{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T22:53:26Z","timestamp":1785711206173,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:00:00Z","timestamp":1679875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Alzheimer's disease\u2010related dementias (ADRD) are a leading cause of disability and death. In late\u2010stage ADRD most people prioritize comfort, but care to achieve comfort is rare.\n                      <jats:italic>Comfort Matters<\/jats:italic>\n                      combines palliative and geriatric care practices for nursing home dementia care, but in\u2010person training reaches few sites. To facilitate dissemination, we developed\n                      <jats:italic>Comfort First<\/jats:italic>\n                      , a web\u2010based training toolkit with video demonstration of\n                      <jats:italic>Comfort Matters<\/jats:italic>\n                      practices.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We developed and pilot\u2010tested\n                      <jats:italic>Comfort First<\/jats:italic>\n                      (NIA Intervention Stage 1)\n                      <jats:italic>.<\/jats:italic>\n                      Stakeholder advisors representing nursing home residents, caregiver, and clinical perspectives guided development. Professional videographers filmed\n                      <jats:italic>Comfort Matters<\/jats:italic>\n                      staff to illustrate comfort\u2010focused dementia care skills. Video training modules, supported by an implementation manual, address Understanding the Person with Dementia, Promoting Quality of Life and Comfort, Working as a Team, Responding When People with Dementia are Distressed, Addressing Pain, and Making Comfort First a Reality. We then delivered\n                      <jats:italic>Comfort First<\/jats:italic>\n                      to 3 nursing homes. Implementation and outcome evaluation assessed the number and clinically diverse roles of trained staff and post\u2010test knowledge.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nursing home staff roles (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0146) were diverse: certified nursing assistants (40%), nurses (19%), administrators (11%), activities staff (6%), therapy staff (5%) and other roles. Individual participants' knowledge scores ranged from 50\u2013100%; however average post\u2010test knowledge scores were high, ranging from 90% (Addressing Pain) to 99% (Promoting Quality of Life and Comfort, Making Comfort First a Reality).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic>Comfort First<\/jats:italic>\n                      web\u2010based training toolkit combines best practices in palliative care and geriatric care for ADRD, using video demonstrations to support broader dissemination of these skills. Initial evaluation demonstrates acceptability and knowledge uptake for staff in diverse clinical roles; future research should include evaluation of practice change. Consistent with the intent of its public funding,\n                      <jats:italic>Comfort First<\/jats:italic>\n                      will be widely disseminated at a minimal cost.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18346","type":"journal-article","created":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T00:15:34Z","timestamp":1679962534000},"page":"2564-2570","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["<i>Comfort First<\/i>\n                    : Development and pilot testing of a web\u2010based video training to disseminate\n                    <i>Comfort Matters<\/i>\n                    dementia care"],"prefix":"10.1111","volume":"71","author":[{"given":"Laura C.","family":"Hanson","sequence":"first","affiliation":[{"name":"Division of Geriatric Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"Cecil G. Sheps Center for Health Services Research University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Meeks","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Guo","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School of Brown University  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tena R. M.","family":"Alonzo","sequence":"additional","affiliation":[{"name":"Comfort Matters  Beatitudes Campus Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Comfort Matters  Beatitudes Campus Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maribeth","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Hospice of the Valley  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Toles","sequence":"additional","affiliation":[{"name":"School of Nursing University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianna","family":"Harder","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheryl","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Cecil G. Sheps Center for Health Services Research University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"Schools of Social Work and Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.139.9.1136"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31828726f5"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2013.1268"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.wad.0000213854.04861.cc"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2006.00986.x"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3928\/00989134-20081201-03"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01388.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2013.05.015"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2012.03905.x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.4103"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.7031"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2017.04.020"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0902234"},{"key":"e_1_2_11_15_1","unstructured":"MeadR.The sense of an ending. 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