# Changing Talk Online Training (CHATO): A National Trial to Reduce Behavioral Symptoms in Long Term Care Residents with Alzheimer's Disease and Other Dementias

> **NIH NIH R01** · UNIVERSITY OF KANSAS MEDICAL CENTER · 2021 · $148,811

## Abstract

Project Abstract
The COVID-19 pandemic has greatly impacted care of persons living with Alzheimer’s disease and other
dementias (ADOD) in long-term service and support settings. Notably, nursing home residents, including an
estimated 50% or more who experience dementia, have extremely high rates of infection and comprise a
predominant number of deaths from COVID-19. New infection control precautions, regulations, and
surveillance have been implemented to reduce these overwhelming effects on older adults in nursing home
(NH) care. Central to infection control precautions is the use of personal protective equipment (PPE). Although
a necessary and critical aspect of reducing COVID-19 transmission in NHs, secondary effects of PPE on
communication, behavioral and psychological symptoms of dementia (BPSD), and other aspects of care for
persons with dementia remain to be addressed. As PPE presents additional challenges to communication,
interventions to optimize communication while using PPE have the potential to improve dementia care by
reducing negative reactions by persons with ADOD and supporting nursing staff by identifying person-centered
best practices.
Our research team is currently conducting a randomized clinical trial (R01 AG069171-06A1), to test an online
communication training program “Changing Talk Online” (CHATO). This staff educational intervention includes
three evidence-based training modules that have resulted in improved communication and reduced BPSD in
NHs. The CHATO pragmatic randomized controlled trial will test the effects of CHATO on BPSD and on use of
psychotropic medication for residents with dementia in 120 NHs nationwide. In addition, we will test strategies
to engage staff and maximize CHATO effects and evaluate cost and sustainability for widespread
dissemination. The overall goal is to provide ready access and support to NH staff to improve communication
that subsequently reduces BPSD and the need for psychoactive medications inappropriately and dangerously
used to control these symptoms.
This administrative supplement (CHAT-PPE) will expand the scope of our R01 study to: (1) identify evidence-
based best practices for communication while using PPE; and (2) create and test a brief training module for
nursing staff to be used alone or in conjunction with the CHATO training. Strategies for effective
communication while wearing PPE are of critical importance across long-term service and support settings that
care for older adults with dementia. Our research established evidence of the importance of communication in
dementia care, noting that improved communication reduced BPSD and the need for antipsychotic medication
use. Our team is uniquely qualified to identify communication best practices and then to develop and test
interventions to overcome PPE communication barriers in dementia care. This research meets the NIA
objective to develop novel interventions to meet the needs of dementia caregivers and care recipients.

## Key facts

- **NIH application ID:** 10425636
- **Project number:** 3R01AG069171-07S1
- **Recipient organization:** UNIVERSITY OF KANSAS MEDICAL CENTER
- **Principal Investigator:** Kristine N. Williams
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $148,811
- **Award type:** 3
- **Project period:** 2020-09-15 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10425636

## Citation

> US National Institutes of Health, RePORTER application 10425636, Changing Talk Online Training (CHATO): A National Trial to Reduce Behavioral Symptoms in Long Term Care Residents with Alzheimer's Disease and Other Dementias (3R01AG069171-07S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10425636. Licensed CC0.

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