AgingNCT06239688
Evaluating a National Person-Centered Training Program to Strengthen the Dementia Care Workforce
A study testing essentiALZ and Project ECHO in people with Aging and Knowledge, Attitudes, Practice, run by University of North Carolina, Chapel Hill at 1 site in United States.
Trial summary
This project will compare two training models of an evidence-based online dementia care training program for direct care staff in assisted living to a waitlist control: 1) essentiALZ training and 2) essentiALZ training + Project ECHO. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Aging, Knowledge, Attitudes, Practice, Long-Term Care
- What is being tested?
- essentiALZ and Project ECHO
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,764 participants
- Where
- 1 siteUnited States
- Study dates
- 12 Apr 2024to 30 Apr 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- AL Staff:
- Staff (part-time, full-time, and including contract staff) who provide direct care to residents at the participating assisted living community (e.g., certified nursing assistants, personal care aides, registered nurses, licensed practical nurses, activity directors, social workers, and others) as determined by the administrator/health care supervisor
- Are 18 years of age or older
- Are able to read and speak English fluently
- Family:
- Resident not expected to die or be transferred in the next six months at baseline
Show all 11Show fewer
- At follow-up, resident lived in AL community at least one month during the three months prior to interview date
- Are a family member/legally authorized representative (LAR), or designated contact of a resident with Alzheimer's disease and related dementia (ADRD) of a participating AL community
- Are 18 years of age or older
- Are English speaking
- Visit the resident at least monthly
Who cannot join
- AL Staff \& Family:
- Are under 18 years of age
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, 27599
Johanna Hickey, MSW, 919-843-3085, jvtsilbersack@unc.edu
Sheryl Zimmerman, PhD
About this study
This project will compare two training models of an evidence-based online dementia care training program for direct care staff in assisted living to a waitlist control: 1) essentiALZ training and 2) essentiALZ training + Project ECHO. It will examine the extent to which each model is implemented and achieves its intended outcomes to improve staff knowledge and attitudes, change care practices, and improve the wellbeing of staff, residents, and residents' family members. Results will inform next steps in dementia care training for the assisted living (AL) and broader long-term care workforce.
To examine these outcomes, data will be collected from AL staff and families over the course of 6 months. Staff will complete questionnaires and participate in interviews (as applicable) at baseline, post-training, 3-months, and 6-months. Families will participate in interviews at baseline, 3-months, and 6-months.
Read the detailed description
More than 75% of persons living with Alzheimer's disease and related dementias who reach 80 years of age require residential long-term care, which is increasingly provided in assisted living (AL). Across the country, almost 29,000 AL communities with more than 996,000 beds have become the primary residential care provider for persons with dementia: 90% of AL residents have cognitive impairment and 42% have recorded moderate or severe dementia, with actual rates being higher. AL provides supportive but not nursing services; consequently, virtually all care is provided by direct care workers (nursing assistants and personal care aides).
Unfortunately, direct care workers are undervalued and under-trained, leading to poor care, workplace injury, dissatisfaction, and high turnover. AL is state-regulated, and only 17 states stipulate minimum training hours (some being as low as one hour), meaning that two-thirds of states are silent on training. Fewer than 40% of staff have education beyond high school, and so it is not surprising that a minority report sufficient knowledge to care for persons with dementia. In striving to fill this gap, training for direct care workers must be accessible and have efficacy in benefitting the staff, organization, and persons with dementia.
Online training is an especially promising option due to its low cost, wide availability, and potential for self pacing, automated skills tests, and certification. The Alzheimer's Association is the national leader in dementia care training, and in 2021 developed essentiALZ (pronounced "essentials"), an online program teaching evidence-based, person-centered care, which can be accessed from a computer, tablet, or mobile device. Already more than 1,500 staff have essentiALZ certification, but as is true of the majority of training programs, evidence as to its ability to improve care and outcomes is lacking. It is possible that essentiALZ is effective in changing care and outcomes, but it may also be that additional supports are necessary to do so. A timely model of support is Project ECHO, which has flooded the field of long-term care as a proven way to provide expert guidance and peer support via a remote, online approach. Adding ECHO to online dementia training might provide a necessary boost to achieve care change and improved outcomes.
