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

5043 Participants Needed

Trial Summary

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 data supports the effectiveness of the treatment Changing Talk Online (CHATO) for dementia?

Research shows that the Changing Talk Online (CHATO) training helps reduce elderspeak (a simplified way of speaking to older adults) and improves communication in nursing homes, which can lead to fewer behavioral challenges in residents with dementia. Additionally, staff who participated in CHATO training reported increased knowledge and confidence in providing dementia care. ^{1 2 3 4 5}

How is the CHATO treatment different from other dementia treatments?

CHATO is unique because it is an online communication training program designed to reduce elderspeak (a simplified way of speaking to older adults) and improve interactions between nursing home staff and residents with dementia. Unlike traditional treatments that may focus on medication, CHATO emphasizes enhancing communication skills to address behavioral challenges in dementia care. ^{1 2 3 6 7}

What is the purpose of this trial?

The National Plan to Address Alzheimer's disease has identified education of dementia care providers as a top priority to address the need for quality care for the population of persons with dementia that will triple in the next 30 years. This study will test new online interactive training for nursing home staff that improves staff communication and also reduces behavioral symptoms of persons with dementia that they care for. Innovative approaches to reach care providers are essential to achieve implementation of evidence-based practices to improve care.

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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 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 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]

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]

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]

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]

References

1. England 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. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Promoting Elderspeak Awareness: Adapting Changing Talk Online Communication Education for Adult Day Services Staff. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Transitioning Communication Education to an Interactive Online Module Format. [2018]

4. United States 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. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Connecting Through Conversation: A Novel Video-Feedback Intervention to Enhance Long-Term Care Aides' Person-Centred Dementia Communication. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Certified nursing assistants' perspectives of the CARES® activities of daily living dementia care program. [2020]

7. United States pubmed.ncbi.nlm.nih.gov

Feasibility of Internet training for care staff of residents with dementia: the CARES program. [2022]