Reablement in Residential Aged Care (Re-RAC): study protocol for a multi-center pragmatic randomized controlled open-label trial
Bibliographic record
Abstract
BACKGROUND: Living in residential aged care (RAC) facilities can be passivating and negatively impact residents' well-being and quality of life. With a growing global population of older adults and an increasing number residing in RAC facilities, it is crucial to address these concerns. Person-centered reablement, which enhances activity and participation through tailored, multidisciplinary strategies, has shown promising results in home settings. However, its implementation in RAC facilities, especially in Sweden, requires further evaluation. This research project will examine whether the reablement intervention in RAC (Re-RAC) impacts activity performance and satisfaction, participation, quality of life, and well-being, in older adults living in RAC facilities. Additionally, the project will evaluate the health-economic effects of the intervention and explore potential associations with the outcomes. A further aim is to describe the experiences of both the participating older adults and RAC facility staff involved in Re-RAC. METHODS: This is a multi-center prospective pragmatic randomized controlled trial has two parallel groups comparing the Re-RAC intervention with usual care. A total of 86 participants are planned to be enrolled. The 8-week intervention will be evaluated using quantitative, qualitative, and health-economic methods. Data will be collected at baseline and after the intervention. Health-economic data will also be gathered 3 months before and after intervention. Primary outcomes are activity performance and satisfaction with performance captured using the Canadian Occupational Performance Measure; secondary outcomes, i.e., health-related quality of life, psychological well-being, and physical activity levels will also be evaluated. Experiences of participants and staff will be captured through individual and focus-group interviews. Cost-effectiveness will be estimated by calculating the cost per quality-adjusted life year gained. Quantitative data will be analyzed using descriptive and comparative statistics; qualitative data will be analyzed using thematic analysis and focus-group methodology. DISCUSSION: This study evaluates the Re-RAC intervention for older adults in RAC through a real-world pragmatic trial, examining activity performance, satisfaction, quality of life, well-being, and health outcomes for older adults in RAC facilities. The study also explores participant and staff experiences and evaluates cost-effectiveness. The results will offer valuable insights informing the future implementation and assessment of reablement interventions in RAC settings. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT06793501 . Registered on 20 January 2025.
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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 | 0.042 | 0.031 |
| Meta-epidemiology (narrow) | 0.008 | 0.004 |
| Meta-epidemiology (broad) | 0.016 | 0.007 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.004 | 0.005 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.005 | 0.003 |
| Research integrity | 0.009 | 0.008 |
| Insufficient payload (model declined to judge) | 0.055 | 0.011 |
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".