The project responds to the National Institute on Aging Notice of Special Interest that calls for strengthening the workforce through enhancing and supporting skills training. It will conduct a hybrid implementation/effectiveness randomized trial in 126 AL communities, comparing essentiALZ alone, essentiALZ + ECHO enhancement, and a waitlist control. Outcomes grounded in the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model and the Kirkpatrick training effectiveness model will be examined over six months, comparing the arms in terms of (1) implementation and (2) effectiveness, and (3) examining the extent to which implementation and effectiveness differ based on characteristics of the AL community, staff, residents, and family members. Results will inform next steps in dementia care training for the AL and broader long-term care workforce.
- Conditions
- Aging, Knowledge, Attitudes, Practice, Long-Term Care, Dementia
- Being tested
- essentiALZ, Project ECHO
- Keywords
- Workplace Training
- Medical subject headings
- Behavior, Dementia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
essentiALZBehavioural
essentiALZ is a web-based training that contains three hours of self-paced content separated into five modules, plus a final review. Modules include: 1) Alzheimer's disease and dementia; 2) person-centered care; 3) assessment and care planning; 4) activities of daily living; and 5) behaviors and communication. Staff will be encouraged to take the training over the course of four weeks.
Project ECHOBehavioural
ECHO is a virtual tele-mentoring model grounded in case-based learning. It includes six weekly one-hour sessions of didactic and discussive learning. The first five sessions will reflect the content of the five essentiALZ modules, and the final session will address maintenance. ECHO sessions are group sessions that will be conducted via Zoom.
| Study group | Role | What they receive |
|---|---|---|
| essentiALZ | Experimental | Communities randomized to this arm will receive the essentiALZ training: a web-based training taken by AL staff that contains three hours of self-paced content separated into five modules, plus a final review. Modules include: 1) Alzheimer's disease and dementia; 2) person-centered care; 3) assessment and care planning; 4) activities of daily living; and 5) behaviors and communication. Staff will be encouraged to take the training over the course of four weeks. Receives: Behavioral: essentiALZ |
| essentiALZ + ECHO | Experimental | Communities randomized to this arm will receive the essentiALZ training: a web-based training taken by AL staff that contains three hours of self-paced content separated into five modules, plus a final review. Modules include: 1) Alzheimer's disease and dementia; 2) person-centered care; 3) assessment and care planning; 4) activities of daily living; and 5) behaviors and communication. Staff will be encouraged to take the training over the course of four weeks. Additionally, they will receive access to Project ECHO. ECHO is a virtual tele-mentoring model grounded in case-based learning. It includes six weekly one-hour sessions of didactic and discussive learning. The first five sessions will reflect the content of the five essentiALZ modules, and the final session will address maintenance. ECHO sessions are group sessions that will be conducted via Zoom. Receives: Behavioral: essentiALZ; Behavioral: Project ECHO |
| No Intervention | No intervention | Standard care will be provided. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Score Over Time of Sense of Competence in Dementia Care (SCIDS)
Sense of Competence in Dementia Care (SCIDS) is a 17-item instrument. Responses are indicated using a 4-point Likert scale. Minimum score (worst value) = 1. Maximum score (best value) = 4. Higher values represent a better outcome (range 17-68). Measure is assessed at Baseline Questionnaire, a 3-month Follow Up Questionnaire and at a 6-month Follow Up Questionnaire.
Measured: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Change in Score Over Time of Staff Experience of Working with Residents with Dementia Questionnaire - Care Organization, Satisfactory Contact with the Patient, and Satisfaction with the Expectations of Others Subscales (SEWDRQ)
Staff Experience of Working with Residents with Dementia Questionnaire - Care Organization, Satisfactory Contact with the Patient, and Satisfaction with the Expectations of Others Subscales (SEWDRQ) is a 9-item instrument. Responses are indicated using a 5-point Likert scale. Minimum score (worst value) = 0. Maximum score (best value) = 4. Higher values represent a better outcome (range 0-36). Measure is assessed at Baseline Questionnaire, a 3-month Follow Up Questionnaire and at a 6-month Follow Up Questionnaire.
Measured: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Change in Score Over Time of Dementia Attitude Scale - Short Form (DAS-6)
Dementia Attitudes Scale (Short-Form) is a 6-item instrument. Responses are indicated using a 7-point Likert scale. Minimum score (worst value) = 1. Maximum score (best value) = 7. Higher values represent a better outcome (range 6-42). Measure is assessed at Baseline Questionnaire, a 3-month Follow Up Questionnaire and at a 6-month Follow Up Questionnaire.
