A process evaluation of the NIDUS-Professional dementia training intervention for UK homecare workers

Daniel Kelleher; Karen Windle; Rebecca Randell; Kathryn Lord; Larisa Duffy; Amirah Akhtar; Jessica Budgett; Sedigheh Zabihi; Sara Banks; Penny Rapaport; Teresa Lee; Julie Barber; Vasiliki Orgeta; Jill Manthorpe; Kate Walters; Kenneth Rockwood; Briony Dow; Juanita Hoe; Sube Banerjee; Claudia Cooper

doi:10.1093/ageing/afae109

A process evaluation of the NIDUS-Professional dementia training intervention for UK homecare workers

Daniel Kelleher
, Karen Windle
, Rebecca Randell
, Kathryn Lord
, Larisa Duffy
, Amirah Akhtar
, Jessica Budgett
, Sedigheh Zabihi
, Sara Banks
, Penny Rapaport
, Teresa Lee
, Julie Barber
, Vasiliki Orgeta
, Jill Manthorpe
, Kate Walters
, Kenneth Rockwood
, Briony Dow
, Juanita Hoe
, Sube Banerjee
, Claudia Cooper

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

21 Downloads (Pure)

Abstract

INTRODUCTION: This process evaluation was conducted in parallel to the randomised controlled feasibility trial of NIDUS-Professional, a manualised remote dementia training intervention for homecare workers (HCWs), delivered alongside an individualised intervention for clients living with dementia and their family carers (NIDUS-Family). The process evaluation reports on: (i) intervention reach, dose and fidelity; (ii) contexts influencing agency engagement and (iii) alignment of findings with theoretical assumptions about how the intervention might produce change.

METHODS: We report proportions of eligible HCWs receiving any intervention (reach), number of sessions attended (dose; attending ≥4/6 main sessions was predefined as adhering), intervention fidelity and adherence of clients and carers to NIDUS-Family (attending all 6-8 planned sessions). We interviewed HCWs, managers, family carers and facilitators. We integrated and thematically analysed, at the homecare agency level, qualitative interview and intervention recording data.

RESULTS: 32/141 (23%) of eligible HCWs and 7/42 (17%) of family carers received any intervention; most who did adhered to the intervention (89% and 71%). Intervention fidelity was high. We analysed interviews with 20/44 HCWs, 3/4 managers and 3/7 family carers, as well as intervention recordings involving 32/44 HCWs. All agencies reported structural challenges in supporting intervention delivery. Agencies with greater management buy-in had higher dose and reach. HCWs valued NIDUS-Professional for enabling group reflection and peer support, providing practical, actionable care strategies and increasing their confidence as practitioners.

CONCLUSION: NIDUS-Professional was valued by HCWs. Agency management, culture and priorities were key barriers to implementation; we discuss how to address these in a future trial.

Original language	English
Article number	afae109
Pages (from-to)	1-11
Number of pages	11
Journal	Age and Ageing
Volume	53
Issue number	5
Early online date	25 May 2024
DOIs	https://doi.org/10.1093/ageing/afae109
Publication status	Published (in print/issue) - 25 May 2025

Bibliographical note

Funding

This work was supported by the Alzheimer’s Society (Centre of Excellence grant 330). C.C.’s time is supported by the Dementia and Neurodegenerative Disease Policy Research Unit-Queen Mary (NIHR206110) and an NIHR Senior Investigator Award (NIHR205009). S.B.’s time is supported by the Dementia and Neurodegenerative Disease Policy Research Unit-Queen Mary (NIHR206110) and an NIHR Senior Investigator Award. The views expressed in this publication are those of the authors and not necessarily those of the 9. Downloaded from https://academic.oup.com/ageing/article/53/5/afae109/7682290 by guest on 20 July 2025 D. Kelleher et al. National Institute for Health and Care Research or the Department of Health and Social Care. K.W.’s time as PhD supervisor was supported by the Centre for Applied Dementia Studies at the University of Bradford.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Humans
Dementia/therapy
Caregivers/education
Home Health Aides/education
Home Care Services
Male
Female
Health Knowledge, Attitudes, Practice
United Kingdom
Process Assessment, Health Care
Middle Aged
Attitude of Health Personnel
Interviews as Topic

