSD. Implementation strategies will be assessed by survey and leadership interviews completed by an external evaluator. Interventions and Duration Changing Talk Online (CHATO) training is a course is to increase awareness of the importance of effective communication with older adults and to use evidence-based person-centered communication during interactions with older adults in nursing homes and other health care settings. The total program is approximately 3 hours, split into 3 modules. Each module is approximately an hour, depending on the individual user. Each NH will work with the research team for three months to plan, implement, and collect data. Sample Size and Population This course is designed for staff in nursing homes, independent and assisted living, and health care settings in the community that include registered nurses, nursing assistants, nursing home dieticians, direct care professionals, other administrations and support employees. All the employees at all seven nursing homes will be asked to participate. Assignment of NHs to intervention and wait-list control groups will be at random. A sample of 150 training participants are estimated.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Sep 2019
2 active sites
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
First Submitted
Initial submission to the registry
January 22, 2019
CompletedFirst Posted
Study publicly available on registry
February 21, 2019
CompletedStudy Start
First participant enrolled
September 3, 2019
CompletedPrimary Completion
Last participant's last visit for primary outcome
May 31, 2020
CompletedStudy Completion
Last participant's last visit for all outcomes
August 31, 2020
CompletedResults Posted
Study results publicly available
August 19, 2021
CompletedSeptember 27, 2021
August 1, 2021
9 months
January 22, 2019
May 27, 2021
August 30, 2021
Conditions
Keywords
Outcome Measures
Primary Outcomes (4)
Knowledge Gain Scores for CHATO Training Participants
CHATO Knowledge Test was given to participants pre training and post training. Scoring: 13 items scored incorrect (0) or correct (1). Test score was calculated as the percentage of correct answers (0-100%). The mean percentage was used for each group in the the analysis. Two forms (Forms A and B) measures knowledge gained from training.
Baseline, 1 month, 3 months
Communication Rating Scores for CHATO Training Participants
Participant watches a video and answers questions testing their ability to visually and audibly identify effective vs ineffective communication strategies and recognize elderspeak vs. person-centered care. Effective rating: mean score for one item scored 1 = Ineffective to 5 = Effective; lower score indicates improvement. Appropriate rating: mean score for one item scored 1 = Inappropriate to 5 = Appropriate; lower score indicates improvement. Recognizes elderspeak subscale: mean score for 6-items scored yes (1) or no (0); higher score indicates improvement. Recognizes person-centered communication subscale: mean score for 3-items scored yes (1) or no (0); lower score indicates improvement.
Baseline (pre-training), 1 month (post-training)
BPSD Reports for the One-month Period Before Baseline Data Collection and One Month After Will be Compared Between the Intervention and Wait-list Control Groups and Within Nursing Homes Before and After the CHATO Training.
NH Level Deidentified Resident data from nursing homes
Baseline, 1 month
Psychotropic Medication Reports for the One-month Period Before Baseline Data Collection and One Month After Will be Compared Between the Intervention and Wait-list Control Groups and Within Nursing Homes Before and After the CHATO Training.
NH Level Deidentified Resident data from nursing homes
Baseline, 1 month
Secondary Outcomes (4)
Number of Implementation Strategies Used in Each Nursing Home (Nursing Home Level Data)
1 month (post training)
Artifacts of Culture Change Scores Per Nursing Home to Assess Nursing Home Practices, Environment, and Staffing (Nursing Home Level Training)
1 month (post training)
Nursing Home Implementation Strategies Assessed by Interviews Will be Described, Categorized, and Correlated With Participation Rates.
1 month (post training)
The Cost Associated With Hypothesized BPSD Reductions After the CHATO Training Will be Calculated Using Primary Outcomes and Wage Data.
1 month (post training)
Study Arms (2)
Intervention
EXPERIMENTALThree nursing homes will receive the training and three control nursing homes will complete assessments, but not receive the training.
Waitlist Control
ACTIVE COMPARATORAfter the intervention group takes the training, the waitlist control group will crossover and take the training.
Interventions
Three, one-hour online training modules highlighting barriers and ineffective communication behaviors with older adults while teaching and modeling alternative, effective communication strategies.
Eligibility Criteria
You may qualify if:
- Nursing Homes that serve people with dementia.
- Nursing Homes that have internet available for staff to complete the CHATO training.
- Nursing Homes that are willing to complete leadership interviews and surveys.
- CNAs and nurses who are permanent employees and who provide direct care at least 8 hours weekly will be invited to complete the CHATO training, available by URL link.
- Other personnel, such as housekeeping, dietary, and administrators may also participate. Participation by as many staff as possible is desired to achieve facility-wide communication change.
- Aggregate, deidentified data for residents with Alzheimer's disease or non-Alzheimer's dementia documented on the MDS Active Diagnoses list.
You may not qualify if:
- Assisted Living facilities or other types of facilities are excluded due to lack of MDS data as well as NHs that previously participated in the CHAT study.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- University of Kansas Medical Centerlead
- University of Iowacollaborator
Study Sites (2)
University of Iowa School of Nursing
Iowa City, Iowa, 52242, United States
University of Kansas School of Nursing
Kansas City, Kansas, 66160, United States
Related Publications (1)
Williams KN, Coleman CK, Perkhounkova Y, Beachy T, Hein M, Shaw CA, Berkley A. Moving Online: A Pilot Clinical Trial of the Changing Talk Online Communication Education for Nursing Home Staff. Gerontologist. 2021 Nov 15;61(8):1338-1345. doi: 10.1093/geront/gnaa210.
PMID: 33346349DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Results Point of Contact
- Title
- Kristine Williams, RN, PhD, FNP-BC, FGSA, FAAN, E. Jean Hill Professor
- Organization
- University of Kansas School of Nursing
Publication Agreements
- PI is Sponsor Employee
- No
- Restrictive Agreement
- No
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- OTHER
- Intervention Model
- CROSSOVER
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
January 22, 2019
First Posted
February 21, 2019
Study Start
September 3, 2019
Primary Completion
May 31, 2020
Study Completion
August 31, 2020
Last Updated
September 27, 2021
Results First Posted
August 19, 2021
Record last verified: 2021-08
Data Sharing
- IPD Sharing
- Will not share