Evaluating the implementation of a toolkit with meaningful activities for residents with dementia

Abstract

Objectives: Engagement in meaningful activities supports the well-being , quality of life of nursing home residents with dementia. This study evaluated the implementability of a toolkit to choose meaningful activities for residents with dementia. Design: A process evaluation was conducted using the RE-AIM framework. Two nursing homes were involved in the implementation of the toolkit through a 6-month participatory action research approach, whereas 3 nursing homes followed an implementation track of equal duration without participatory action research. Setting and Participants: The toolkit was implemented within 5 Dutch nursing homes, involving health care professionals and family caregivers of residents with dementia. Methods: Demographics were collected at baseline, user experience questionnaires were administered monthly , at the end of the study, activity logs were collected and interviews conducted. Qualitative data were analyzed using a thematic analysis, based on a combined inductive and deductive approach (Consolidated Framework for Implementation Research). Results: In total, 64 residents, 26 family caregivers, and 84 health care professionals were reached. Reach involved a mix of relevant stakeholders; however, family caregivers were least involved. Adoption declined from 40.4% to 28.1% during the study, with most users selecting a perceived lack of necessity and time constraints as reasons for nonuse. Implementation barriers and facilitators were categorized into the following 6 themes: individual characteristics, intervention characteristics, inner setting, outer setting, implementation process, and resident factors. Conclusions and Implications: The toolkit was well received by end users and generally considered user- friendly. Prominent facilitators to implementation were leadership, peer support, and regular reminders, among others. Key barriers included staff turnover, workload, and limited perceived use- fulness. Addressing these via task transfer, retraining and clear framing can improve toolkit imple- mentation. This study provides practical insights to strengthen future implementation of the toolkit and similar innovations. (c) 2026 The Author(s). Published by Elsevier Inc. on behalf of Post-Acute and Long-Term Care Medical Association. This is an open access article under the CC BY license (http://creativecommons.org/licenses/ by/4.0/).