Mixed methods developmental evaluation of the CHOICE program: a relationship-centred mealtime intervention for long-term care
Abstract Background Mealtimes are important to quality of life for residents in long-term care (LTC). CHOICE (which stands for Connecting, Honouring dignity, Offering support, supporting Identity, Creating opportunities, and Enjoyment) is a multi-component intervention to improve relationship-centre...
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doaj-dc206ac8abce45e393318074720026c52020-11-25T03:58:30ZengBMCBMC Geriatrics1471-23182018-11-0118111410.1186/s12877-018-0964-3Mixed methods developmental evaluation of the CHOICE program: a relationship-centred mealtime intervention for long-term careSarah Wu0Jill M. Morrison1Hilary Dunn-Ridgeway2Vanessa Vucea3Sabrina Iuglio4Heather Keller5University of WaterlooUniversity of WaterlooResearch Institute for AgingUniversity of WaterlooUniversity of WaterlooUniversity of WaterlooAbstract Background Mealtimes are important to quality of life for residents in long-term care (LTC). CHOICE (which stands for Connecting, Honouring dignity, Offering support, supporting Identity, Creating opportunities, and Enjoyment) is a multi-component intervention to improve relationship-centred care (RCC) and overall mealtime experience for residents. The objective of this developmental evaluation was to determine: a) if the dining experience (e.g. physical, social and RCC practices) could be modified with the CHOICE Program, and b) how program components needed to be adapted and/or if new components were required. Methods A mixed methods study conducted between April–November 2016 included two home areas (64 residents; 25 care staff/home management) within a single LTC home in Ontario. Mealtime Scan (MTS), which measures mealtime experience at the level of the dining room, was used to evaluate the effectiveness of CHOICE implementation at four time points. Change in physical, social, RCC dining environment ratings and overall quality of the mealtime experience over time was determined with linear mixed-effects analyses (i.e., repeated measures). Semi-structured interviews (n = 9) were conducted with home staff to identify what components of the intervention worked well and what improvements could be made. Results Physical and overall mealtime environment ratings showed improvement over time in both areas; one home area also improved social ratings (p < 0.05). Interviews revealed in-depth insights into the program and implementation process: i) Knowing the context and culture to meet staff and resident needs; ii) Getting everyone on board, including management; iii) Keeping communication lines open throughout the process; iv) Sharing responsibility and accountability for mealtime goals and challenges; v) Empowering and supporting staff’s creative mealtime initiatives. Conclusions This developmental evaluation demonstrated the potential value of CHOICE. Findings suggest a need to: extend the time to tailor program components; empower home staff in change management; and provide increased coaching.http://link.springer.com/article/10.1186/s12877-018-0964-3DiningComplex intervention implementationEvaluationProgram developmentImplementation scienceMealtimes |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sarah Wu Jill M. Morrison Hilary Dunn-Ridgeway Vanessa Vucea Sabrina Iuglio Heather Keller |
spellingShingle |
Sarah Wu Jill M. Morrison Hilary Dunn-Ridgeway Vanessa Vucea Sabrina Iuglio Heather Keller Mixed methods developmental evaluation of the CHOICE program: a relationship-centred mealtime intervention for long-term care BMC Geriatrics Dining Complex intervention implementation Evaluation Program development Implementation science Mealtimes |
author_facet |
Sarah Wu Jill M. Morrison Hilary Dunn-Ridgeway Vanessa Vucea Sabrina Iuglio Heather Keller |
author_sort |
Sarah Wu |
title |
Mixed methods developmental evaluation of the CHOICE program: a relationship-centred mealtime intervention for long-term care |
title_short |
Mixed methods developmental evaluation of the CHOICE program: a relationship-centred mealtime intervention for long-term care |
title_full |
Mixed methods developmental evaluation of the CHOICE program: a relationship-centred mealtime intervention for long-term care |
title_fullStr |
Mixed methods developmental evaluation of the CHOICE program: a relationship-centred mealtime intervention for long-term care |
title_full_unstemmed |
Mixed methods developmental evaluation of the CHOICE program: a relationship-centred mealtime intervention for long-term care |
title_sort |
mixed methods developmental evaluation of the choice program: a relationship-centred mealtime intervention for long-term care |
publisher |
BMC |
series |
BMC Geriatrics |
issn |
1471-2318 |
publishDate |
2018-11-01 |
description |
Abstract Background Mealtimes are important to quality of life for residents in long-term care (LTC). CHOICE (which stands for Connecting, Honouring dignity, Offering support, supporting Identity, Creating opportunities, and Enjoyment) is a multi-component intervention to improve relationship-centred care (RCC) and overall mealtime experience for residents. The objective of this developmental evaluation was to determine: a) if the dining experience (e.g. physical, social and RCC practices) could be modified with the CHOICE Program, and b) how program components needed to be adapted and/or if new components were required. Methods A mixed methods study conducted between April–November 2016 included two home areas (64 residents; 25 care staff/home management) within a single LTC home in Ontario. Mealtime Scan (MTS), which measures mealtime experience at the level of the dining room, was used to evaluate the effectiveness of CHOICE implementation at four time points. Change in physical, social, RCC dining environment ratings and overall quality of the mealtime experience over time was determined with linear mixed-effects analyses (i.e., repeated measures). Semi-structured interviews (n = 9) were conducted with home staff to identify what components of the intervention worked well and what improvements could be made. Results Physical and overall mealtime environment ratings showed improvement over time in both areas; one home area also improved social ratings (p < 0.05). Interviews revealed in-depth insights into the program and implementation process: i) Knowing the context and culture to meet staff and resident needs; ii) Getting everyone on board, including management; iii) Keeping communication lines open throughout the process; iv) Sharing responsibility and accountability for mealtime goals and challenges; v) Empowering and supporting staff’s creative mealtime initiatives. Conclusions This developmental evaluation demonstrated the potential value of CHOICE. Findings suggest a need to: extend the time to tailor program components; empower home staff in change management; and provide increased coaching. |
topic |
Dining Complex intervention implementation Evaluation Program development Implementation science Mealtimes |
url |
http://link.springer.com/article/10.1186/s12877-018-0964-3 |
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