Statewide implementation of "reducing disability in Alzheimer's disease": impact on family caregiver outcomes.

There have been few replications of efficacious evidence-based programs for dementia caregivers offered in community settings. This study highlights the replication of the evidence-based Reducing Disability in Alzheimer's Disease program and explores the changes in outcomes for participating caregivers and whether those changes are related to level of program utilization. With data from 219 caregivers, regression results indicate that more exercise sessions are associated with a decrease in caregiver strain and more behavior management sessions are associated with a decrease in unmet needs after 3 months. Findings demonstrate how a multicomponent program can have positive benefits for family caregivers.

Program Components and Outcomes of Individuals With Dementia: Results From the Replication of an Evidence-Based Program.

This study examines whether the delivery of three components, (a) exercise training, (b) behavior management skill building, and (c) dementia-related education, in an evidence-based program are differentially associated with changes in outcomes for individuals with dementia (IWDs) after 3 months. Data come from 508 IWDs participating in the community replication of the evidence-based "Reducing Disability in Alzheimer's Disease" program. Regression results indicate that after 3 months, more exercise sessions are associated with improvements in physical functioning, mobility, minutes exercising, and symptoms of depression; more dementia education sessions are related to fewer restricted activity days; and more behavior management sessions are related to more symptoms of depression. As resource-strapped agencies look to best serve participants, further analysis and consideration is needed to determine the ideal balance of program efficacy, feasibility, and resources, as well as program benefits for IWDs and caregivers.

Evidence-Based Program Replication: Translational Activities, Experiences, and Challenges.

With a growing number of evidence-based programs, it is necessary to understand the translation activities, experiences, and challenges of program replication in a community setting. This article reviews the implementation tasks necessary for agencies to implement the Reducing Disability in Alzheimer's Disease (RDAD) intervention. It presents the importance of using original evidence-based program protocols and enhancing them to best fit service settings by reviewing the translation and implementation activities of (a) selecting and training program and supervisory staff; (b) recruiting, screening, and consenting participants to enroll in the program; and (c) developing a manual to guide community-based program replication. Furthermore, the process revealed that the replication of an evidence-based program can take place within the realities of a community setting with input from program oversight, implementation, and evaluation staff and the original researcher.

Translation of two evidence-based programs for training families to improve care of persons with dementia.

The need for evidence-based non-pharmacological community programs to improve care of older adults with dementia is self-evident, considering the sheer numbers of affected individuals; the emotional, physical, and financial toll on affected individuals and their caregivers; the impact on our health care system; and the growing availability of evidence regarding the potential for psychosocial interventions to enhance care and decrease costs. To address this need, the Administration on Aging has begun funding translation of evidence-based programs into community settings. Two programs, Reducing Disability in Alzheimer's Disease and STAR-Community Consultants (STAR-C), were selected by the Ohio Department of Aging (in collaboration with the Alzheimer's Association Chapters in Ohio) and the Oregon Department of Health Services (in partnership with Area Agencies on Aging and the Oregon Chapter of the Alzheimer's Association) to be implemented by their staff. Both programs are designed to improve care, enhance life quality, and reduce behavioral problems of persons with dementia and have demonstrated efficacy via randomized controlled trials. This article addresses the developmental and ongoing challenges encountered in the translation of these programs to inform other community-based organizations considering the translation of evidence-based programs and to assist researchers in making their work more germane to their community colleagues.