Open Access Highly Accessed Study protocol

A new combined strategy to implement a community occupational therapy intervention: designing a cluster randomized controlled trial

Carola ME Döpp12*, Maud JL Graff123, Steven Teerenstra4, Eddy Adang4, Ria WG Nijhuis - van der Sanden15, Marcel GM OldeRikkert26 and Myrra JFJ Vernooij-Dassen1278

Author Affiliations

1 Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University, Nijmegen Medical Centre, Nijmegen, the Netherlands

2 Alzheimer Centre Nijmegen, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

3 Dept. of Rehabilitation-Occupational Therapy, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

4 Dept. of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

5 Dept. of Rehabilitation, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

6 Department of Geriatrics, Alzheimer Centre Nijmegen, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

7 Dep. of Primary and Community Care, and Alzheimer Center Nijmegen, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

8 Kalorama Foundation, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

For all author emails, please log on.

BMC Geriatrics 2011, 11:13  doi:10.1186/1471-2318-11-13

Published: 30 March 2011

Abstract

Background

Even effective interventions for people with dementia and their caregivers require specific implementation efforts. A pilot study showed that the highly effective community occupational therapy in dementia (COTiD) program was not implemented optimally due to various barriers. To decrease these barriers and make implementation of the program more effective a combined implementation (CI) strategy was developed. In our study we will compare the effectiveness of this CI strategy with the usual educational (ED) strategy.

Methods

In this cluster randomized, single-blinded, controlled trial, each cluster consists of at least two occupational therapists, a manager, and a physician working at Dutch healthcare organizations that deliver community occupational therapy. Forty-five clusters, stratified by healthcare setting (nursing home, hospital, mental health service), have been allocated randomly to either the intervention group (CI strategy) or the control group (ED strategy). The study population consists of the professionals included in each cluster and community-dwelling people with dementia and their caregivers. The primary outcome measures are the use of community OT, the adherence of OTs to the COTiD program, and the cost effectiveness of implementing the COTiD program in outpatient care. Secondary outcome measures are patient and caregiver outcomes and knowledge of managers, physicians and OTs about the COTiD program.

Discussion

Implementation research is fairly new in the field of occupational therapy, making this a unique study. This study does not only evaluate the effects of the CI-strategy on professionals, but also the effects of professionals' degree of implementation on client and caregiver outcomes.

Clinical trials registration

NCT01117285