{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:25:23Z","timestamp":1789129523013,"version":"build-2803163510"},"reference-count":58,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Economic and Social Research Council (ESRC) and National Institute for Health and Care Research (NIHR) through the ESRC\/NIHR Dementia Initiative 2018","award":["ES\/S010327\/1"],"award-info":[{"award-number":["ES\/S010327\/1"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["DIGITAL HEALTH"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Care homes are the main provider of palliative care for people living with dementia. In the UK around 70% of care homes are residential, with no onsite medical or nursing staff to manage residents\u2019 complex needs. eHealth interventions can support holistic care delivery in this context; however, adoption in care homes has been limited. Innovative approaches grounded in implementation science are required to encourage uptake. This study aimed to assess the feasibility of a theoretically informed implementation plan for the EMBED-Care Framework, an eHealth intervention delivered via a mobile app to support holistic assessment and decision-making for people living with dementia in care homes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An embedded mixed-methods feasibility study was conducted in two residential homes. Qualitative data included non-participant observations, focus groups and semi-structured interviews with staff, analysed using codebook thematic analysis informed by Normalisation Process Theory. Quantitative data comprised app-usage metrics, analysed descriptively. Patient and public involvement informed the study design and conduct.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty staff across two care homes used the intervention with 26 residents. Although some uptake was observed, usage data indicated that the Framework was largely not used as intended. Whilst care staff acknowledged its potential benefit, they faced substantial practical challenges to its use related to workload and a sense it was duplicating existing care processes. These issues led to negative appraisals of its impact and compromised staff engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Feasibility evaluation enabled rapid identification of barriers and refinement of implementation strategies. Iterative revisions to strategies related to providing further staff support, including a more tailored approach to training, and additional reminders to use the Framework. The Framework itself also requires adaptation to improve \u2018fit\u2019 in the care home context. Further collaboration on the revised strategies with people living with dementia and their family carers is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552076261476137","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:39:36Z","timestamp":1788856776000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementing the Empowering Better End of life Dementia Care (EMBED-Care) Framework to improve palliative dementia care in care homes: A feasibility evaluation"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9752-1704","authenticated-orcid":false,"given":"Juliet","family":"Gillam","sequence":"first","affiliation":[{"name":"University of West London, United Kingdom"},{"name":"King\u2019s College London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Davies","sequence":"additional","affiliation":[{"name":"Queen Mary University of London, United Kingdom"},{"name":"Research Department of Primary Care and Population Health, University College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Ellis-Smith","sequence":"additional","affiliation":[{"name":"King\u2019s College London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Dar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Sampson","sequence":"additional","affiliation":[{"name":"Queen Mary University of London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Evans","sequence":"additional","affiliation":[{"name":"King\u2019s College London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.q2387"},{"key":"e_1_3_7_3_2","unstructured":"Care Home. 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