Improving the provision of hearing care to long-term care home residents with dementia:developing a behaviour change intervention for care staff

Context: Hearing loss disproportionately affects long-term care home (LTCH) residents with dementia, impacting their quality of life. Most residents with dementia rely on LTCH staff to provide hearing care. However, previous research shows provision is inconsistent. The Behaviour Change Wheel (BCW) can be used for developing behaviour-change interventions. Objective: To describe the structured, multistage development of an intervention to help LTCH staff provide hearing care to residents with dementia. Method: Using results from qualitative and quantitative studies and patient and public involvement sessions, we outlined problems associated with hearing care and determined the changes that should be made using the Capabilities, Opportunities, and Motivation-Behaviour Change Model. We then selected and specified five target behaviours for intervention, and identified relevant intervention functions, behaviour change techniques (BCTs), and modes of delivery. Findings: The multi-component intervention is designed to boost the psychological capability, reflective motivation, and physical opportunity of care assistants. The intervention functions deemed most appropriate were education, modelling, incentivisation, and environmental restructuring, alongside several specific BCTs. Limitations: Some of the larger-scale issues relating to hearing care, such as collaborations between LTCHs and audiology services and the costs of hearing devices, were not able to be addressed in this intervention. Conclusions: This study is the first to use the BCW to develop an intervention targeting the staff’s provision of hearing care to LTCH residents with dementia. This intervention addresses the wide-ranging barriers that staff experience when providing hearing care. Trialling this intervention will provide insight into its effectiveness and acceptability for residents and staff.