Maintenance Cognitive Stimulation Therapy (CST) in practice: study protocol for a randomized controlled trial.
BACKGROUND
Cognitive Stimulation Therapy (CST) is a psychosocial evidence-based group intervention for people with dementia recommended by the UK NICE guidelines. In clinical trials, CST has been shown to improve cognition and quality of life, but little is known about the best way of ensuring implementation of CST in practice settings. A recent pilot study found that a third of people who attend CST training go on to run CST in practice, but staff identified a lack of support as a key reason for the lack of implementation.


METHODS
There are three projects in this study: The first is a pragmatic multi-centre, randomised controlled trial (RCT) of staff training, comparing CST training and outreach support with CST training only; the second, the monitoring and outreach trial, is a phase IV trial that evaluates implementation of CST in practice by staff members who have previously had the CST manual or attended training. Centres will be randomised to receive outreach support. The primary outcome measure for both of these trials is the number of CST sessions run for people with dementia. Secondary outcomes include the number of attenders at sessions, job satisfaction, dementia knowledge and attitudes, competency, barriers to change, approach to learning and a controllability of beliefs and the level of adherence. Focus groups will assess staff members' perceptions of running CST groups and receiving outreach support. The third study involves monitoring centres running groups in their usual practice and looking at basic outcomes of cognition and quality of life for the person with dementia.


CONCLUSIONS
These studies assess the effects of outreach support on putting CST into practice and running groups effectively in a variety of care settings with people with dementia; evaluate the effectiveness of CST in standard clinical practice; and identify key factors promoting or impeding the successful running of groups.


BACKGROUND
Clinical trial ISRCTN28793457.
Unit of Mental Health Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London, UK. a.streater@ucl.ac.uk
Amy
A
Streater
Aimee
A
Spector
Elisa
E
Aguirre
Juanita
J
Hoe
Zoe
Z
Hoare
Robert
R
Woods
Ian
I
Russell
Martin
M
Orrell
D000375:Aging / Q000523:psychology; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D015928:Cognitive Behavioral Therapy / Q000592:standards; D003156:Community Mental Health Services / Q000592:standards; D003704:Dementia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education* / Q000592:standards; D006299:Health Services for the Aged / Q000592:standards; D006801:Humans; D007318:Inservice Training / Q000592:standards; D007588:Job Satisfaction; D008370:Manuals as Topic; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D012107:Research Design; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom; D014742:Videodisc Recording; D000078329:Workforce