Pre-implementation planning for a new personalised, dementia post-diagnostic support intervention: exploring the perspective of professional stakeholders.
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Background: Only a third of people with dementia receive both a diagnosis and post-diagnostic support. A new eight session, manualised, modular post-diagnostic support system (NIDUS (New Interventions for Independence in Dementia Study) – family), delivered remotely by non-clinical facilitators is the first scalable intervention to improve personalised goal attainment for people living with dementia. If widely translated into practice it could significantly improve care quality.Aims: We aimed to explore system-readiness for a scalable, personalised post-diagnostic support intervention.Methods: We conducted semi-structured interviews with professionals from dementia care services; the Consolidated Framework for Implementation Research (CFIR) guided interviews and their thematic analysis. Results: From 2022-23, we interviewed a purposive sample of 21 professionals from seven English NHS, health and social care services. We identified three themes: 1. Potential value of a personalised intervention: interviewees perceived the capacity for choice, supporting person-centred care and delivery by non-clinical facilitators as relative advantages over existing resources. 2. Compatibility and deliverability with existing systems: the NIDUS-family intervention model was perceived as compatible with service goals and clients’ needs, but current service infrastructures, financing and commissioning briefs constraining resources to those at greatest need as barriers to providing universal, post-diagnostic care. 3. Fit with current workforce skills: The intervention model aligned well with staff development plans and national policy to upskill support workers. Conclusion: Translating evidence for scalable and effective post-diagnostic care into practice will support national policies to widen access to support, but require a greater focus on prevention in commissioning briefs and resource planning.