Measured: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Secondary outcomes (5)
Change in Score Over Time of essentiALZ exam items
essentiALZ exam items is a 5-item instrument. Instrument is a measure of knowledge on the subject of the intervention training. Responses are multiple choice, with only one answer per question considered 'correct'. Higher values of correct responses represent a better outcome/retention of knowledge (range 0-5). Measure is assessed at Baseline Questionnaire, Post-Training Questionnaire, a 3-month Follow Up Questionnaire and at a 6-month Follow Up Questionnaire.
Measured: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Change in Score Over Time of essentiALZ organizational practices
essentiALZ exam items is a 5-item instrument. Instrument is a measure of knowledge on the subject of the intervention training. Responses are multiple choice, with only one answer per question considered 'correct'. Higher values of correct responses represent a better outcome/retention of knowledge (range 0-5). Measure is assessed at Baseline Questionnaire, a 3-month Follow Up Questionnaire and at a 6-month Follow Up Questionnaire.
Measured: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Change in Score Over Time of Emotional Burnout
The researchers will assess intent to leave job by asking "Overall, based on your definition of burnout, how would you rate your level of burnout? Select one." Response options are: "1 = I enjoy my work. I have no symptoms of burnout.", "2 = Occasionally I am under stress, and I don't always have as much energy as I once did, but I don't feel burned out.", "3 - I am definitely burning out and have one or more symptoms of burnout, such as physical and emotional exhaustion.", "4 = The symptoms of burnout that I'm experiencing won't go away. I think about frustration at work a lot.", "5 = I feel completely burned out and often wonder if I can go on. I am at the point where I may need some changes or may need to seek some sort of help." Minimum = 1 (best value), maximum = 5 (worst value). Measure is assessed at Baseline Questionnaire, a 3-month Follow Up Questionnaire and at a 6-month Follow Up Questionnaire.
Measured: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Change in Score Over Time of Intention to Leave
The researchers will assess intent to leave job by asking "How likely is it that you will leave this job in the next year? "Would you say... 1 is Not at All Likely, 2 is Somewhat Likely, 3 is Very Likely." Minimum = 1 (best value), maximum = 3 (worst value). Measure is assessed at Baseline Questionnaire, a 3-month Follow Up Questionnaire and at a 6-month Follow Up Questionnaire.
Measured: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Change in Score Over Time of Feeling Valued
essentiALZ exam items is a 5-item instrument. Instrument is a measure of knowledge on the subject of the intervention training. Responses are multiple choice, with only one answer per question considered 'correct'. Higher values of correct responses represent a better outcome/retention of knowledge (range 0-5). Measure is assessed at Baseline Questionnaire, a 3-month Follow Up Questionnaire and at a 6-month Follow Up Questionnaire.
Measured: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Feb 2024
- Study start12 Apr 2024
- Primary completion30 Apr 2027 (estimated)
- Study completion30 Apr 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (152)Papers the sponsor has linked to this study.
- Other trials for AgingStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Investigator
- Enrolment
- 1,764 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of North Carolina, Chapel Hill
- Sponsor type
- University, hospital or other
- Collaborators
- Alzheimer's Association, National Institute on Aging (NIA)
- Responsible party
- Sponsor
- Investigators
- Sheryl Zimmerman, PhD, Principal investigator, University of North Carolina, Chapel Hill
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06239688
- Sponsor's protocol ID
- 23-1643
- Other IDs
- R01AG079124
- Status last verified
- Apr 2026
- First submitted
- 24 Jan 2024
- Last updated
- 13 Apr 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: A de-identified computerized dataset will be available for the use of other researchers. The de-identification of the dataset will follow IRB guidance. Select data will be transformed as appropriate (e.g., items in a scale that were reverse coded will be transformed), and scales will be developed from individual items where indicated (maintaining the individual items). The de-identified dataset will be shared in excel or CSV format and will include a codebook for use. Similarly, all data collection instruments will be made available. No specialized tools or software will be necessary to access or use the data. The project coordinator and/or senior analyst will work with potential users for procedures to share the dataset using secure methods informed by Cecil G. Sheps Center for Health Services Data Analytics and Information Technology Department.
Publications
Alzheimer's Disease International. Dementia: A Public Health Priority. Geneva, Switzerland: World Health Organization; 2015.
