{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:34:58Z","timestamp":1790188498600,"version":"4.1.0"},"reference-count":44,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Trans. Sci."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2059866125102355_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Person-centered care that honors individual preferences can improve the well-being of nursing home (NH) residents with Alzheimer\u2019s disease and related dementias (ADRD). However, preferences such as going outside independently are often restricted due to perceived safety risks. There is a critical need for strategies that help NH staff balance safety concerns with residents\u2019 autonomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2059866125102355_as2\">\n                    <jats:title>Materials and methods:<\/jats:title>\n                    <jats:p>We developed the Decision-making In aGing and demeNtIa for autonomy (DIGNITY) intervention using the Community-Engaged Intervention Mapping (CEIM) Model. This multilevel, theory informed program was codesigned with NH stakeholders to support shared decision-making and promote preference-congruent dementia care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2059866125102355_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 53 stakeholders participated in focus groups and engagement sessions. Feedback informed six key refinements to the DIGNITY program: manual formatting, communication strategies, staff role delineation, addressing resident decision-making capacity, and identifying implementation barriers and facilitators. The final intervention includes a structured manual, decision-making tools, and a training and coaching program to support NH staff in honoring resident preferences while managing perceived risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2059866125102355_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>DIGNITY is a novel, stakeholder-informed intervention designed to support preference-based dementia care in rural NHs. Future research should assess its feasibility, acceptability, and impact on staff attitudes and resident outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/cts.2025.10235","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T08:51:03Z","timestamp":1767862263000},"source":"Crossref","is-referenced-by-count":3,"title":["Community-engaged intervention mapping for developing the DIGNITY program: Supporting decision-making in aging and dementia for autonomy in rural nursing homes"],"prefix":"10.1017","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6143-2654","authenticated-orcid":false,"given":"Liza L.","family":"Behrens","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04p491231","id-type":"ROR","asserted-by":"publisher"}],"name":"Pennsylvania State"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly S.","family":"Van Haitsma","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04p491231","id-type":"ROR","asserted-by":"publisher"}],"name":"Pennsylvania State"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Center for Innovation Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalei H.","family":"Crimi","sequence":"additional","affiliation":[{"name":"The Wright Center for Community Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie L.","family":"Boltz","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04p491231","id-type":"ROR","asserted-by":"publisher"}],"name":"Pennsylvania State"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Kraschnewski","sequence":"additional","affiliation":[{"name":"Pennsylvania State"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"S2059866125102355_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/0749-5978(91)90020-T"},{"key":"S2059866125102355_ref23","doi-asserted-by":"publisher","DOI":"10.3928\/00989134-20210107-02"},{"key":"S2059866125102355_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnaa099"},{"key":"S2059866125102355_ref20","volume-title":"Risk Assessment and Management for Living Well with Dementia","author":"Clarke","year":"2011"},{"key":"S2059866125102355_ref26","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-015-0209-1"},{"key":"S2059866125102355_ref27","doi-asserted-by":"publisher","DOI":"10.31887\/DCNS.2011.13.2\/npatsopoulos"},{"key":"S2059866125102355_ref3","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnaf134"},{"key":"S2059866125102355_ref41","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2011.613995"},{"key":"S2059866125102355_ref28","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-015-0089-9"},{"key":"S2059866125102355_ref21","unstructured":"21. CNA Aging Services. Aging services - 2018 claim report: Valuing employees, minimizing risk. 2018."