# Evaluating a National Person-Centered Training Program to Strengthen the Dementia Care Workforce

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2024 · $726,320

## Abstract

Project Summary/Abstract
More than 75% of persons living with Alzheimer's disease and related dementias who reach 80 years of age
require residential long-term care, which is increasingly provided in assisted living (AL). Across the country,
almost 29,000 AL communities with more than 996,000 beds have become the primary residential care
provider for persons with dementia: 90% of AL residents have cognitive impairment and 42% have recorded
moderate or severe dementia, with actual rates being higher. AL provides supportive but not nursing services;
consequently, virtually all care is provided by direct care workers (nursing assistants and personal care aides).
Unfortunately, direct care workers are undervalued and undertrained, leading to poor care, workplace injury,
dissatisfaction, and high turnover. AL is state-regulated, and only 17 states stipulate minimum training hours
(some being as low as one hour), meaning that two-thirds of states are silent on training. Fewer than 40% of
staff have education beyond high school, and so it is not surprising that a minority report sufficient knowledge
to care for persons with dementia. In striving to fill this gap, training for direct care workers must be accessible
and have efficacy in benefitting the staff, organization, and persons with dementia.
Online training is an especially promising option due to its low cost, wide availability, and potential for self-
pacing, automated skills tests, and certification. The Alzheimer's Association is the national leader in dementia
care training, and in 2021 developed essentiALZTM (pronounced “essentials”), an online program teaching
evidence-based, person-centered care, which can be accessed from a computer, tablet, or mobile device.
Already more than 1,500 staff have essentiALZ certification, but as is true of the majority of training programs,
evidence as to its ability to improve care and outcomes is lacking. It is possible that essentiALZ is effective in
changing care and outcomes, but it may also be that additional supports are necessary to do so. A timely
model of support is Project ECHO, which has flooded the field of long-term care as a proven way to provide
expert guidance and peer support via a remote, online approach. Adding ECHO to online dementia training
might provide a necessary boost to achieve care change and improved outcomes.
The proposed project responds to the NIA Notice of Special Interest that calls for strengthening the workforce
through enhancing and supporting skills training. It will conduct a hybrid implementation/effectiveness cluster-
randomized trial in 126 AL communities across six states, comparing essentiALZ alone, essentiALZ + ECHO
enhancement, and a waitlist control. Outcomes grounded in the RE-AIM model and the Kirkpatrick training
effectiveness model will be examined over six months, comparing the arms in terms of (1) implementation and
(2) effectiveness, and (3) examining the extent to which implementation and effectiveness ...

## Key facts

- **NIH application ID:** 10900576
- **Project number:** 5R01AG079124-03
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Sheryl Zimmerman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $726,320
- **Award type:** 5
- **Project period:** 2022-08-15 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10900576

## Citation

> US National Institutes of Health, RePORTER application 10900576, Evaluating a National Person-Centered Training Program to Strengthen the Dementia Care Workforce (5R01AG079124-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10900576. Licensed CC0.

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