Evaluating the Implementation of a Toolkit With Meaningful Activities for Residents With Dementia.

OBJECTIVES: Engagement in meaningful activities supports the well-being and quality of life of nursing home residents with dementia. This study evaluated the implementability of a toolkit to choose meaningful activities for residents with dementia. DESIGN: A process evaluation was conducted using the RE-AIM framework. Two nursing homes were involved in the implementation of the toolkit through a 6-month participatory action research approach, whereas 3 nursing homes followed an implementation track of equal duration without participatory action research. SETTING AND PARTICIPANTS: The toolkit was implemented within 5 Dutch nursing homes, involving health care professionals and family caregivers of residents with dementia. METHODS: Demographics were collected at baseline, user experience questionnaires were administered monthly, and at the end of the study, activity logs were collected and interviews conducted. Qualitative data were analyzed using a thematic analysis, based on a combined inductive and deductive approach (Consolidated Framework for Implementation Research). RESULTS: In total, 64 residents, 26 family caregivers, and 84 health care professionals were reached. Reach involved a mix of relevant stakeholders; however, family caregivers were least involved. Adoption declined from 40.4% to 28.1% during the study, with most users selecting a perceived lack of necessity and time constraints as reasons for nonuse. Implementation barriers and facilitators were categorized into the following 6 themes: individual characteristics, intervention characteristics, inner setting, outer setting, implementation process, and resident factors. CONCLUSIONS AND IMPLICATIONS: The toolkit was well received by end users and generally considered user-friendly. Prominent facilitators to implementation were leadership, peer support, and regular reminders, among others. Key barriers included staff turnover, workload, and limited perceived usefulness. Addressing these via task transfer, retraining and clear framing can improve toolkit implementation. This study provides practical insights to strengthen future implementation of the toolkit and similar innovations.