City Research Online

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

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. ORCID: 0000-0003-4647-8950, Banerjee, S. & Cooper, C. (2024). A process evaluation of the NIDUS-Professional dementia training intervention for UK homecare workers. Age and Ageing, 53(5), article number afae109. doi: 10.1093/ageing/afae109


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.

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.

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.

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.

Publication Type: Article
Additional Information: This is an open access article distributed under the terms of the Creative Commons CC BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords: dementia, homecare, training, carers, process evaluation, implementation, older people
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health & Psychological Sciences
School of Health & Psychological Sciences > Nursing
Related URLs:
SWORD Depositor:
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