STRATEGIES AND TECHNOLOGIES TO SUSTAIN NATIONWIDE IMPLEMENTATION OF ALIVIADO DEMENTIA CARE

It is well documented that knowledge improvement alone is not sufficient to sustain systems level changes. Through supporting dementia care workforce training and the embedding of Aliviado program tools (treatment algorithms, assessments, care plans, and caregiver education materials) into hospices' clinical workflow across the U.S., we learned that both technologies and human support strategies are essential for lasting changes. In this presentation, we first discuss our experience leveraging a powerful customer relationship management software (Salesforce) to assign, manage, and encourage completion of the interprofessional Aliviado Dementia Care training for thousands of active users across the nation. We then share how we provide additional human support and implementation tools in the face of COVID-19, which can inform implementation of similar trials, including office hours, training reports, Plan-Do-Study-Act worksheets, symptom management cheat sheets, champion calls, and electronic health records integration meetings with each agency to locally tailor and embed Aliviado tools.

ALIVIADO HOME HEALTH AND HOSPICE AIDE DEMENTIA CARE EXPERT PROGRAM IMPROVES AIDE DEMENTIA KNOWLEDGE

Most persons living with dementia receive home health or hospice aide services during their hospice stay. To equip aides with essential knowledge and skills to effectively communicate with and care for persons living with dementia, we developed a 17-video dementia care expert program for aides, available in both English and Spanish. The objective of this presentation is two-fold: first, describe the development and refinement of the Aliviado aide dementia care expert program, including topic selection, usability testing, and cultural tailoring;and second, discuss aide knowledge improvement, along with special considerations for training aides during COVID-19. The Aliviado dementia care expert program for aides has been completed by 414 aides across 15 hospices as of February 2022;of which, 384 aides (93%) completed a dementia knowledge assessment both before and after the training and demonstrated significant knowledge gains with moderate-to-large effect sizes (p<0.0001;Cohen's d=0.63).

INTERDISCIPLINARY DEMENTIA CARE WORKFORCE TRAINING DURING COVID-19 AND TWO HOSPICE CASE STUDIES

Hospice is a care model characterized by interdisciplinary team-based, person and family-centered care. To optimize agency-wide interdisciplinary team-based hospice dementia care, at least two levels of tailoring of the dementia care workforce training are imperative, first, by discipline, and second, by hospices' local culture and needs. As of February 2022, a thousand and one skilled hospice interdisciplinary team members (not counting champions) across 18 hospice agencies have completed their discipline-specific Aliviado dementia care training, including 56 providers, 763 nurses, 129 social workers, and 53 chaplains. In this presentation, we describe how we tailored dementia workforce training for skilled interdisciplinary team members (first level tailoring), as well as provide two case studies elucidating how we performed further tailoring of the program for two large hospice agencies (average daily census: 354 and 868, respectively) in two different states to meet their local needs (second level tailoring), and lessons learned.

Mask reuse during the COVID-19 pandemic: a national survey in Taiwan

Background The use of masks is an effective measure to prevent severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection;however, mask reuse is not recommended. Studies examining the factors associated with mask reuse during the coronavirus disease (COVID-19) pandemic are limited. This nationwide survey aimed to determine the prevalence and factors associated with mask reuse among Taiwanese citizens during the pandemic. Methods From May 18 through May 31, 2020, a computer-assisted telephone interview system was used to randomly select Taiwanese citizens who were interviewed for COVID-19 preventive behaviors and knowledge on the usage of masks. Multivariate logistic regression was used to identify factors associated with mask reuse during the COVID-19 pandemic. Moreover, generalized estimating equations (GEE) were used to analyze the rate of mask reuse among participants before and during the pandemic. Results For a total of 1,075 participants, the overall mean age was 57.4 years, and 82.2% of participants reported mask reuse during the COVID-19 pandemic. After controlling for other covariates, participants who had a greater knowledge on mask usage or had a high supply of masks were less likely to reuse masks during the pandemic. GEE analysis showed that compared with the participants' mask wearing behaviors before the COVID-19 pandemic, they were more likely to reuse masks during the pandemic. Conclusions The rate of mask reuse among the general population during the pandemic was significantly higher than that before the pandemic. Individuals were less likely to reuse masks if they had adequate knowledge on mask usage or had a high supply of masks. Since mask reuse is associated with a higher risk of COVID-19 due to the possibility of wearing SAS-CoV-2-contaminated masks, it is imperative to educate people on the correct usage of masks. Further, the government should provide sufficient masks to the general population to decrease the reuse of masks. Key messages Mask reuse increased during the COVID-19 pandemic due to the shortage in supply. It is imperative to educate people about the correct usage of masks.