{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:03:42Z","timestamp":1780329822771,"version":"3.54.1"},"reference-count":51,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment programme","doi-asserted-by":"publisher","award":["NIHR128865"],"award-info":[{"award-number":["NIHR128865"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journalslibrary.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["Health Technol Assess"],"abstract":"\n Background<\/jats:title>\n Incontinence-associated dermatitis is prevalent in long-term care facilities and homecare settings among adults who are incontinent of urine and\/or faeces. Strategies to protect skin integrity are needed. This study aimed to co-design and test the feasibility of a training manual and care guidance (Incontinence-Associated Dermatitis Manual) to prevent and treat incontinence-associated dermatitis in long-term care facilities and homecare settings.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was a three-phase study: (1) evidence synthesis and intervention development, (2) definitive study design (a cluster-randomised controlled trial with an embedded process evaluation) and (3) a 3-month feasibility study.<\/jats:p>\n Our Cochrane review was updated following a similar methodology to the original review.<\/jats:p>\n The intervention (underpinned by findings from the Cochrane review) was developed with 16 stakeholders.<\/jats:p>\n The feasibility study targeted four long-term care facilities and two homecare providers, randomising them (each as a cluster) to intervention or control. Recruitment targeted 288 participants (48 per cluster). Feasibility outcomes included recruitment and retention rates, completeness of data, acceptability of intervention and methods and intervention fidelity. Outcome measures included: Ghent Global incontinence-associated dermatitis categorisation tool, minimum data set and incontinence-associated dermatitis intervention tool. Process evaluation interviews with two care recipients, 11 family carers and 13 care staff implementing the Incontinence-Associated Dermatitis Manual and their managers were conducted. Observations of 22 episodes of care assessed intervention fidelity. Qualitative data were analysed using thematic analysis. Summary feasibility outcome measures using means or proportions, together with 95% confidence intervals, were reported.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The reviews of interventions for prevention and treatment of incontinence-associated dermatitis included 15 trials with 1089 participants and 19 trials with 1164 participants, respectively. All participants were incontinent of urine, stool or both. Little evidence, of very low to low quality, was found on the effects of interventions for preventing and treating incontinence-associated dermatitis in adults.<\/jats:p>\n The proposed cluster-randomised controlled trial was agreed, with one additional outcome measure added, and the co-designed intervention (incontinence-associated dermatitis manual) included training (3 hours face-to-face and online), an online manual and a poster\/flow chart to support care decision-making.<\/jats:p>\n \n After a COVID-19-related pause of 7 months, obtaining governance and ethical approvals for the feasibility study was delayed by 27 months. Five sites were recruited from 49 approached. All randomised sites were retained. Seventy-six (16%) of the 477 participants approached were randomised, of which 58 (76%) completed the study. Ghent Global incontinence-associated dermatitis categorisation tool, minimum data set and incontinence-associated dermatitis intervention tool had complete or almost-complete 3-month outcome data in participants, whereas other outcome measures had contrastingly poor data completeness due to participant cognitive impairment. Process evaluation showed few potential participants had capacity to consent, and gaining consultee approval was challenging. Care staff liked the incontinence-associated dermatitis manual, describing it as \u2018\n helpful<\/jats:italic>\n \u2019. Twenty-eight people accessed the incontinence-associated dermatitis manual online, and 15 care staff downloaded a certificate of completion of training. Intervention fidelity was not always observed.\n <\/jats:p>\n <\/jats:sec>\n \n Limitations<\/jats:title>\n The study was limited by the impact of COVID on both the social care sector and research governance systems and processes. The prevalence of incontinence-associated dermatitis in study sites was lower than expected.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n It was feasible to develop the Incontinence-Associated Dermatitis Manual. The randomised controlled trial was not feasible as designed, with specific challenges regarding site and participant recruitment, governance and intervention fidelity.<\/jats:p>\n <\/jats:sec>\n \n Future work<\/jats:title>\n We plan to revise the methods used in this feasibility study to address limitations, especially issues of recruitment, and develop a protocol for a new trial with nested feasibility study.<\/jats:p>\n <\/jats:sec>\n \n Funding<\/jats:title>\n This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR128865.