Access to Document

10.1093/ageing/afae109Licence: CC BY

afae109Final published version, 0.98 MBLicence: CC BY

Cite this

Kelleher, D., Windle, K., Randell, R., Lord, K., Duffy, L., Akhtar, A., Budgett, J., Zabihi, S., Banks, S., Rapaport, P., Lee, T., Barber, J., Orgeta, V., Manthorpe, J., Walters, K., Rockwood, K., Dow, B., Hoe, J., Banerjee, S., & Cooper, C. (2025). A process evaluation of the NIDUS-Professional dementia training intervention for UK homecare workers. Age and Ageing, 53(5), 1-11. Article afae109. https://doi.org/10.1093/ageing/afae109

@article{589d917f5eca445591f3d3ad9cb8a92b,

title = "A process evaluation of the NIDUS-Professional dementia training intervention for UK homecare workers",

abstract = "INTRODUCTION: This process evaluation was conducted in parallel to the randomised controlled feasibility trial of NIDUS-Professional, a manualised remote dementia training intervention for homecare workers (HCWs), delivered alongside an individualised intervention for clients living with dementia and their family carers (NIDUS-Family). The process evaluation reports on: (i) intervention reach, dose and fidelity; (ii) contexts influencing agency engagement and (iii) alignment of findings with theoretical assumptions about how the intervention might produce change.METHODS: We report proportions of eligible HCWs receiving any intervention (reach), number of sessions attended (dose; attending ≥4/6 main sessions was predefined as adhering), intervention fidelity and adherence of clients and carers to NIDUS-Family (attending all 6-8 planned sessions). We interviewed HCWs, managers, family carers and facilitators. We integrated and thematically analysed, at the homecare agency level, qualitative interview and intervention recording data.RESULTS: 32/141 (23\%) of eligible HCWs and 7/42 (17\%) of family carers received any intervention; most who did adhered to the intervention (89\% and 71\%). Intervention fidelity was high. We analysed interviews with 20/44 HCWs, 3/4 managers and 3/7 family carers, as well as intervention recordings involving 32/44 HCWs. All agencies reported structural challenges in supporting intervention delivery. Agencies with greater management buy-in had higher dose and reach. HCWs valued NIDUS-Professional for enabling group reflection and peer support, providing practical, actionable care strategies and increasing their confidence as practitioners.CONCLUSION: NIDUS-Professional was valued by HCWs. Agency management, culture and priorities were key barriers to implementation; we discuss how to address these in a future trial.",

keywords = "Humans, Dementia/therapy, Caregivers/education, Home Health Aides/education, Home Care Services, Male, Female, Health Knowledge, Attitudes, Practice, United Kingdom, Process Assessment, Health Care, Middle Aged, Attitude of Health Personnel, Interviews as Topic",

author = "Daniel Kelleher and Karen Windle and Rebecca Randell and Kathryn Lord and Larisa Duffy and Amirah Akhtar and Jessica Budgett and Sedigheh Zabihi and Sara Banks and Penny Rapaport and Teresa Lee and Julie Barber and Vasiliki Orgeta and Jill Manthorpe and Kate Walters and Kenneth Rockwood and Briony Dow and Juanita Hoe and Sube Banerjee and Claudia Cooper",

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year = "2025",

month = may,

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doi = "10.1093/ageing/afae109",

language = "English",

volume = "53",

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Kelleher, D, Windle, K, Randell, R, Lord, K, Duffy, L, Akhtar, A, Budgett, J, Zabihi, S, Banks, S, Rapaport, P, Lee, T, Barber, J, Orgeta, V, Manthorpe, J, Walters, K, Rockwood, K, Dow, B, Hoe, J, Banerjee, S & Cooper, C 2025, 'A process evaluation of the NIDUS-Professional dementia training intervention for UK homecare workers', Age and Ageing, vol. 53, no. 5, afae109, pp. 1-11. https://doi.org/10.1093/ageing/afae109

TY - JOUR

T1 - A process evaluation of the NIDUS-Professional dementia training intervention for UK homecare workers