},{"key":"S2059866125102355_ref34","doi-asserted-by":"publisher","DOI":"10.1027\/2151-2604\/a000255"},{"key":"S2059866125102355_ref7","doi-asserted-by":"publisher","DOI":"10.3928\/00989134-20171206-02"},{"key":"S2059866125102355_ref1","volume-title":"The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff","year":"2022"},{"key":"S2059866125102355_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.08.016"},{"key":"S2059866125102355_ref29","doi-asserted-by":"publisher","DOI":"10.1097\/NNR.0000000000000500"},{"key":"S2059866125102355_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.06.033"},{"key":"S2059866125102355_ref4","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.22111"},{"key":"S2059866125102355_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-3743.2006.00027.x"},{"key":"S2059866125102355_ref15","unstructured":"15. American Health Care Association and National Center for Assisted Living. BLS March 2022 jobs report. 2022. (https:\/\/www.ahcancal.org\/News-and-Communications\/Fact-Sheets\/FactSheets\/BLS-MARCH2022-JOBS-REPORT.pdf) Accessed August 11, 2022."},{"key":"S2059866125102355_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2017.10.001"},{"key":"S2059866125102355_ref40","unstructured":"40. Ajzen, I. TPB questionnaire construction: Constructing a theory of planned behavior questionnaire . 2019: 7."},{"key":"S2059866125102355_ref30","doi-asserted-by":"publisher","DOI":"10.1177\/1090198117709885"},{"key":"S2059866125102355_ref24","doi-asserted-by":"publisher","DOI":"10.7748\/ns.30.28.41.s47"},{"key":"S2059866125102355_ref14","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnx174"},{"key":"S2059866125102355_ref31","doi-asserted-by":"publisher","DOI":"10.1186\/s41155-017-0072-x"},{"key":"S2059866125102355_ref25","doi-asserted-by":"publisher","DOI":"10.3928\/00989134-20160531-01"},{"key":"S2059866125102355_ref42","doi-asserted-by":"publisher","DOI":"10.1007\/s40596-022-01701-5"},{"key":"S2059866125102355_ref9","doi-asserted-by":"publisher","DOI":"10.3928\/00989134-20230106-02"},{"key":"S2059866125102355_ref18","doi-asserted-by":"publisher","DOI":"10.1111\/j.0029-6473.2004.00011.x"},{"key":"S2059866125102355_ref39","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2022.12.008"},{"key":"S2059866125102355_ref37","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"S2059866125102355_ref16","doi-asserted-by":"publisher","DOI":"10.3928\/00989134-20151218-02"},{"key":"S2059866125102355_ref38","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000000794"},{"key":"S2059866125102355_ref43","first-page":"1","article-title":"Education on fall prevention to improve self-efficacy of nursing staff in long term care: A pilot study","volume":"16","author":"Leverenz","year":"2018","journal-title":"Internet J Allied Health Sci Pract"},{"key":"S2059866125102355_ref12","doi-asserted-by":"publisher","DOI":"10.1080\/07317115.2018.1467522"},{"key":"S2059866125102355_ref44","doi-asserted-by":"publisher","DOI":"10.3389\/frhs.2023.1219308"},{"key":"S2059866125102355_ref17","doi-asserted-by":"publisher","DOI":"10.1177\/1471301214555542"},{"key":"S2059866125102355_ref13","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnv697"},{"key":"S2059866125102355_ref32","doi-asserted-by":"publisher","DOI":"10.3928\/19404921-20220930-01"},{"key":"S2059866125102355_ref35","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.1878"},{"key":"S2059866125102355_ref10","doi-asserted-by":"publisher","DOI":"10.1080\/07317115.2016.1151968"},{"key":"S2059866125102355_ref22","unstructured":"22. The MITRE Corporation. Coronovirus commission on safety and quality in nursing homes: Commission final report. 2020: 186. (https:\/\/www.cms.gov\/files\/document\/covid-final-nh-commission-report.pdf)."},{"key":"S2059866125102355_ref36","volume-title":"Focus Groups: A Practical Guide for Applied Research","author":"Krueger","year":"2014"},{"key":"S2059866125102355_ref5","first-page":"469580211005191","article-title":"Challenges to admitting residents: Perspectives from rural nursing home administrators and staff","volume":"58","author":"Henning-Smith","year":"2021","journal-title":"Inq J Med Care Organ Provis Financ"}],"container-title":["Journal of Clinical and Translational Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2059866125102355","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T07:16:28Z","timestamp":1784272588000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2059866125102355\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S2059866125102355"],"URL":"https:\/\/doi.org\/10.1017\/cts.2025.10235","relation":{},"ISSN":["2059-8661"],"issn-type":[{"value":"2059-8661","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e26"}}