Lord K, et al. - This trial strived to implement and gauge an initial dissemination programme for the Strategies for Relatives (START), for family carers of people with dementia. The clinical psychologists and admiral nurses were trained to deliver and implement START locally.This cost–effective manualised intervention was cascaded further and used in practice in some areas. However, it was not known if START was implemented by non–respondents. Prospective dissemination warranted management buy–in, availability of practitioners and supervisors and consideration of other ways of delivery.

Methods

• 3-hour ‘train-the-trainer’ sessions were given via the British Psychological Society and Dementia UK.
• Candidates included clinical psychologists and admiral nurses across the UK.
• The primary measure was: Following the training session, attendees completed an evaluation.
• Attendees were enquired as to how they implemented START 6 and 12 months later, and were instructed to participate in telephone interviews about their experiences of what aided or hindered the implementation 1 year after training.

Results

• 134 clinical psychologists and 39 admiral nurses were trained via 14 training sessions between October 2014 and September 2015 in nine UK locations and made materials available online.
• The 40 survey respondents had trained 75 other staff.
• 136 carers had received START across 11 service areas.
• 13 qualitative interviews reported that few clinical psychologists had begun to implement START, enabled by buy-in from colleagues, existing skills in delivering this type of intervention, availability of other staff to deliver the intervention and support from the research team.
• Admiral nurses did not supervise other staff.
• They were unable to cascade the intervention.
• Common barriers included lack of staff to deliver the intervention and family carer support not being a service priority, where START was not used.
• The candidates desired longer training.