CHATO Training for Dementia

Overseen By Carissa K Coleman, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Kansas Medical Center

Disqualifiers: Psychiatric diagnoses, Terminal illness, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new online training program called Changing Talk Online (CHATO), designed to improve how nursing home staff communicate with and care for people with dementia. The goal is to enhance staff interaction and reduce behavioral issues in residents with dementia. Nursing homes serving dementia patients and providing internet access for staff to complete the training are eligible. The trial involves two groups: one receives the training immediately, while the other waits to receive it later. The focus is on implementing effective practices to improve dementia care. As an unphased trial, this study offers an opportunity to contribute to innovative approaches in dementia care.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this training is safe for dementia care providers?

Research has shown that the Changing Talk Online (CHATO) training is safe to use. In past studies, CHATO improved communication between nursing home staff and residents with dementia. It also reduced the use of "elderspeak," which occurs when older adults are spoken to like children. Notably, over 63% of participants in these studies reported better communication without any negative effects.

Since this trial tests an educational program, not a drug or medical device, there is no risk of physical side effects. The goal is to enhance how staff communicate with and care for residents, potentially leading to better outcomes for people with dementia. Based on the available information, CHATO training appears well-tolerated and safe for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about CHATO Training for Dementia because it offers a fresh approach to improving communication in dementia care. Unlike traditional treatments that focus on medication or physical therapies, CHATO is an online training program designed to enhance the way caregivers interact with dementia patients. This method emphasizes changing communication styles to better meet the needs of individuals with dementia, potentially improving their quality of life and reducing caregiver stress. By focusing on communication, CHATO aims to address the emotional and social aspects of dementia care, which are often overlooked in standard treatments.

What evidence suggests that the CHATO training is effective for improving dementia care?

Research has shown that the Changing Talk Online (CHATO) training can improve communication in dementia care. In this trial, some nursing homes will receive the CHATO training as part of the intervention arm, while others will be in the waitlist control arm, completing assessments without initially receiving the training. Studies have found that staff who completed the CHATO training increased their knowledge of effective communication with dementia patients by 15%. This increase in understanding is linked to better interactions with residents and may help reduce difficult behaviors often seen in dementia. The training also emphasizes proven, person-centered communication methods, which are crucial for providing high-quality care. Early findings suggest that this approach might also help reduce the use of antipsychotic medications in nursing homes. ^{1 3 6 7 8}

Are You a Good Fit for This Trial?

This trial is for nursing homes with internet access, willing to have staff complete CHATO training and participate in interviews/surveys. It's aimed at improving care for residents with Alzheimer's or other dementias. Staff providing direct care for 8+ hours weekly will do the training. Facilities that served in prior CHAT/CHATO studies, assisted living, or those with residents on hospice or certain psychiatric conditions are excluded.

Inclusion Criteria

My facility provides care for individuals with dementia.

Data for residents in participating NHs with Alzheimer's disease or non-Alzheimer's dementia documented on the MDS Active Diagnoses list will be included in the analyses

Nursing Homes that are willing to complete leadership interviews and surveys

Exclusion Criteria

Assisted Living facilities or other types of facilities are excluded due to lack of MDS data as well as NHs that previously participated in other CHAT/CHATO studies

I do not have severe mental health issues, am not in hospice care, and can communicate with staff.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Nursing home staff undergo the CHATO online training to improve communication and reduce behavioral symptoms in residents with dementia

3 months

Online modules, self-paced

Follow-up

Participants are monitored for changes in behavioral symptoms and psychotropic medication use

6 months

Quarterly assessments

Sustainability Evaluation

Evaluation of the sustainability of CHATO training and its long-term effects on nursing home practices

1 year

What Are the Treatments Tested in This Trial?

Interventions

• Changing Talk Online (CHATO)

Trial Overview The study tests an online interactive training program (CHATO) designed to enhance communication skills of nursing home staff. The goal is to improve interactions with dementia patients and reduce their behavioral symptoms, contributing to better overall care.

How Is the Trial Designed?

Group I: Intervention Experimental Treatment 1 Intervention

Intervention nursing homes will receive the training and control nursing homes will complete assessments, but not receive the training.

Group II: Waitlist Control Active Control 1 Intervention

After the intervention nursing homes complete the training, the waitlist control nursing homes will crossover and complete the training.

Changing Talk Online (CHATO) is already approved in United States for the following indications:

Approved in United States as CHATO for:

• Education for dementia care providers
• Reduction of behavioral symptoms in persons with dementia

Who Is Running the Clinical Trial?

University of Kansas Medical Center

Lead Sponsor

Trials

527

Recruited

181,000+

University of Iowa

Collaborator

Trials

486

Recruited

934,000+

Published Research Related to This Trial

The Changing Talk Online (CHATO) education program significantly improved knowledge about person-centered communication among adult day services staff, with scores increasing by 15 percentage points after the training (p < 0.001).

Staff confidence in providing dementia care also increased after the CHATO program (p = 0.037), indicating that the training effectively prepared them to implement better communication strategies in their care practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promoting Elderspeak Awareness: Adapting Changing Talk Online Communication Education for Adult Day Services Staff. Williams, K., Coleman, CK., Hein, M., et al.[2023]

The Internet-based CARES training module significantly improved dementia care knowledge among 40 certified nursing assistants (CNAs) in nursing homes and assisted living facilities, indicating its effectiveness as a training tool.

