Learning from a multidisciplinary randomized controlled intervention in retirement village residents

Author(s):  
Katherine Bloomfield ◽  
Zhenqiang Wu ◽  
Joanna B. Broad ◽  
Annie Tatton ◽  
Cheryl Calvert ◽  
...  
2019 ◽  
Author(s):  
Martin Joseph Connolly ◽  
Joanna Hikaka ◽  
Katherine Bloomfield ◽  
Joanna Broad ◽  
Zhenqiang Wu ◽  
...  

Abstract Background Retirement Villages (RVs) for older people represent a burgeoning industry. However, we know little about residents’ demographics and health/disability issues - information which could inform health planning, facilitate independence and reduce service demand. RVs are semi-closed communities: access for researchers is most conveniently gained via RV managers. We are studying RV residents in Auckland, New Zealand (NZ) to acquire demographic, health, disability and social data, with a randomized-controlled-trial of a multidisciplinary intervention aimed to reduce adverse outcomes. We here describe recruitment problems we encountered. Methods We planned to approach all RVs in Auckland/Waitemata Districts, with random sampling of residents in each village using unit/apartment lists as the sampling frame. Exclusions: Refusal of/inability to consent (complying with NZ legislation; ACER<65, or person clinicians felt lacked capacity). We planned access via RV managers and contact residents by ‘letter-drop’ then ‘door-knocks’. In ‘small’ RVs (n<60 units), we planned to contact all residents, with random selection in ‘larger’ RVs. Results We approached managers of 53 of the 65 RVs. 38 initially replied positively, of which 34 permitted us to recruit residents, 6 did not reply. Another 9 declined our first approach, of which eight were ‘small’, seven independently-owned. Some managers prohibited ‘letter-drops’ or ‘door-knocks’ at all or without prior residents’ meetings to assess acceptance of this methodology. Hence, we had to recruit volunteers (in 23 villages) via residents’ meetings, posters/newsletters and word-of-mouth. We recruited 578 residents from 33 villages (one village had no volunteers) (median age=82yrs; 420 female; 217 sampled, 361 volunteers). Conclusions Due to organizational/managers’ policy, and the fact that NZ legislation did not allow recruitment of residents without legal capacity to consent, our sample does not fully represent our RV population. Future RV research should consider alternative recruitment strategies e.g. random sampling from national census, electoral roll, or via residents’ organizations.


2019 ◽  
Author(s):  
Martin Joseph Connolly ◽  
Joanna Hikaka ◽  
Katherine Bloomfield ◽  
Joanna Broad ◽  
Zhenqiang Wu ◽  
...  

Abstract Background Retirement Villages (RVs) for older people represent a burgeoning industry. However, we know little about residents’ demographics and health/disability issues - information which could inform health planning, facilitate independence and reduce service demand. RVs are semi-closed communities: access for researchers is most conveniently gained via RV managers. We are studying RV residents in Auckland, New Zealand (NZ) to acquire demographic, health, disability and social data, with a randomized-controlled-trial of a multidisciplinary intervention aimed to reduce adverse outcomes. We here describe recruitment problems we encountered. Methods We planned to approach all RVs in Auckland/Waitemata Districts, with random sampling of residents in each village using unit/apartment lists as the sampling frame. Exclusions: Refusal of/inability to consent (complying with NZ legislation; ACER<65, or person clinicians felt lacked capacity). We planned access via RV managers and contact residents by ‘letter-drop’ then ‘door-knocks’. In ‘small’ RVs (n<60 units), we planned to contact all residents, with random selection in ‘larger’ RVs. Results We approached managers of 53 of the 65 RVs. 38 initially replied positively, of which 34 permitted us to recruit residents, 6 did not reply. Another 9 declined our first approach, of which eight were ‘small’, seven independently-owned. Some managers prohibited ‘letter-drops’ or ‘door-knocks’ at all or without prior residents’ meetings to assess acceptance of this methodology. Hence, we had to recruit volunteers (in 23 villages) via residents’ meetings, posters/newsletters and word-of-mouth. We recruited 578 residents from 33 villages (one village had no volunteers) (median age=82yrs; 420 female; 217 sampled, 361 volunteers). Conclusions Due to organizational/managers’ policy, and the fact that NZ legislation did not allow recruitment of residents without legal capacity to consent, our sample does not fully represent our RV population. Future RV research should consider alternative recruitment strategies e.g. random sampling from national census, electoral roll, or via residents’ organizations.


2019 ◽  
Author(s):  
Martin Joseph Connolly ◽  
Joanna Hikaka ◽  
Katherine Bloomfield ◽  
Joanna Broad ◽  
Zhenqiang Wu ◽  
...  

