EFFECTIVENESS OF PEER-BASED REMINDERS TO SUSTAIN CARE PROVIDER PRACTICE CHANGE: A CLUSTER RCT
Bibliographic record
Abstract
Increasing demand for residential aged care has strained already tight healthcare budgets. Identifying novel strategies to optimize best-practice use in these settings may improve quality and efficiency of care and reduce caregiver burden. The purpose of this study was to assess the effect of peer-based and paper-based reminders targeting direct care providers to sustain a mobility innovation with older adults in residential care facilities. START (Sustaining Transfers through Affordable Research Translation) was a 23-site cluster-randomized controlled trial that took place in Alberta, Canada. A mobility intervention was introduced to 23 study sites; between March 2014 and April 2015, 11 sites were randomly assigned to receive paper reminders and a peer reminder intervention either monthly (n=5) or quarterly (n=6) for 1 year. The remaining 12 sites were randomly assigned to receive paper-reminders only either monthly (n=6) or quarterly (n=6) for 1 year. Direct care staff daily documented the uptake of the mobility intervention for 1 year in all 23 sites. Uptake data were analyzed using linear mixed models that mirrored the clustered repeated-measures factorial trial design. A statistically significant improvement was detected in sustainability of the mobility intervention in the sites receiving peer and paper reminder interventions, compared with sites receiving paper-only interventions (p = 0.007). No significant difference was detected in sustainability between monthly or quarterly implementation of either the paper or peer intervention (p = 0.72). This peer reminder intervention is an effective knowledge translation strategy to change and sustain care provider behaviour in residential care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".