<\/jats:p>\n <\/jats:sec>","DOI":"10.3310\/lmas8546","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T12:34:03Z","timestamp":1756989243000},"page":"1-48","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prevention and treatment of incontinence-associated dermatitis through optimising care: the PREVENT-IAD Synopsis"],"prefix":"10.3310","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5390-7253","authenticated-orcid":true,"given":"Sue","family":"Woodward","sequence":"first","affiliation":[{"name":"Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7238-4865","authenticated-orcid":true,"given":"Tanya","family":"Graham","sequence":"additional","affiliation":[{"name":"Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5673-305X","authenticated-orcid":true,"given":"Nicholas","family":"Beckley-Hoelscher","sequence":"additional","affiliation":[{"name":"Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3080-8716","authenticated-orcid":true,"given":"Dimitri","family":"Beeckman","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, UZ Gent, Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Chatterton","sequence":"additional","affiliation":[{"name":"Patient and Public Involvement Representative, Bedfordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0801-543X","authenticated-orcid":true,"given":"Mandy","family":"Fader","sequence":"additional","affiliation":[{"name":"School of Health Sciences, University of Southampton, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9817-6634","authenticated-orcid":true,"given":"Francesca","family":"Fiorentino","sequence":"additional","affiliation":[{"name":"Division of Clinical Trials Research, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6285-180X","authenticated-orcid":true,"given":"Joanne M","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4377-5063","authenticated-orcid":true,"given":"Ruth","family":"Harris","sequence":"additional","affiliation":[{"name":"Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0750-3818","authenticated-orcid":true,"given":"Jan","family":"Kottner","sequence":"additional","affiliation":[{"name":"Institute for Clinical Nursing Science, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2259-0948","authenticated-orcid":true,"given":"Christine","family":"Norton","sequence":"additional","affiliation":[{"name":"Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0657-371X","authenticated-orcid":true,"given":"Sangeeta","family":"Sooriah","sequence":"additional","affiliation":[{"name":"Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0145-5042","authenticated-orcid":true,"given":"Peter R","family":"Worsley","sequence":"additional","affiliation":[{"name":"School of Health Sciences, University of Southampton, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6221","published-online":{"date-parts":[[2026,5]]},"reference":[{"key":"key2026060120510500_ref1-bib1","article-title":"Skin cleansers and leave-on product interventions for preventing incontinence-associated dermatitis in adults","volume":"7","author":"Graham","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"key":"key2026060120510500_ref2-bib2","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.jtv.2018.10.004","article-title":"Minimum data set for incontinence-associated dermatitis (MDS-IAD) in adults: design and pilot study in nursing home residents","volume":"27","author":"Van den Bussche","year":"2018","journal-title":"J Tissue Viability"},{"key":"key2026060120510500_ref3-bib3","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1111\/jan.12189","article-title":"International prevalence measurement of care problems: results","volume":"69","author":"Halfens","year":"2013","journal-title":"J Adv Nurs"},{"key":"key2026060120510500_ref4-bib4","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/WON.0000000000000159","article-title":"Incidence and characteristics of incontinence-associated dermatitis in community-dwelling persons with fecal incontinence","volume":"42","author":"Bliss","year":"2015","journal-title":"J Wound Ostomy Continence Nurs"},{"key":"key2026060120510500_ref5-bib5","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/WON.0b013e31827e8b3d","article-title":"Incontinence-associated dermatitis in community-dwelling individuals with fecal incontinence","volume":"40","author":"Rohwer","year":"2013","journal-title":"J Wound Ostomy Continence Nurs"},{"key":"key2026060120510500_ref6-bib6","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.12968\/bjon.2016.25.18.1016","article-title":"Incontinence-associated dermatitis: reducing adverse events","volume":"25","author":"Rippon","year":"2016","journal-title":"Br J Nurs"},{"key":"key2026060120510500_ref7-bib7","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1002\/nau.20668","article-title":"Prevalence of urinary incontinence and associated risk factors in nursing home residents: a systematic review","volume":"28","author":"Offermans","year":"2009","journal-title":"Neurourol Urodyn"},{"key":"key2026060120510500_ref8-bib8","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1159\/000489532","article-title":"Skin care products for healthy and diseased skin","volume":"54","author":"Surber","year":"2018","journal-title":"Curr Probl Dermatol"},{"key":"key2026060120510500_ref9-bib9","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1097\/WON.0000000000000313","article-title":"Incidence and predictors of incontinence-associated skin damage in nursing home residents with new-onset incontinence","volume":"44","author":"Bliss","year":"2017","journal-title":"J Wound Ostomy Continence Nurs"},{"key":"key2026060120510500_ref10-bib10","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/S0965-206X(04)42001-4","article-title":"The benefits of implementing a new skin care protocol in nursing homes","volume":"14","author":"Bale","year":"2004","journal-title":"J Tissue Viability"},{"key":"key2026060120510500_ref11-bib11","doi-asserted-by":"crossref","first-page":"76,78","DOI":"10.12968\/jowc.2011.20.2.76","article-title":"Clinical and economic evidence supporting a transparent barrier film dressing in incontinence-associated dermatitis and peri-wound skin protection","volume":"20","author":"Guest","year":"2011","journal-title":"J Wound Care"},{"key":"key2026060120510500_ref12-bib12","article-title":"Interventions for preventing and treating incontinence-associated dermatitis in