A critical examination of fidelity, adaptability, and maintenance in a national training program for staff in long-term care

The quality of care in long-term care settings depends in large part upon the ability of staff to meet resident needs. Reviews of recent staff training programs indicate effective staff training is related to improved resident satisfaction and quality of life. However, although numerous training programs have been developed, few have been rigorously evaluated. In particular, there is a dearth of information describing the fidelity, sustainability and potential dissemination of training programs. These factors are critical in promoting and maintaining positive change among staff members and ultimately improving resident care across heterogeneous long-term care settings. Therefore, the purpose of this dissertation study is to evaluate a standardized staff-training program specifically developed for staff caring for residents with dementia in long-term care settings. The Foundations of Dementia Care (FDC) program was developed by staff at the National Alzheimer's Association and is intended for national dissemination. Specifically, the dissertation aims are to: (1) To examine to what extent FDC was consistently implemented as intended in diverse settings and using multiple trainers (2) To examine trainer and trainee reactions to a standardized training program and, (3) To examine the Reach, Adoptability, Effectiveness and Maintenance of FDC using the RE-AIM evaluation model. These aims are consistent with the goals of the Geriatric Social Work Initiative (GSWI) and the Council of Social Work Education National Center for Gerontological Social Work Education. Funding for this dissertation study was provided by the Hartford Doctoral Fellowship in Geriatric Social Work, the National Alzheimer's Association Medical and Scientific Division (Grant IIRG-05-14332), and the RAND/John A. Hartford Foundation Building Interdisciplinary Geriatric Health Care Research Centers Initiative.