Connecting Today to Combat Social Isolation and Loneliness

Justification For decades, care home residents living with dementia have suffered disproportionately from social isolation (being alone), loneliness (feeling alone), and poor quality of life. Paradoxically, they have also been excluded from intervention research to address these pernicious problems. The investigators developed Connecting Today, a facilitated remote visiting program, to engage care home residents with dementia in positive interactions with their family members, friends, and care partners. Scoping reviews, a mixed methods study, and pilot/ feasibility studies in Alberta support feasibility and high acceptability of Connecting Today.

Purpose This study will evaluate the feasibility of a multi-province RCT of Connecting Today in preparation for a full effectiveness trial.

Objectives

1. Assess feasibility of a pragmatic randomized wait-list control trial of Connecting Today, a remote visiting program, when used in care homes in Alberta, Saskatchewan and Ontario. 2. Examine Connecting Today's hypothesized mechanisms of action within intervention and wait-list control groups.

Research Method/Procedures The investigators will recruit 80 residents living with dementia from 4 total care homes (one each in Alberta, Saskatchewan, and two in Ontario) and their family members, friends, or care partners (1 to 3 for each resident). Participants will receive 6 weeks of Connecting Today: facilitated video calls (up to 60 min weekly). Residents' designated decision-makers will provide consent for resident participation. Research assistants (blinded to assignment status) will collect reliable and valid outcome measures in telephone interviews for residents (via proxy report) and remote visitors (via self-report). Outcomes are measured for all participants at: T0=baseline (weeks 1-2), T1=after 6 weeks of intervention delivery to the treatment group (weeks 9-10), and T2=after 6 weeks of intervention delivery to the control group (weeks 17-18).

The difference between the control group and intervention group is timing of intervention delivery. The intervention group will receive the intervention in weeks 3-8 (i.e. between T0 and T1) and the control group will receive the intervention in weeks 11-16 (i.e. between T1 and T2).

Plan for Data Analysis To address aim 1 (feasibility), the investigators will complete a quantitative assessment of trial and intervention processes including rates of recruitment, retention, attrition, fidelity of intervention delivery, and missing data (compared to pre-specified thresholds), assignment beliefs, treatment experiences and perceptions, and features of usual care.

To address aim 2 (mechanisms of action), the investigators will use generalized estimating equations and a single group before-after design combining intervention and wait-list control groups to complete a within-group outcomes analysis, adjusted for care home cluster and with gender and intervention processes included as covariates/moderators.

• Change in single item from the Dementia Quality of Life Instrument (DEMQOL- proxy) [Срок оценки: Baseline (T0), after 6 weeks of intervention delivery to the treatment group (T1), and after 6 weeks of intervention delivery to the control group (T2).]
• Change in a single item from the Dementia Quality of Life - Care Home Instrument (DEMQOL- CH) [Срок оценки: Baseline (T0), after 6 weeks of intervention delivery to the treatment group (T1), and after 6 weeks of intervention delivery to the control group (T2).]
• Change in three items from the Dementia Quality of Life Instrument (DEMQOL- proxy) [Срок оценки: Baseline (T0), after 6 weeks of intervention delivery to the treatment group (T1), and after 6 weeks of intervention delivery to the control group (T2).]
• Change in three items from the Dementia Quality of Life - Care Home Instrument (DEMQOL- CH) [Срок оценки: Baseline (T0), after 6 weeks of intervention delivery to the treatment group (T1), and after 6 weeks of intervention delivery to the control group (T2).]
• Change in the Social Connection In Long-Term Care Home Residents (SONNET) Scale-proxy [Срок оценки: Baseline (T0), after 6 weeks of intervention delivery to the treatment group (T1), and after 6 weeks of intervention delivery to the control group (T2).]
• Change in the Cohen-Mansfield Agitation Inventory - short form [Срок оценки: Baseline (T0), after 6 weeks of intervention delivery to the treatment group (T1), and after 6 weeks of intervention delivery to the control group (T2).]
• Change in the 3-item Loneliness Scale total score [Срок оценки: Baseline (T0), after 6 weeks of intervention delivery to the treatment group (T1), and after 6 weeks of intervention delivery to the control group (T2).]
• Change in the Multidimensional Scale of Perceived Social Support (MSPSS) total score [Срок оценки: Baseline (T0), after 6 weeks of intervention delivery to the treatment group (T1), and after 6 weeks of intervention delivery to the control group (T2).]
• Change in the Quality of Life Scale (QOLS) [Срок оценки: Baseline (T0), after 6 weeks of intervention delivery to the treatment group (T1), and after 6 weeks of intervention delivery to the control group (T2).]
• Change in the Satisfaction with Life Scale (SWLS) [Срок оценки: Baseline (T0), after 6 weeks of intervention delivery to the treatment group (T1), and after 6 weeks of intervention delivery to the control group (T2).]
• Change in a single item from the World Health Organization Quality of Life (WHOQOL- BREF) [Срок оценки: Baseline (T0), after 6 weeks of intervention delivery to the treatment group (T1), and after 6 weeks of intervention delivery to the control group (T2).]