title: Sustaining Transfers through Affordable Research Translation (START): study protocol to assess knowledge translation interventions in continuing care settings.
abstract: BACKGROUND
  Bridging the research-practice gap is an important research focus in continuing care facilities, because the population of older adults (aged 65 years and over) requiring continuing care services is the fastest growing demographic among countries in the Organisation for Economic Co-operation and Development (OECD). Unlicensed practitioners, known as health care aides, provide the majority of care for residents living in continuing care facilities. However, little research examines how to sustain health care aide behavior change following initial adoption of current research evidence.
  
  
  METHODS
  We will conduct a phase III, multicentre, cluster randomized controlled trial (RCT) using a stratified 2 × 2 additive factorial design, including an embedded process evaluation, in 24 supportive living facilities within the health zone of Edmonton, AB, Canada. We will determine which combination of frequency and intensity of reminders most effectively sustains the completion of the sit-to-stand activity by health care aides with residents. Frequency refers to how often a reminder is implemented; intensity refers to whether a reminder is social or paper-based. We will compare monthly reminders with reminders implemented every 3 months, and we will compare low intensity, paper-based reminders and high intensity reminders provided by a health care aide peer.Using interviews, questionnaires, and observations, Sustaining Transfers through Affordable Research Translation (START) will evaluate the processes that inhibit or promote the mobility innovation's sustainability among health care aides in daily practice. We will examine how the reminders are implemented and perceived by health care aides and licensed practical nurses, as well as how health care aides providing peer reminders are identified, received by their peers, and supported by their supervisors.
  
  
  CONCLUSIONS
  START will connect up-to-date innovation research with the practice of health care aides providing direct care to a growing population of older Albertans. The project's reach extends to both supportive living and long-term care settings. Furthermore, START has the potential to introduce and sustain a broad range of innovations in various care areas, such as dementia care, wound care, and pain management - domains where the uptake and sustainability of innovations also encounter significant challenges. By identifying the optimal frequency and intensity of knowledge translation interventions, we hope to enable continuing care organizations to efficiently integrate care innovations into the day-to-day care of residents.
  
  
  BACKGROUND
  ClinicalTrials.gov, NCT01746459.
authors.affiliation: Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB T6G 1C9, Canada. susan.slaughter@ualberta.ca.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Slaughter
authors.forename: Carole A
authors.initials: CA
authors.lastname: Estabrooks
authors.forename: C Allyson
authors.initials: CA
authors.lastname: Jones
authors.forename: Adrian S
authors.initials: AS
authors.lastname: Wagg
authors.forename: Misha
authors.initials: M
authors.lastname: Eliasziw
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000416:Alberta; D000488:Allied Health Personnel / Q000523:psychology*; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care; D019317:Evidence-Based Medicine; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D009043:Motor Activity; D010465:Perception; D017010:Reminder Systems; D012107:Research Design; D013997:Time Factors; D057170:Translational Research, Biomedical