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Program Evaluation Workforce Issues Person-Centered Quality Assurance Caregiving Care Management Dementia Long-Term Care

An Embedded Pragmatic Clinical Trial of the Individualized Positive Psychosocial Interaction (IPPI) Program

We implemented a pilot embedded pragmatic clinical trial of the evidence-based Individualized Positive Psychosocial Interaction (IPPI) program for people living with dementia (PLWD) in nursing homes.

Program Evaluation Workforce Issues Person-Centered Quality Assurance Caregiving Care Management Dementia Long-Term Care

An Embedded Pragmatic Clinical Trial of the Individualized Positive Psychosocial Interaction (IPPI) Program

Objectives

We implemented a pilot embedded pragmatic clinical trial of the evidence-based Individualized Positive Psychosocial Interaction (IPPI) program for people living with dementia (PLWD) in nursing homes. We sought to answer the following questions: Can staff consistently deliver IPPIs to enrolled residents over 6 months? How does IPPI completion impact the immediate outcome of resident mood? Can we track the impact of IPPI completion on a distal (3-month and 6-month) pragmatic clinical outcome (ie, symptoms of distress) recorded in the Minimum Dataset (MDS) 3.0?

Design

Nursing home staff completed an online training on emotion-focused communication and were trained to deliver IPPIs, which are short (ie, 10-minute) protocol-guided, one-on-one preference-aligned, interactions with PLWD. Staff were instructed to complete 2 IPPIs per week per resident for 6 months.

Setting and Participants

130 residents from 7 nursing homes.

Methods

Pre- and post-IPPI observed emotion evaluations were completed and MDS 3.0 data were collected for all eligible residents in the nursing home community during the study period. Descriptive statistics and frequencies were computed for rates of IPPI completions, sample descriptives, endorsement of mood change, and symptoms of distress at baseline, 3 months, and 6 months.

Results

IPPI participants who did not die or discharge from the nursing home completed on average 45 IPPIs over 6 months. In 59% (n = 2813) of IPPIs, mood immediately improved from negative to neutral/positive or from neutral to positive, whereas in 42% (n = 1994) of cases, mood stayed stable. MDS 3.0 data were able to show change over time in symptoms of distress from baseline to 3 months and 6 months, with most improving during the intervention period.

Conclusions and Implications

The IPPI program is an effective person-centered intervention for PLWD in nursing homes. It can be integrated into care and improve resident mood, and symptoms of distress can be tracked in existing clinical data.

Journal of the American Medical Directors Association,  https://doi.org/10.1016/j.jamda.2025.105700

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