CHOICE+ Quality Improvement for Long Term Care Homes

NCT07505407 | Enrolling By Invitation

• 1 other identifier: REB #46942
• Study Type: observational
• Target: 800
• Locations: 1 country
• Sites: 4

Brief Summary

CHOICE+ is an eLearning program that empowers staff to improve the mealtime experience of long-term care (LTC) residents. This program is based on principles that align with relationship-centered care and promote resident quality of life and food intake. In a prior study, the investigators have showed that this program can improve the mealtime experience; eLearning has been created to promote spreading of this training. The investigators have created an implementation model that supports uptake of this eLearning. Designated home staff Champions will complete the eLearning, be provided four virtual training sessions to reinforce key concepts and be mentored in monthly virtual community of practice sessions around making improvements. Champions will work with a small team of staff, residents, and family to identify and make improvements (e.g., less rushed mealtime). This study will evaluate this model of implementation in 13-18 LTC homes. Homes in the region of research centres are invited to apply, and where required, will be randomly selected. We will also determine if the mealtime experience, resident health (body weight and food intake), resident/family food and care satisfaction, and staff job satisfaction improve. This implementation study is designed to sustain improvements that the Champions and their team make and build capacity to improve the quality of care in their home. We will track implementation activities and influences on implementation through champion diaries, monthly meetings, and end of study interviews. Researchers will measure the mealtime experience with a standardized observational tool and aggregate food waste (to assess food intake). Resident body weight to determine nutritional status will be collected monthly. Questionnaires will be used with staff, residents, and family members for other outcomes. Outcomes will be measured six months before, during, and six months after the one year of implementation. Findings and learnings about implementation will support the scaling of CHOICE+ to other LTC homes.

Conditions

Long Term Care Homes; Malnutrition Elderly; Malnutrition Risk in Elder

Keywords

mealtimes; implementation; relationship-centred care; champion training

Outcome Measures

Primary Outcomes (1)

• Mealtime Scan+

  a standardized validated observational tool that measures the physical, social and relationship-centred practices; score 0-32

  21 months

Secondary Outcomes (2)

• Food /fluid intake

  21 months

• body weight

  21 months

Other Outcomes (2)

• Team member Mealtime Experience Questionnaire

  week 0 and week 52

• Mealtime Satisfaction Questionnaire

  week 0 and week 52

Study Arms (1)

13- 18 long term care homes

Homes will be provided a quality improvement program called CHOICE+. Home staff will be trained on the principles of CHOICE+ and an 8 step process to implement mealtime improvements in their home.

Other: CHOICE+ virtual training program

Interventions

CHOICE+ virtual training program OTHER

The CHOICE+ virtual training program consists of three components a) an elearning course for home champions, b) virtual training of key concepts for home champions, and c) a monthly virtual community of practice to support implementation and mentor home champions.

13- 18 long term care homes

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

long term care home residents and staff

You may qualify if:

• residents will eat in the intervention dining room on a routine basis
• team members will work in the intervention dining room
• champions will be home leaders who can support the implementation effort

You may not qualify if:

• residents not in the intervention dining room
• team members who rarely work in the intervention dining room

Sponsors & Collaborators

• University of Waterloo: lead
• University of Saskatchewan: collaborator
• University of Manitoba: collaborator
• St. Francis Xavier University: collaborator

Study Sites (4)

University of Manitoba

Winnipeg, Manitoba, R3T2N2, Canada

Location

St Francis Xavier University

Antigonish Nova Scotia, Nova Scotia, B2G 2W5, Canada

Location

University of Waterloo

Waterloo, Ontario, N2L 3G1, Canada

Location

University of Saskatchewan

Saskatoon, Saskatchewan, S7N 5A2, Canada

Location

Study Officials

• Heather H Keller, PhD

  University of Waterloo

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: March 17, 2026
• First Posted: April 1, 2026
• Study Start: May 15, 2026
• Primary Completion (Estimated): September 30, 2028
• Study Completion (Estimated): September 30, 2028
• Last Updated: April 1, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

CA (4)