AU - Kelleher, Daniel

AU - Windle, Karen

AU - Randell, Rebecca

AU - Lord, Kathryn

AU - Duffy, Larisa

AU - Akhtar, Amirah

AU - Budgett, Jessica

AU - Zabihi, Sedigheh

AU - Banks, Sara

AU - Rapaport, Penny

AU - Lee, Teresa

AU - Barber, Julie

AU - Orgeta, Vasiliki

AU - Manthorpe, Jill

AU - Walters, Kate

AU - Rockwood, Kenneth

AU - Dow, Briony

AU - Hoe, Juanita

AU - Banerjee, Sube

AU - Cooper, Claudia

PY - 2025/5/25

Y1 - 2025/5/25

N2 - INTRODUCTION: This process evaluation was conducted in parallel to the randomised controlled feasibility trial of NIDUS-Professional, a manualised remote dementia training intervention for homecare workers (HCWs), delivered alongside an individualised intervention for clients living with dementia and their family carers (NIDUS-Family). The process evaluation reports on: (i) intervention reach, dose and fidelity; (ii) contexts influencing agency engagement and (iii) alignment of findings with theoretical assumptions about how the intervention might produce change.METHODS: We report proportions of eligible HCWs receiving any intervention (reach), number of sessions attended (dose; attending ≥4/6 main sessions was predefined as adhering), intervention fidelity and adherence of clients and carers to NIDUS-Family (attending all 6-8 planned sessions). We interviewed HCWs, managers, family carers and facilitators. We integrated and thematically analysed, at the homecare agency level, qualitative interview and intervention recording data.RESULTS: 32/141 (23%) of eligible HCWs and 7/42 (17%) of family carers received any intervention; most who did adhered to the intervention (89% and 71%). Intervention fidelity was high. We analysed interviews with 20/44 HCWs, 3/4 managers and 3/7 family carers, as well as intervention recordings involving 32/44 HCWs. All agencies reported structural challenges in supporting intervention delivery. Agencies with greater management buy-in had higher dose and reach. HCWs valued NIDUS-Professional for enabling group reflection and peer support, providing practical, actionable care strategies and increasing their confidence as practitioners.CONCLUSION: NIDUS-Professional was valued by HCWs. Agency management, culture and priorities were key barriers to implementation; we discuss how to address these in a future trial.

AB - INTRODUCTION: This process evaluation was conducted in parallel to the randomised controlled feasibility trial of NIDUS-Professional, a manualised remote dementia training intervention for homecare workers (HCWs), delivered alongside an individualised intervention for clients living with dementia and their family carers (NIDUS-Family). The process evaluation reports on: (i) intervention reach, dose and fidelity; (ii) contexts influencing agency engagement and (iii) alignment of findings with theoretical assumptions about how the intervention might produce change.METHODS: We report proportions of eligible HCWs receiving any intervention (reach), number of sessions attended (dose; attending ≥4/6 main sessions was predefined as adhering), intervention fidelity and adherence of clients and carers to NIDUS-Family (attending all 6-8 planned sessions). We interviewed HCWs, managers, family carers and facilitators. We integrated and thematically analysed, at the homecare agency level, qualitative interview and intervention recording data.RESULTS: 32/141 (23%) of eligible HCWs and 7/42 (17%) of family carers received any intervention; most who did adhered to the intervention (89% and 71%). Intervention fidelity was high. We analysed interviews with 20/44 HCWs, 3/4 managers and 3/7 family carers, as well as intervention recordings involving 32/44 HCWs. All agencies reported structural challenges in supporting intervention delivery. Agencies with greater management buy-in had higher dose and reach. HCWs valued NIDUS-Professional for enabling group reflection and peer support, providing practical, actionable care strategies and increasing their confidence as practitioners.CONCLUSION: NIDUS-Professional was valued by HCWs. Agency management, culture and priorities were key barriers to implementation; we discuss how to address these in a future trial.

KW - Humans

KW - Dementia/therapy

KW - Caregivers/education

KW - Home Health Aides/education

KW - Home Care Services

KW - Male

KW - Female

KW - Health Knowledge, Attitudes, Practice

KW - United Kingdom

KW - Process Assessment, Health Care

KW - Middle Aged

KW - Attitude of Health Personnel

KW - Interviews as Topic

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DO - 10.1093/ageing/afae109

M3 - Article

C2 - 38796316

SN - 0002-0729

VL - 53

SP - 1

EP - 11

JO - Age and Ageing

JF - Age and Ageing

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M1 - afae109

ER -

A process evaluation of the NIDUS-Professional dementia training intervention for UK homecare workers

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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Cite this