Meeting Centers 3.0 (WC 2015-089)

Methods

Starting date: 01/02/2016

The following research questions will be answered:

  1. Are the Meeting Centers 3.0 with their widened activating- and support program more capable of meeting the different needs and preferences of individuals regarding activities and support (including contributing to society, social inclusion)? Will more people with dementia and informal carers make use of the widened service offer? What are the characteristics of the participants in the new interventions? Are these characteristics different from the characteristics of the participants in the regular Meeting Centers? 
  2. Will the new interventions facilitate finding the way to the Meeting Centers, when there is a need for more intense and combined support?
  3. What facilitators and barriers (for users, organizations and law) are identified during the implementation of the new interventions in the Meeting Centers?
  4. What is the (cost)effectiveness (of the widened offer) of the new interventions compared to the regular offer in the Meeting Centers regarding the following outcomes: - Person living with dementia: self-esteem, neuropsychiatric problems, experienced autonomy, quality of life; - Carer: sense of competence, quality of life.

Design
To answer these questions a randomized controlled trial will be conducted. 32 Meeting Centers will be assigned to the experimental (=16)- and control group (n=16) by a randomization procedure. In the experimental group, in twelve centers DemenTalent will be implemented, in four centers Dementelcoach and STAR-education and in 4 centers all three interventions will be implemented. The control group will continue to offer only the regular program. This regular program consists of a social club for persons with dementia, discussion groups and psychoeducational meetings for carers and a weekly consultation hour and regular center meetings for both. A second control group of people who do not use day care or support (reference group) will be selected from the NPO data bank. Finally to investigate if the Meeting Centers participating in the project are representative for Meeting Centers in the Netherlands regarding their participants (people with dementia and carers), a national survey among Meeting Centers will be carried out. The measurements about the (cost)effectiveness will take place among new participants at baseline (before they start using the new interventions or the regular Meeting Centers program) and after six months.

Implementation of new interventions
The new interventions will be implemented by a one-day training for staff and ‘coaching on the job’, provided by DAZ, Dementelcoach and Amsterdam Center on Aging VUmc-VU.

Outcome measures and data collection
This study will use mixed methods, both qualitative interviews and process-analysis and quantitative methods to answer the research questions.

  • Reference file: To set up the reference file, questions from the NPO-minimum dataset will be asked to all participants in Meeting Centers in the Netherlands who consented to participate in the study.
  • Number of participants: The number of participants (people with dementia and carers) in the Meeting Centers in the experimental group and in the control group will be registered, before the implementation of the new interventions take place, to answer research question 1.
  • Data collection process-analysis: During the first and second year key figures will be interviewed about the implementation of the new interventions (including municipalities where the study take place) to identify facilitators and barriers in implementing and continuation of the new interventions, and people with dementia and carers will be interviewed to collect data to answer question 1, 2 and 3.
  • Data collection impact assessment (question 4): Questionnaires will be conducted in the control group and in the experimental groups among new participants. These questionnaires will be conducted at the start of using the intervention program (baseline) and after six months to identify self-esteem, neuropsychiatric problems, experienced autonomy (person with dementia), quality of life (person with dementia and carer) and sense of competence (carer).
  • (Cost)effectiveness (question 4) in a social perspective: The following cost data will be collected:
    • Among participants: healthcare-related costs (doctor visits, medication, hospitalization, nursing home admission etc.) and costs outside healthcare (time cost of carers, costs due to loss of carers labor productivity).
    • Among organizations: rental costs, location management, administration, personnel costs and costs associated with the implementation of the new interventions, such as training staff in working as Dementelcoach, organizing DemenTalent and in advising on STAR, telephone charges, travel expenses and other material costs.

Analysis, reporting and dissemination
At the end of the second year the qualitative data about the facilitators and barriers in implementing the new interventions will be analyzed by a qualitative data-analysis program. A manual with dvd will be developed based on this analysis. The quantitative data about the participants in Meeting Centers 3.0 will be analyzed by descriptive statistics and (non)parametric tests. Covariance analysis will be used to measure the impact of the new interventions, where the baseline measurement and potential confounders will be included as covariates.
The research results will be reported at (inter)national congresses and published in scientific and professional journals. The Amsterdam Center on Aging VUmc-VU and DAZ will spread a practical implementation guide which can help other Meeting Centers and day care centers to implement the new interventions at their facility.