Alzheimer's Association. Alzheimer's Impact Movement March 2018. Costs of Alzheimer's to Medicare and Medicaid. http://act.alz.org/site/DocServer/2012_Costs_Fact_Sheet_version_2.pdf?docID=7161. Accessed October 30, 2021.
Langa KM, Larson EB, Crimmins EM, Faul JD, Levine DA, Kabeto MU, Weir DR. A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012. JAMA Intern Med. 2017 Jan 1;177(1):51-58. doi: 10.1001/jamainternmed.2016.6807.
PubMed 27893041Friedman EM, Shih RA, Langa KM, Hurd MD. US Prevalence And Predictors Of Informal Caregiving For Dementia. Health Aff (Millwood). 2015 Oct;34(10):1637-41. doi: 10.1377/hlthaff.2015.0510.
PubMed 26438738Arrighi HM, Neumann PJ, Lieberburg IM, Townsend RJ. Lethality of Alzheimer disease and its impact on nursing home placement. Alzheimer Dis Assoc Disord. 2010 Jan-Mar;24(1):90-5. doi: 10.1097/WAD.0b013e31819fe7d1.
PubMed 19568155Zimmerman S, Gruber-Baldini AL, Sloane PD, Eckert JK, Hebel JR, Morgan LA, Stearns SC, Wildfire J, Magaziner J, Chen C, Konrad TR. Assisted living and nursing homes: apples and oranges? Gerontologist. 2003 Apr;43 Spec No 2:107-17. doi: 10.1093/geront/43.suppl_2.107.
PubMed 12711731Zimmerman S, Love K, Cohen LW, Pinkowitz J, Nyrop KA. Person-Centeredness in Home- and Community-Based Services and Supports: Domains, Attributes, and Assisted Living Indicators. Clin Gerontol. 2014;37(5):429-445. doi: 10.1080/07317115.2014.937548. Epub 2014 Jun 30.
PubMed 29033493Smith M, Buckwalter KC, Kang H, Ellingrod V, Schultz SK. Dementia care in assisted living: needs and challenges. Issues Ment Health Nurs. 2008 Aug;29(8):817-38. doi: 10.1080/01612840802182839.
PubMed 18649209Harris-Kojetin L, Sengupta M, Lendon JP, et al. Long-term care providers and services users in the United States, 2015-2016. National Center for Health Statistics. Vital Health Stat. 2019;3(43). https://www.cdc.gov/nchs/data/series/sr_03/sr03_43-508.pdf. Accessed October 30, 2021.
Harrington C, Chapman S, Miller E, et al. Trends in the supply of long-term-care facilities and beds in the United States. J Appl Gerontol 2005;24(4):265-282.
Paraprofessional Healthcare Institute. Caring for the Future: The Power and Potential of America's Direct Care Workforce. 2021. http://phinational.org/resource/caring-for-the-future-the-power-andpotential-of-americas-direct-care-workforce/. Accessed October 30, 2021.
Han K, Trinkoff AM, Storr CL, Lerner N, Yang BK. Variation Across U.S. Assisted Living Facilities: Admissions, Resident Care Needs, and Staffing. J Nurs Scholarsh. 2017 Jan;49(1):24-32. doi: 10.1111/jnu.12262. Epub 2016 Nov 10.
PubMed 27860170Zimmerman S, Sloane PD, Williams CS, Dobbs D, Ellajosyula R, Braaten A, Rupnow MF, Kaufer DI. Residential care/assisted living staff may detect undiagnosed dementia using the minimum data set cognition scale. J Am Geriatr Soc. 2007 Sep;55(9):1349-55. doi: 10.1111/j.1532-5415.2007.01289.x.
PubMed 17767676Rosenblatt A, Samus QM, Steele CD, Baker AS, Harper MG, Brandt J, Rabins PV, Lyketsos CG. The Maryland Assisted Living Study: prevalence, recognition, and treatment of dementia and other psychiatric disorders in the assisted living population of central Maryland. J Am Geriatr Soc. 2004 Oct;52(10):1618-25. doi: 10.1111/j.1532-5415.2004.52452.x.
PubMed 15450036National Center for Assisted Living. Assisted Living: A Growing Aspect of Long-Term Care. https://www.ahcancal.org/Advocacy/IssueBriefs/NCAL_Factsheet_2019.pdf. Accessed October 30, 2021.