Over 85% of CNAs reported that the CARES protocol enhanced their care competency and reduced stress related to caring for residents with dementia, suggesting that such online training programs are beneficial and efficient for long-term care settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of Internet training for care staff of residents with dementia: the CARES program. Hobday, JV., Savik, K., Smith, S., et al.[2022]

The Changing Talk: Online Training (CHATO) effectively reduced elderspeak and improved communication among nursing home staff, with over 63% of participants completing the training and 87% passing the posttest, indicating strong engagement and understanding of the material.

Implementation strategies such as assigning champions, using multiple reminder mediums, and providing recognition were linked to better outcomes, suggesting that active leadership and tailored approaches are crucial for successful training in dementia care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing and Testing Remote Implementation for the Changing Talk Online (CHATO) Communication Intervention for Nursing Home Staff: A Pilot Pragmatic Randomized Controlled Trial. K Coleman, C., Hein, M., Shaw, CA., et al.[2023]

The CARES® Dementia-Related Behavior™ Online Training Program significantly improved the knowledge of 40 direct care workers (DCWs) in responding to dementia-related behaviors, as evidenced by higher post-test scores compared to pre-test scores (p < .01).

Feedback from participants indicated that the training was not only acceptable and useful but also effectively delivered interactive, real-world content that could positively influence the clinical care provided to individuals with dementia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Direct Care Worker Training to Respond to the Behavior of Individuals With Dementia: The CARES&#174; Dementia-Related Behavior&#8482; Online Program. Gaugler, JE., Hobday, JV., Robbins, JC., et al.[2020]

The Changing Talk intervention, when transitioned to an online format, effectively improved nursing home staff's knowledge about communication, with scores increasing from an average of 82.4% to 91.2% after training.

Participants in both online and classroom formats reported similar intentions to apply the skills learned, indicating that the online modules can successfully maintain the effectiveness of the original training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transitioning Communication Education to an Interactive Online Module Format. Williams, K., Abd-Hamid, NH., Perkhounkova, Y.[2018]

A pilot study involving 11 care aide-resident pairs demonstrated that a video-feedback communication intervention significantly improved person-centred dementia communication skills, particularly in linguistic reciprocity and continuity.

Care aides reported increased confidence, competence, and relationship closeness with residents after the intervention, suggesting that this approach could enhance the quality of care in dementia settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Connecting Through Conversation: A Novel Video-Feedback Intervention to Enhance Long-Term Care Aides' Person-Centred Dementia Communication. O'Rourke, DJ., Lobchuk, MM., Thompson, GN., et al.[2022]

The online CARES® ADL Dementia Care training program significantly improved the knowledge, understanding, and confidence of 48 certified nursing assistants (CNAs) in caring for residents with dementia across ten nursing homes in six states.

CNAs reported high satisfaction with the training, finding it user-friendly and effective, suggesting that online training can be a practical solution for enhancing dementia care in nursing homes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Certified nursing assistants' perspectives of the CARES® activities of daily living dementia care program. Dobbs, D., Hobday, J., Roker, R., et al.[2020]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8556275/

CHANGING TALK ONLINE The primary resident outcome, behavioral response by residents with dementia, will be extracted from CMS MDS data along with the secondary resident outcome, ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10037668/

Adapting Changing Talk Online (CHATO) Communication ... Results: Mean scores on the Changing Talk Scale (CHATS) knowledge test increased by 15.0 percentage points (N=19, p<. 001). Confidence in providing dementia ...

3. sciencedirect.com sciencedirect.com/science/article/abs/pii/S155171442100286X

Changing Talk Online: Protocol for a cluster pragmatic trial ... This pragmatic randomized clinical trial will test the effects of online staff education on NHs and their residents' BPSD and antipsychotic medication use.

4. impactcollaboratory.org impactcollaboratory.org/wp-content/uploads/2022/09/Grand-Rounds_CHATO-Design_Williams.pdf

Changing Talk Online Training (CHATO): A National Trial ... Changing Talk. Online: Protocol for a cluster pragmatic trial testing communication education to reduce behavioral and psychological symptoms of.

5. kumc.edu kumc.edu/school-of-nursing/research/school-of-nursing-research/chato.html

Changing Talk: Online Training (CHATO) The goal of the CHATO course is to increase awareness of the importance of effective communication with older adults and to use evidence-based, person-centered ...

6. alz-journals.onlinelibrary.wiley.com alz-journals.onlinelibrary.wiley.com/doi/abs/10.1002/alz.047450

The Changing Talk: Online training (CHATO) — Developing ... The Changing Talk (CHAT) training effectively reduces elderspeak and subsequent behavioral challenges in residents with dementia in nursing homes.

7. ltc.health.mo.gov ltc.health.mo.gov/wp-content/uploads/sites/18/2022/07/CHATO-Summary.pdf

Changing Talk Online Training (CHATO) We will be working with CMS to access deidentified MDS and Quality Indicator data to evaluate resident and nursing home outcomes. ... • Qualifies for CMS dementia ...

8. withpower.com withpower.com/trial/phase-alzheimer-disease-3-2021-026a1

CHATO Training for Dementia · Info for Participants The Changing Talk: Online Training (CHATO) effectively reduced elderspeak and improved communication among nursing home staff, with over 63% of participants ...