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Journal of Pain and Symptom Management ; 63(6):1122-1122, 2022.
Article in English | Web of Science | ID: covidwho-1894086
Journal of the American Geriatrics Society ; 69(SUPPL 1):S218, 2021.
Article in English | EMBASE | ID: covidwho-1214858


Background: Implementation of non-pharmacologic programs for people with dementia is often challenging in skilled nursing facilities (SNFs). We previously implemented Preventing Loss of Independence through Exercise (PLIÉ)-an integrative, group movement program for SNF residents with dementia-at the San Francisco VA. This study aimed to identify barriers and facilitators to implementing PLIÉ in VA SNFs nationally. Methods: We conducted a formative evaluation using semi-structured interviews with key stakeholder groups (SNF staff, SNF directors, and VA health system leaders). Questions focused on PLIÉ's fit with current dementia programs and VA policies, characteristics of individual SNFs, and training and implementation strategies. We used rapid qualitative analyses to identify key barriers and facilitators to inform implementation activities. Results: We interviewed 23 people from geographically diverse VA SNFs and national program offices (SNF staff, n=14;SNF directors, n=3;Health system leaders, n=7). Barriers to implementing PLIÉ included: 1) Staff turnover and limited dementia experience;2) Space restrictions and limits on group size (e.g. quarantine periods);and 3) technical issues with training staff remotely. Implementation facilitators for PLIÉ included: 1) compatibility with SNF needs and goals (e.g. maintaining function, reducing disruptive behavior);2) adaptability (e.g., engaging residents with limited mobility, using individual instruction during the COVID-19 pandemic);3) engaging and training interprofessional staff;and 4) alignment with national VA priorities and programs for dementia care. Conclusions: Successful implementation of evidence-based, non-pharmacologic programs such as PLIÉ is facilitated by compatibility, adaptability, interprofessionalism and alignment with VA priorities while barriers are related to staff, space, and technology. PLIÉ's adaptability suggests it is a scalable model for increasing access to non-pharmacologic dementia programs that can serve large numbers of SNF residents. These findings will inform the development of a remote training program for SNF staff to become instructors and facilitate national spread to other VA SNFs.

Psychosomatics ; 61(6):859-860, 2020.
Article in English | Web of Science | ID: covidwho-1001247
Journal of Australian Political Economy ; - (85):7-10, 2020.
Article in English | Web of Science | ID: covidwho-1001053