Study at a glance
From the registry record, last updated by the sponsor on 13 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluating a National Person-Centered Training Program to Strengthen the Dementia Care Workforce
- ClinicalTrials.gov ID
- NCT06239688
- Acronym / sponsor ID
- 23-1643
- Conditions
- Aging, Knowledge, Attitudes, Practice, Long-Term Care, Dementia
- Keywords
- Workplace Training
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 1,764 participants (estimated)
- Lead sponsor
- University of North Carolina, Chapel HillUniversity, hospital or other
- Collaborators
- Alzheimer's Association, National Institute on Aging (NIA)
- Study start
- 12 Apr 2024 (actual)
- Primary completion
- 30 Apr 2027 (estimated)
- Study completion
- 30 Apr 2027 (estimated)
- First posted
- 2 Feb 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This project will compare two training models of an evidence-based online dementia care training program for direct care staff in assisted living to a waitlist control: 1) essentiALZ training and 2) essentiALZ training + Project ECHO. It will examine the extent to which each model is implemented and achieves its intended outcomes to improve staff knowledge and attitudes, change care practices, and improve the wellbeing of staff, residents, and residents' family members. Results will inform next steps in dementia care training for the assisted living (AL) and broader long-term care workforce.
To examine these outcomes, data will be collected from AL staff and families over the course of 6 months. Staff will complete questionnaires and participate in interviews (as applicable) at baseline, post-training, 3-months, and 6-months. Families will participate in interviews at baseline, 3-months, and 6-months.
Detailed description
More than 75% of persons living with Alzheimer's disease and related dementias who reach 80 years of age require residential long-term care, which is increasingly provided in assisted living (AL). Across the country, almost 29,000 AL communities with more than 996,000 beds have become the primary residential care provider for persons with dementia: 90% of AL residents have cognitive impairment and 42% have recorded moderate or severe dementia, with actual rates being higher. AL provides supportive but not nursing services; consequently, virtually all care is provided by direct care workers (nursing assistants and personal care aides).
Unfortunately, direct care workers are undervalued and under-trained, leading to poor care, workplace injury, dissatisfaction, and high turnover. AL is state-regulated, and only 17 states stipulate minimum training hours (some being as low as one hour), meaning that two-thirds of states are silent on training. Fewer than 40% of staff have education beyond high school, and so it is not surprising that a minority report sufficient knowledge to care for persons with dementia. In striving to fill this gap, training for direct care workers must be accessible and have efficacy in benefitting the staff, organization, and persons with dementia.
Online training is an especially promising option due to its low cost, wide availability, and potential for self pacing, automated skills tests, and certification. The Alzheimer's Association is the national leader in dementia care training, and in 2021 developed essentiALZ (pronounced "essentials"), an online program teaching evidence-based, person-centered care, which can be accessed from a computer, tablet, or mobile device. Already more than 1,500 staff have essentiALZ certification, but as is true of the majority of training programs, evidence as to its ability to improve care and outcomes is lacking. It is possible that essentiALZ is effective in changing care and outcomes, but it may also be that additional supports are necessary to do so. A timely model of support is Project ECHO, which has flooded the field of long-term care as a proven way to provide expert guidance and peer support via a remote, online approach. Adding ECHO to online dementia training might provide a necessary boost to achieve care change and improved outcomes.