Abstract Background Retirement Villages (RVs) for older people represent a burgeoning industry. However, we know little about residents’ demographics and health/disability issues - information which could inform health planning, facilitate independence and reduce service demand. RVs are semi-closed communities: access for researchers is most conveniently gained via RV managers. We are studying RV residents in Auckland, New Zealand (NZ) to acquire demographic, health, disability and social data, with a randomized-controlled-trial of a multidisciplinary intervention aimed to reduce adverse outcomes. We here describe recruitment problems we encountered. Methods We planned to approach all RVs in Auckland/Waitemata Districts, with random sampling of residents in each village using unit/apartment lists as the sampling frame. Exclusions: Refusal of/inability to consent (complying with NZ legislation; ACER<65, or person clinicians felt lacked capacity). We planned access via RV managers and contact residents by ‘letter-drop’ then ‘door-knocks’. In ‘small’ RVs (n<60 units), we planned to contact all residents, with random selection in ‘larger’ RVs. Results We approached managers of 53 of the 65 RVs. 38 initially replied positively, of which 34 permitted us to recruit residents, 6 did not reply. Another 9 declined our first approach, of which eight were ‘small’, seven independently-owned. Some managers prohibited ‘letter-drops’ or ‘door-knocks’ at all or without prior residents’ meetings to assess acceptance of this methodology. Hence, we had to recruit volunteers (in 23 villages) via residents’ meetings, posters/newsletters and word-of-mouth. We recruited 578 residents from 33 villages (one village had no volunteers) (median age=82yrs; 420 female; 217 sampled, 361 volunteers). Conclusions Due to organizational/managers’ policy, and the fact that NZ legislation did not allow recruitment of residents without legal capacity to consent, our sample does not fully represent our RV population. Future RV research should consider alternative recruitment strategies e.g. random sampling from national census, electoral roll, or via residents’ organizations.


2020 ◽  
Vol 29 (1S) ◽  
pp. 412-424
Author(s):  
Elissa L. Conlon ◽  
Emily J. Braun ◽  
Edna M. Babbitt ◽  
Leora R. Cherney

Purpose This study reports on the treatment fidelity procedures implemented during a 5-year randomized controlled trial comparing intensive and distributed comprehensive aphasia therapy. Specifically, the results of 1 treatment, verb network strengthening treatment (VNeST), are examined. Method Eight participants were recruited for each of 7 consecutive cohorts for a total of 56 participants. Participants completed 60 hr of aphasia therapy, including 15 hr of VNeST. Two experienced speech-language pathologists delivered the treatment. To promote treatment fidelity, the study team developed a detailed manual of procedures and fidelity checklists, completed role plays to standardize treatment administration, and video-recorded all treatment sessions for review. To assess protocol adherence during treatment delivery, trained research assistants not involved in the treatment reviewed video recordings of a subset of randomly selected VNeST treatment sessions and completed the fidelity checklists. This process was completed for 32 participants representing 2 early cohorts and 2 later cohorts, which allowed for measurement of protocol adherence over time. Percent accuracy of protocol adherence was calculated across clinicians, cohorts, and study condition (intensive vs. distributed therapy). Results The fidelity procedures were sufficient to promote and verify a high level of adherence to the treatment protocol across clinicians, cohorts, and study condition. Conclusion Treatment fidelity strategies and monitoring are feasible when incorporated into the study design. Treatment fidelity monitoring should be completed at regular intervals during the course of a study to ensure that high levels of protocol adherence are maintained over time and across conditions.


2019 ◽  
Vol 62 (12) ◽  
pp. 4464-4482 ◽  
Author(s):  
Diane L. Kendall ◽  
Megan Oelke Moldestad ◽  
Wesley Allen ◽  
Janaki Torrence ◽  
Stephen E. Nadeau

Purpose The ultimate goal of anomia treatment should be to achieve gains in exemplars trained in the therapy session, as well as generalization to untrained exemplars and contexts. The purpose of this study was to test the efficacy of phonomotor treatment, a treatment focusing on enhancement of phonological sequence knowledge, against semantic feature analysis (SFA), a lexical-semantic therapy that focuses on enhancement of semantic knowledge and is well known and commonly used to treat anomia in aphasia. Method In a between-groups randomized controlled trial, 58 persons with aphasia characterized by anomia and phonological dysfunction were randomized to receive 56–60 hr of intensively delivered treatment over 6 weeks with testing pretreatment, posttreatment, and 3 months posttreatment termination. Results There was no significant between-groups difference on the primary outcome measure (untrained nouns phonologically and semantically unrelated to each treatment) at 3 months posttreatment. Significant within-group immediately posttreatment acquisition effects for confrontation naming and response latency were observed for both groups. Treatment-specific generalization effects for confrontation naming were observed for both groups immediately and 3 months posttreatment; a significant decrease in response latency was observed at both time points for the SFA group only. Finally, significant within-group differences on the Comprehensive Aphasia Test–Disability Questionnaire ( Swinburn, Porter, & Howard, 2004 ) were observed both immediately and 3 months posttreatment for the SFA group, and significant within-group differences on the Functional Outcome Questionnaire ( Glueckauf et al., 2003 ) were found for both treatment groups 3 months posttreatment. Discussion Our results are consistent with those of prior studies that have shown that SFA treatment and phonomotor treatment generalize to untrained words that share features (semantic or phonological sequence, respectively) with the training set. However, they show that there is no significant generalization to untrained words that do not share semantic features or phonological sequence features.


2001 ◽  
Vol 26 (1) ◽  
pp. 67-71 ◽  
Author(s):  
S. A. Ahmadi-Abhari ◽  
S. Akhondzadeh ◽  
S. M. Assadi ◽  
O. L. Shabestari ◽  
Z. M. Farzanehgan ◽  
...  

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