The impact of elder abuse training on subacute health providers and older adults: Study protocol for a randomized control trial

Introduction: Elder abuse often goes unreported and undetected. Older people may be ashamed, fearful or otherwise reticent to disclose abuse; and many health providers are not confident in asking about it. In the No More Shame study, we will evaluate a co-designed, multi-component intervention that aims to improve health providers’ recognition, response, and referral of elder abuse. Methods: This is a single-blinded, pragmatic, cluster randomised controlled trial. Ten subacute hospital sites (i.e., clusters) across Australia will be allocated 1:1, stratified by state to a multi-component intervention comprising a training program for health providers, implementation of a screening tool and use of site champions, or no additional training or support. Outcomes will be collected at baseline, 4 and 9 months. Our co-primary outcomes are health providers’ knowledge of responding to elder abuse; and older people’s quality of life. We will include all inpatients at participating sites, aged 65+ (or aged 50+ if Aboriginal or Torres Strait Islander), who are able to provide informed consent and all unit staff who provide direct care to older people; a sample size of at least 92 health providers and 612 older people will provide sufficient power for primary analyses. Results: Recruitment will commence in October 2023. Discussion: This will be one of the first trials in the world to evaluate a multi-component elder abuse intervention. If successful, it will provide the most robust evidence base to date for health providers to draw on to create a safe environment for reporting, response, and referral. Trial registration: ANZCTR, ACTRN12623000676617p. Registered 22 June 2023, https://www.anzctr.org.au/ACTRN12623000676617p.aspx