title: Process evaluation of the implementation of dementia-specific case conferences in nursing homes (FallDem): study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Challenging behaviors exhibited by individuals with dementia might result from an unmet need that they cannot communicate directly due to cognitive restrictions. A dementia-specific case conference represents a promising means of analyzing and exploring these unmet needs. The ongoing FallDem study is a stepped-wedged, cluster-randomized trial evaluating the effects of two different types of dementia-specific case conferences on the challenging behaviors of nursing home residents. This study protocol describes the process evaluation that is conducted, along with the FallDem study.The goal of the process evaluation is to explain potential discrepancies between expected and observed outcomes, and to provide insights into implementation processes and recruitment strategies, as well as the contexts and contextual factors that promote or inhibit the implementation of dementia-specific case conferences.
  
  
  METHODS
  The process evaluation will use a mixed-method design comprising longitudinal elements, in which quantitative and qualitative data will be gathered. Qualitative data will be analyzed using content analysis, documentary analysis and a documentary method. Quantitative data (standardized questionnaires) will be analyzed using descriptive statistics. Both types of data will complement one another and provide a more comprehensive picture of the different objects under investigation.
  
  
  CONCLUSIONS
  The process evaluation will allow for a comprehensive understanding of the changing processes and mechanisms underlying the 'black box' of the complex intervention of the FallDem study. These findings will provide practical knowledge regarding issues related to the implementation of dementia-specific case conferences in nursing homes.
  
  
  BACKGROUND
  Current Controlled Trials identifier: ISRCTN20203855, registered on 10th July 2013.
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Stockumer Str, 12, 58453 Witten, Germany. daniela.holle@dzne.de.
authors.forename: Daniela
authors.initials: D
authors.lastname: Holle
authors.forename: Martina
authors.initials: M
authors.lastname: Roes
authors.forename: Ines
authors.initials: I
authors.lastname: Buscher
authors.forename: Sven
authors.initials: S
authors.lastname: Reuther
authors.forename: René
authors.initials: R
authors.lastname: Müller
authors.forename: Margareta
authors.initials: M
authors.lastname: Halek
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000367:Age Factors; D001291:Attitude of Health Personnel; D003071:Cognition; D003704:Dementia / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006707:Homes for the Aged; D006801:Humans; D024802:Nurse's Role; D009735:Nursing Homes; D009740:Nursing Staff / Q000523:psychology*; D018802:Patient-Centered Care / Q000379:methods*; D036301:Qualitative Research; D012107:Research Design; D011795:Surveys and Questionnaires; D016896:Treatment Outcome