A Complex Intervention to Strengthen Person-Centered Care and Leadership in Residential Care Facilities (the PERLE Study): Protocol for a Development and Implementation Study
Bibliographic record
Abstract
BACKGROUND: Although the benefits of person-centered care (PCC) are widely recognized, there is a lack of empirical research on how PCC is best developed and implemented by the leaders responsible for driving such initiatives. To achieve meaningful change and ensure the sustainability of PCC practices, it is crucial to understand how leaders can foster care environments rooted in person-centered values while managing operational challenges. This knowledge gap highlights the need for an in-depth exploration of the conceptual foundations, experiences, mechanisms, strategies, and outcomes of person-centered leadership (PCL) to design an intervention for strengthening such leadership. OBJECTIVE: The Person-Centered Care and Leadership in Residential Care Facilities (PERLE) study aims to (1) explore and develop tools to measure PCL; (2) develop, test, implement, and investigate the effects of an intervention to strengthen PCL in residential care facilities (RCFs) for older people; and (3) generate knowledge about the process of development and implementation of the intervention. METHODS: The PERLE study builds on the Medical Research Council framework for the development of complex interventions. It includes several studies with exploratory, descriptive, correlational, and quasi-experimental designs and is based on the research group's previous research on PCL. The project is composed of 5 work packages (WPs). Each WP includes research questions with different samples; data collection; and methodological approaches, such as qualitative, mixed methods, and quantitative studies. As this project involves sensitive issues, a high level of ethical awareness was maintained throughout. The primary challenge is the possible interference with participants' work time, which could otherwise be devoted to supporting older people and staff. Nevertheless, the involvement of leaders and staff can lead to valuable knowledge that can improve the quality of PCC. Participants will be provided with both oral and written information about the study and assured of their right to withdraw at any time without providing a reason. RESULTS: As of July 2025, 6 studies in WP I have been conducted, and one is in progress. The conducted studies address leaders' understanding of PCC, the meaning of PCL in RCFs from the perspective of leaders, the ethical challenges in providing PCC during the COVID-19 pandemic, and the cultural adaptation of the aged care clinical leadership qualities framework. CONCLUSIONS: This project aims to provide new insights into the support that first-line managers need to advance PCC in RCFs, highlight their specific challenges, and create tailored support measures for the implementation of PCL. The intervention could potentially reduce staff turnover and related costs while supporting leadership training and education to benefit future leaders in aged care, which may be important from an international perspective. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/76185.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.068 | 0.054 |
| Meta-epidemiology (narrow) | 0.004 | 0.005 |
| Meta-epidemiology (broad) | 0.005 | 0.005 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.006 | 0.004 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.005 | 0.005 |
| Research integrity | 0.006 | 0.009 |
| Insufficient payload (model declined to judge) | 0.064 | 0.016 |
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 source (direct Gemma or distilled Codex), 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".