The project responds to the National Institute on Aging Notice of Special Interest that calls for strengthening the workforce through enhancing and supporting skills training. It will conduct a hybrid implementation/effectiveness randomized trial in 126 AL communities, comparing essentiALZ alone, essentiALZ + ECHO enhancement, and a waitlist control. Outcomes grounded in the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model and the Kirkpatrick training effectiveness model will be examined over six months, comparing the arms in terms of (1) implementation and (2) effectiveness, and (3) examining the extent to which implementation and effectiveness differ based on characteristics of the AL community, staff, residents, and family members. Results will inform next steps in dementia care training for the AL and broader long-term care workforce.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (investigator)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| essentiALZ | Experimental | Behavioral: essentiALZCommunities randomized to this arm will receive the essentiALZ training: a web-based training taken by AL staff that contains three hours of self-paced content separated into five modules, plus a final review. Modules include: 1) Alzheimer's disease and dementia; 2) person-centered care; 3) assessment and care planning; 4) activities of daily living; and 5) behaviors and communication. Staff will be encouraged to take the training over the course of four weeks. |
| essentiALZ + ECHO | Experimental | Behavioral: essentiALZ, Behavioral: Project ECHOCommunities randomized to this arm will receive the essentiALZ training: a web-based training taken by AL staff that contains three hours of self-paced content separated into five modules, plus a final review. Modules include: 1) Alzheimer's disease and dementia; 2) person-centered care; 3) assessment and care planning; 4) activities of daily living; and 5) behaviors and communication. Staff will be encouraged to take the training over the course of four weeks. Additionally, they will receive access to Project ECHO. ECHO is a virtual tele-mentoring model grounded in case-based learning. It includes six weekly one-hour sessions of didactic and discussive learning. The first five sessions will reflect the content of the five essentiALZ modules, and the final session will address maintenance. ECHO sessions are group sessions that will be conducted via Zoom. |
| No Intervention | No intervention | –Standard care will be provided. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (11 listed)
- Staff (part-time, full-time, and including contract staff) who provide direct care to residents at the participating assisted living community (e.g., certified nursing assistants, personal care aides, registered nurses, licensed practical nurses, activity directors, social workers, and others) as determined by the administrator/health care supervisor
- Are 18 years of age or older
- Are able to read and speak English fluently
- Resident not expected to die or be transferred in the next six months at baseline
- At follow-up, resident lived in AL community at least one month during the three months prior to interview date
Key exclusion criteria (2 listed)
- Are under 18 years of age
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| essentiALZessentiALZ is a web-based training that contains three hours of self-paced content separated into five modules, plus a final review. Modules include: 1) Alzheimer's disease and dementia; 2) person-centered care; 3) assessment and care planning; 4) activities of daily living; and 5) behaviors and communication. Staff will be encouraged to take the training over the course of four weeks. | Behavioural | essentiALZ, essentiALZ + ECHO |
| Project ECHOECHO is a virtual tele-mentoring model grounded in case-based learning. It includes six weekly one-hour sessions of didactic and discussive learning. The first five sessions will reflect the content of the five essentiALZ modules, and the final session will address maintenance. ECHO sessions are group sessions that will be conducted via Zoom. | Behavioural | essentiALZ + ECHO |
Primary outcome
Change in Score Over Time of Sense of Competence in Dementia Care (SCIDS)
Time frame: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Sense of Competence in Dementia Care (SCIDS) is a 17-item instrument. Responses are indicated using a 4-point Likert scale. Minimum score (worst value) = 1. Maximum score (best value) = 4. Higher values represent a better outcome (range 17-68). Measure is assessed at Baseline Questionnaire, a 3-month Follow Up Questionnaire and at a 6-month Follow Up Questionnaire.
Change in Score Over Time of Staff Experience of Working with Residents with Dementia Questionnaire - Care Organization, Satisfactory Contact with the Patient, and Satisfaction with the Expectations of Others Subscales (SEWDRQ)
Time frame: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Staff Experience of Working with Residents with Dementia Questionnaire - Care Organization, Satisfactory Contact with the Patient, and Satisfaction with the Expectations of Others Subscales (SEWDRQ) is a 9-item instrument. Responses are indicated using a 5-point Likert scale. Minimum score (worst value) = 0. Maximum score (best value) = 4. Higher values represent a better outcome (range 0-36). Measure is assessed at Baseline Questionnaire, a 3-month Follow Up Questionnaire and at a 6-month Follow Up Questionnaire.
Change in Score Over Time of Dementia Attitude Scale - Short Form (DAS-6)
Time frame: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Dementia Attitudes Scale (Short-Form) is a 6-item instrument. Responses are indicated using a 7-point Likert scale. Minimum score (worst value) = 1. Maximum score (best value) = 7. Higher values represent a better outcome (range 6-42). Measure is assessed at Baseline Questionnaire, a 3-month Follow Up Questionnaire and at a 6-month Follow Up Questionnaire.
5 secondary outcomes
Change in Score Over Time of essentiALZ exam items
Time frame: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Change in Score Over Time of essentiALZ organizational practices
Time frame: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Change in Score Over Time of Emotional Burnout
Time frame: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Change in Score Over Time of Intention to Leave
Time frame: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Change in Score Over Time of Feeling Valued
Time frame: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Apr 2026.
