Home-delivered meals for people with dementia: Which model delays nursing home placement? - Protocol for a feasibility pilot

Home-delivered meals for people with dementia: Which model delays nursing home placement? - Protocol for a feasibility pilot

Home-delivered meals promote food security, socialization, and independence among homebound older adults. However, it is unclear which of the two predominant modes of meal delivery, daily-delivered vs. drop-shipped, frozen meals, promotes community living for homebound older adults with dementia. Ou...

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Published in:Contemporary clinical trials Vol. 121; p. 106897
Main Authors: Thomas, Kali S, Dosa, David M, Fisher, Alison, Gadbois, Emily, Harrison, Jill, Hilgeman, Michelle, Largent, Emily A, Lima, Julie, McAuliff, Katie, McCreedy, Ellen, Mills, Whitney, Ornstein, Katherine A, Shield, Renee R, Barron, Marycela, Callaghan, Shawna, Clark, Kayla, Culak, Chris, Faris, Vinsen, Frankhauser, Anita E, Huerta, Sophie, Krause, Katherine, Martinez, Ileana, Mayer, Amanda, Rodriguez, Jacqueline, Theilheimer, Lucy, Truelove, William, Wilson, Inga, Gutman, Roee
Format: Journal Article
Language:English
Published: United States 01-10-2022
Subjects:
Aged
Dementia
Feasibility Studies
Humans
Meals
Medicare
Nursing Homes
Randomized Controlled Trials as Topic
United States
United States
Waiver of consent
Feasibility pilot
Home-delivered meals
Dementia
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Summary:Home-delivered meals promote food security, socialization, and independence among homebound older adults. However, it is unclear which of the two predominant modes of meal delivery, daily-delivered vs. drop-shipped, frozen meals, promotes community living for homebound older adults with dementia. Our objective is to present the protocol for a pilot multisite, two-arm, pragmatic feasibility trial comparing the effect of two modes of meal delivery on nursing home placement among people with dementia. We include justifications for individual randomization with different consent processes and waivers for specific elements of the trial. 236 individuals with dementia on waiting lists at three Meals on Wheels programs' in Florida and Texas will be randomized to receive either: 1) meals delivered multiple times per week by a Meals on Wheels volunteer or paid driver who may socialize with and provide an informal wellness check or 2) frozen meals that are mailed to participants' homes every two weeks. We will evaluate and refine processes for recruitment and randomization; assess adherence to the intervention; identify common themes in participant experience; and test processes for linking participant data with Medicare records and nursing home assessment data. We will conduct exploratory analyses examining time to nursing home placement, the primary outcome for the larger trial. This pilot will inform the follow-on large-scale, definitive pragmatic trial. In addition, the justifications for individual randomization with differing consent procedures for elements of a pragmatic trial provide a model for future trialists looking to develop ethical and feasible pragmatic studies enrolling people with dementia.
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ISSN:1551-7144
1559-2030
DOI:10.1016/j.cct.2022.106897