Journeying through Dementia Randomised Controlled Trial of a Psychosocial Intervention for People Living with Early Dementia: Embedded Qualitative Study with Participants, Carers and Interventionists

Kirsty Sprange,¹ Jules Beresford-Dent,² Gail Mountain,² Ben Thomas,³ Jessica Wright,³ Clare Mason,² Cindy L Cooper<sup>3

1</sup>Nottingham Clinical Trials Unit, Faculty of Medicine, University of Nottingham, Nottingham, NG7 2RD, UK; ²University of Bradford, Bradford West Yorkshire, BD7 1DP, UK; ³Clinical Trials Research Unit, ScHARR, University of Sheffield, Sheffield, S1 4DP, UK

Correspondence: Kirsty Sprange
Nottingham Clinical Trials Unit, Building 42, Room A05, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
Tel +44 0115 82 31574
Email Kirsty.sprange@nottingham.ac.uk

Objective: To identify the barriers and facilitators to the implementation of a complex psychosocial intervention though a study exploring the experiences of participants, carers and interventionists during a trial.
Methods: Individual semi-structured interviews were conducted with participants, their carers, and interventionists from a sample of recruiting sites that took part in the Journeying through Dementia randomized controlled trial (RCT). Interview data were transcribed and analysed using framework analysis. Co-researcher data analysis workshops were also conducted to explore researcher interpretations of the data through the lens of those with lived experience of dementia. Triangulation enabled comparison of findings from the interviews with findings from the co-researcher workshops.
Results: Three main themes emerged from the interview data: being prepared; intervention engagement; and participation and outcomes from engagement. From these themes, a number of factors that can moderate delivery and receipt of the intervention as intended were identified. These were context and environment; readiness, training, skills and competencies of the workforce; identifying meaningful participation and relationships.
Conclusion: This study highlighted that the observed benefit of the intervention was nuanced for each individual. Mechanisms of change were influenced by a range of individual, social and contextual factors. Future research should therefore consider how best to identify and measure the multifaceted interplay of mechanisms of change in complex interventions.
Trial Registration: ISRCTN17993825.

Keywords: psychosocial, self-management, dementia, wellbeing, occupational therapy, qualitative