- BackgroundAlzheimer's Disease International. Dementia: A Public Health Priority. Geneva, Switzerland: World Health Organization; 2015.
- BackgroundAlzheimer's Association. Alzheimer's Impact Movement March 2018. Costs of Alzheimer's to Medicare and Medicaid. http://act.alz.org/site/DocServer/2012_Costs_Fact_Sheet_version_2.pdf?docID=7161. Accessed October 30, 2021.
- Background: PubMed 27893041Langa KM, Larson EB, Crimmins EM, Faul JD, Levine DA, Kabeto MU, Weir DR. A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012. JAMA Intern Med. 2017 Jan 1;177(1):51-58. doi: 10.1001/jamainternmed.2016.6807.
- Background: PubMed 26438738Friedman EM, Shih RA, Langa KM, Hurd MD. US Prevalence And Predictors Of Informal Caregiving For Dementia. Health Aff (Millwood). 2015 Oct;34(10):1637-41. doi: 10.1377/hlthaff.2015.0510.
- Background: PubMed 19568155Arrighi HM, Neumann PJ, Lieberburg IM, Townsend RJ. Lethality of Alzheimer disease and its impact on nursing home placement. Alzheimer Dis Assoc Disord. 2010 Jan-Mar;24(1):90-5. doi: 10.1097/WAD.0b013e31819fe7d1.
- Background: PubMed 12711731Zimmerman S, Gruber-Baldini AL, Sloane PD, Eckert JK, Hebel JR, Morgan LA, Stearns SC, Wildfire J, Magaziner J, Chen C, Konrad TR. Assisted living and nursing homes: apples and oranges? Gerontologist. 2003 Apr;43 Spec No 2:107-17. doi: 10.1093/geront/43.suppl_2.107.
- Background: PubMed 29033493Zimmerman S, Love K, Cohen LW, Pinkowitz J, Nyrop KA. Person-Centeredness in Home- and Community-Based Services and Supports: Domains, Attributes, and Assisted Living Indicators. Clin Gerontol. 2014;37(5):429-445. doi: 10.1080/07317115.2014.937548. Epub 2014 Jun 30.
- Background: PubMed 18649209Smith M, Buckwalter KC, Kang H, Ellingrod V, Schultz SK. Dementia care in assisted living: needs and challenges. Issues Ment Health Nurs. 2008 Aug;29(8):817-38. doi: 10.1080/01612840802182839.
- BackgroundHarris-Kojetin L, Sengupta M, Lendon JP, et al. Long-term care providers and services users in the United States, 2015-2016. National Center for Health Statistics. Vital Health Stat. 2019;3(43). https://www.cdc.gov/nchs/data/series/sr_03/sr03_43-508.pdf. Accessed October 30, 2021.
- BackgroundHarrington C, Chapman S, Miller E, et al. Trends in the supply of long-term-care facilities and beds in the United States. J Appl Gerontol 2005;24(4):265-282.
- BackgroundParaprofessional Healthcare Institute. Caring for the Future: The Power and Potential of America's Direct Care Workforce. 2021. http://phinational.org/resource/caring-for-the-future-the-power-andpotential-of-americas-direct-care-workforce/. Accessed October 30, 2021.
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- Individual participant dataSharing planned: Yes. A de-identified computerized dataset will be available for the use of other researchers. The de-identification of the dataset will follow IRB guidance. Select data will be transformed as appropriate (e.g., items in a scale that were reverse coded will be transformed), and scales will be developed from individual items where indicated (maintaining the individual items). The de-identified dataset will be shared in excel or CSV format and will include a codebook for use. Similarly, all data collection instruments will be made available. No specialized tools or software will be necessary to access or use the data. The project coordinator and/or senior analyst will work with potential users for procedures to share the dataset using secure methods informed by Cecil G. Sheps Center for Health Services Data Analytics and Information Technology Department.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Sheryl Zimmerman, PhD principal investigator
University of North Carolina, Chapel Hill
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing essentiALZ and Project ECHO in people with Aging and Knowledge, Attitudes, Practice, run by University of North Carolina, Chapel Hill at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 11 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 13 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Johanna Hickey, MSW (9198433085, jvtsilbersack@unc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Score Over Time of Sense of Competence in Dementia Care (SCIDS) (time frame: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06239688, which also lists 152 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Apr 2026.