Minnesota Inclusive LTSS for LGBTQ Seniors

Study Overview
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Brief Summary
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This study is designed to help improve the care of sexual and gender minority (SGM) with Alzheimer's Disease and Alzheimer's Disease Related Dementia (AD/ADRD) in long-term services and supports (LTSS) by training the state's LTSS workforce in SGM culturally responsive care. The randomized controlled trial will rigorously test the effects of an in person versus an online training program on improving SGM culturally responsive care with a waitlist control.

Detailed Description
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The study involves conducting a 3-arm, stratified (management/staff), group (agency) randomized controlled trial (RCT) of the in-person vs. online intervention vs. waitlist control on organizational factors (i.e., environment and policy) and on staff knowledge, attitudes, and skills.

Official Title
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Training the Long-Term Services and Supports Dementia Care Workforce in Provision of Care to Sexual and Gender Minority Residents

Conditions
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Alzheimer Disease, Dementia

Intervention / Treatment
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* Other: Training to Serve (TTS) in person training
* Other: Training to Serve online training (eTTS)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: licensure in Minnesota to provide nursing and/or as a housing with services establishment Willingness to undertake a policy and environment review at baseline and 6 months later having at least 5 managers/ supervisors and 5 staff. Exclusion Criteria: Participants who cannot speak and read English

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The study involves conducting a 3-arm, stratified (management/staff), group (agency) randomized controlled trial (RCT) of the in-person vs. online intervention vs. waitlist control on organizational factors (i.e., environment and policy) and on staff knowledge, attitudes, and skills.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Training to Serve (TTS) in person training<br>Participants are provided access to the pretest one week before the training. On the day of training, when the trainers arrive, participants have a final opportunity to complete the baseline survey before the intervention. Tablets will be available to complete pre- and post- surveys. The training for management takes 3-4 hours, and for staff, one hour. For consistency and feasibility, both trainings are conducted by the same trainers at the same visit. Immediately after the intervention, participants complete the post-intervention seminar evaluation assessing knowledge and attitudes/comfort in serving SGM clients. | Other: Training to Serve (TTS) in person training<br>* Participants receive in person training.<br>|
| Experimental: Training to Serve online training (eTTS)<br>Participants are provided a unique identifier to access the online website. The opening page welcomes them to the study, then directs them to the chunked consent materials and baseline survey. As soon as they have completed this, they receive access to the intervention, which for management is expected to take 1-2 hours and for staff, 30-45 minutes (i.e., the online equivalent of 3-4 and 1 hour, respectively). After completion of the required modules, participants receive access to the optional modules as well as the posttest survey to evaluate the training. Once the post-test is complete, they are thanked for their involvement and informed they will receive an e-mail to access a follow-up survey in six months' time. | Other: Training to Serve online training (eTTS)<br>* Participants receive online training.<br>|
| No Intervention: Waitlist control<br>Participants complete the baseline survey, then they receive a note thanking them for completing all activities and informing them the intervention will be available in 6 months' time. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Environment change | Access to sexual and gender minority (SGM) providers, gender neutral intake forms | baseline and 6-months follow up | 
| Skills assessment | Ability to conduct 7 skills key to providing competent care to SGM | Baseline | 
| Skills assessment | Ability to conduct 7 skills key to providing competent care to SGM | Immediately post-intervention | 
| Competence in SGM Care | Competent scale when it comes to providing care to SGM | 6 months after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| SGM with AD/ADRD referenced explicitly in policies | Human Resources policies and intake forms | Baseline | 
| SGM with AD/ADRD referenced explicitly in policies | HR policies and intake forms | 6 months post-intervention | 
| SGM knowledge | 10-item review of key content in training | Baseline | 
| SGM knowledge | 10-item review of key content in training | immediately post-intervention | 
| SGM knowledge | 10-item review of key content in training | 6 months post-intervention | 
| SGM attitudes | Homonegativity scale | Baseline | 
| SGM attitudes | Homonegativity scale | immediately post-intervention | 
| SGM attitudes | Homonegativity scale | 6 months post-intervention | 
| Health care empathy | Jefferson Physician Empathy student version | Baseline | 
| Health care empathy | Jefferson Physician Empathy student version | immediately post-intervention | 
| Health care empathy | Jefferson Physician Empathy student version | 6 months post-intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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LGBTQ+, Sexual and gender minorities, Long-term support and service facilities, Alzheimer Disease