JMIR Publications

ABSTRACT

Background:

Within the framework of a randomized controlled trial into the impact of a digital, psychosocial Photo-Activity intervention on residents with dementia in the nursing home and their (in)formal carers, a process evaluation was conducted to determine factors that affected implementation of the intervention and potentially influenced intervention outcomes.

Objective:

By tracing facilitators and barriers of implementation, the study also aimed to inform future implementation of the Photo-Activity.

Methods:

Following the Medical Research Council Guidance, mixed-methods were used to investigate contextual, implementation and mechanisms of impact factors during the Photo-Activity intervention via the Fotoscope app versus a general conversation activity (control). Google Analytics was set-up to gain insight in how the Fotoscope was used in practice. For quantitative data descriptive statistics were calculated and differences between groups tested. For qualitative data, thematic analyses was done.

Results:

163 semi-structured interviews were conducted with residents and (in)formal carers. Contextual factors: a minority of formal carers in both groups mentioned time and workload as barriers. Implementation factors: Residents felt that the digital Photo-Activity worked well on a tablet. Informal carers from both groups wanted more intervention updates from formal carers. No significant differences were found in how formal carers from both groups felt about the medium and format of the training, activity duration and frequency, and the four-week activity period. Mechanisms of Impact: Photo-activity residents (n=28) felt significantly more positive about the conversations they had with their carer (U=533.0, z=2.865, p=.004, r=.39). Photo-Activity formal carers got to know the resident significantly better, and rated the Photo-activity as a significantly better way of getting to know the resident.

Conclusions:

The work invested by formal carers in implementing the Photo-Activity did not seem to differ greatly to a general conversation-activity, suggesting that the Photo-activity , as an easy and enjoyable intervention, could be widely implemented and disseminated in nursing homes. Clinical Trial: Netherlands Trial Register: NL9219; registered (21 January 2021); NTR (trialregister.nl)