{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T01:11:02Z","timestamp":1778202662468,"version":"3.51.4"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"5","funder":[{"name":"United States (U.S.) Department of Veterans Affairs Office of Research and Development"},{"name":"Health Services Research and Development Investigator Initiated Research","award":["IIR-16-018"],"award-info":[{"award-number":["IIR-16-018"]}]},{"name":"Health Services Research and Development Investigator Initiated Research","award":["I01 HX 0022233"],"award-info":[{"award-number":["I01 HX 0022233"]}]},{"name":"Health Services Research and Development Investigator Initiated Research","award":["IIR 19-413-2"],"award-info":[{"award-number":["IIR 19-413-2"]}]},{"name":"Health Services Research and Development Investigator Initiated Research","award":["I01 HX003093"],"award-info":[{"award-number":["I01 HX003093"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>We describe nursing home staff perspectives implementing Montessori approaches to person-centered care (MAP-VA) in Veterans Administration Community Living Centers (CLCs) during the coronavirus disease 2019 (COVID-19) pandemic We investigated. staff perspectives on implementing MAP-VA to promote resident autonomy, engagement, and connection in the context of pandemic-related safety precautions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design and Methods<\/jats:title>\n                    <jats:p>We used longitudinal data from a stepped-wedge, randomized clinical trial examining implementation and effectiveness of MAP-VA. Implementation support included 5 weeks during pre-implementation, staff MAP-VA training, 6 months each of implementation facilitation, and sustainment support. Normalization Process Theory informed data collection and analyses. Staff (N\u2009=\u20091,117) from 8 CLCs participated. No site was COVID-19 free: All sites except one experienced at least 1 month where 5% or more of residents were infected; 1 site experienced rates of 16%. We completed individual or group interviews with 162 staff, at baseline, 3, 6, 9, and 12 months between September 2021 and October 2023. We coded transcripts using content analysis and graphed COVID-19 rates over 18 months during implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 4 themes related to implementing MAP-VA during the pandemic: The waves of COVID-19 and changing precautions were associated with (a) barriers to Veteran engagement and connection; (b) staffing-related barriers to implementation; and during COVID, MAP-VA was a positive force that (c) increased Veteran wellbeing; and (d) improved staff morale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Implications<\/jats:title>\n                    <jats:p>Results indicate that supporting person-centered care in nursing home settings is possible\u2014and perhaps even protective for staff and residents\u2014during crises and periods of increased safety concerns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration Number<\/jats:title>\n                    <jats:p>NCT04829500<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/geront\/gnag026","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T17:38:07Z","timestamp":1773855487000},"source":"Crossref","is-referenced-by-count":0,"title":["Montessori approaches counterbalance pandemic precautions in nursing homes: staff perspectives"],"prefix":"10.1093","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5342-0370","authenticated-orcid":false,"given":"Kimberly","family":"Curyto","sequence":"first","affiliation":[{"name":"Center for Integrated Healthcare, VA Western NY Healthcare System , Batavia, New York,","place":["United States"]},{"name":"Research & Development Service, Tuscaloosa Veterans Affairs Medical Center , Tuscaloosa, 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Island,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0083-5417","authenticated-orcid":false,"given":"Teddy","family":"Bishop","sequence":"additional","affiliation":[{"name":"Research & Development Service, Tuscaloosa Veterans Affairs Medical Center , Tuscaloosa, Alabama,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5056-0431","authenticated-orcid":false,"given":"Kevin W","family":"McConeghy","sequence":"additional","affiliation":[{"name":"Transformative Health Systems Research to Improve Veteran Equity and Independence Center of Innovation (THRIVE COIN), VA Providence Healthcare System , Providence, Rhode Island,","place":["United States"]},{"name":"Department of Health Services, Policy and Practice, School of Public Health, Brown University , Providence, Rhode Island,","place":["United 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