adults","volume":"11","author":"Beeckman","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"key2026060120510500_ref13-bib13","volume-title":"Incontinence-associated Dermatitis: Moving Prevention Forward","author":"Beeckman","year":"2015"},{"key":"key2026060120510500_ref14-bib14","doi-asserted-by":"crossref","first-page":"100925","DOI":"10.1016\/j.jtv.2025.100925","article-title":"Exploration of current practice and context for the prevention and treatment of incontinence associated dermatitis for adults living in care homes and community settings: a qualitative study","volume":"34","author":"Woodward","year":"2025","journal-title":"J Tissue Viability"},{"key":"key2026060120510500_ref15-bib15","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1748-5908-6-42","article-title":"The behaviour change wheel: a new method for characterising and designing behaviour change interventions","volume":"6","author":"Michie","year":"2011","journal-title":"Implement Sci"},{"key":"key2026060120510500_ref16-bib16","doi-asserted-by":"crossref","first-page":"n2061","DOI":"10.1136\/bmj.n2061","article-title":"A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance","volume":"374","author":"Skivington","year":"2021","journal-title":"BMJ"},{"key":"key2026060120510500_ref17-bib17","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.ijnurstu.2017.12.001","article-title":"Increasing value and reducing waste by optimizing the development of complex interventions: enriching the development phase of the Medical Research Council (MRC) Framework","volume":"79","author":"Bleijenberg","year":"2018","journal-title":"Int J Nurs Stud"},{"key":"key2026060120510500_ref18-bib18","doi-asserted-by":"crossref","first-page":"h1258","DOI":"10.1136\/bmj.h1258","article-title":"Process evaluation of complex interventions: Medical Research Council guidance","volume":"350","author":"Moore","year":"2015","journal-title":"BMJ"},{"key":"key2026060120510500_ref19-bib19","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1111\/jan.13562","article-title":"Core outcome domains in incontinence-associated dermatitis research","volume":"74","author":"Van den Bussche","year":"2018","journal-title":"J Adv Nurs"},{"key":"key2026060120510500_ref20-bib20","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1111\/j.1464-0597.2008.00341.x","article-title":"From Theory to Intervention: mapping theoretically derived behavioural determinants to behaviour change techniques","volume":"57","author":"Michie","year":"2008","journal-title":"Appl Psychol"},{"key":"key2026060120510500_ref21-bib21","doi-asserted-by":"crossref","first-page":"e092338","DOI":"10.1136\/bmjopen-2024-092338","article-title":"PREVENTion and treatment of incontinence-associated dermatitis through a codesigned manual (PREVENT-IAD): a study protocol for a feasibility cluster randomised controlled trial with a nested process evaluation","volume":"14","author":"Woodward","year":"2024","journal-title":"BMJ Open"},{"key":"key2026060120510500_ref22-bib22","doi-asserted-by":"crossref","first-page":"afaf202","DOI":"10.1093\/ageing\/afaf202","article-title":"Conducting adult social care research in the United Kingdom \u2013 impacts of challenges to study processes on study feasibility","volume":"54","author":"Fitzpatrick","year":"2025","journal-title":"Age Ageing"},{"key":"key2026060120510500_ref24-bib24","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1111\/iwj.12898","article-title":"The Ghent Global IAD Monitoring Tool (GLOBIAD-M) to monitor the healing of incontinence-associated dermatitis (IAD): design and reliability study","volume":"15","author":"Van den Bussche","year":"2018","journal-title":"Int Wound J"},{"key":"key2026060120510500_ref25-bib25","first-page":"56hn1-10; quiz 56hn10-1","article-title":"Beyond \u2018diaper rash\u2019: Incontinence-associated dermatitis: does it have you seeing red?","volume":"38","author":"Junkin","year":"2008","journal-title":"Nursing (Brux)"},{"key":"key2026060120510500_ref26-bib26","first-page":"9","article-title":"Pain in children: comparison of assessment scales","volume":"14","author":"Wong","year":"1988","journal-title":"Pediatr Nurs"},{"key":"key2026060120510500_ref27-bib27","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.jclinepi.2013.12.010","article-title":"Measuring patient satisfaction with health care treatment using the Short Assessment of Patient Satisfaction measure delivered superior and robust satisfaction estimates","volume":"67","author":"Hawthorne","year":"2014","journal-title":"J Clin Epidemiol"},{"key":"key2026060120510500_ref28-bib28","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"key2026060120510500_ref29-bib29","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1177\/0962280215588242","article-title":"How big should the pilot study for my cluster randomised trial be?","volume":"25","author":"Eldridge","year":"2016","journal-title":"Stat Methods Med Res"},{"key":"key2026060120510500_ref30-bib30","doi-asserted-by":"crossref","first-page":"i5239","DOI":"10.1136\/bmj.i5239","article-title":"CONSORT 2010 statement: extension to randomised pilot and feasibility trials","volume":"355","author":"Eldridge","year":"2016","journal-title":"BMJ"},{"key":"key2026060120510500_ref31-bib31","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr Scand"},{"key":"key2026060120510500_ref32-bib32","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1002\/gps.4727","article-title":"Feasibility of a staff training and support programme to improve pain assessment and management in people with dementia living in care homes","volume":"33","author":"Petyaeva","year":"2018","journal-title":"Int J Geriatr Psychiatry"},{"key":"key2026060120510500_ref33-bib33","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1186\/s12912-022-00999-8","article-title":"How to establish workplace learning in long-term care: results from a World Caf\u00e9 dialogue","volume":"21","author":"van Lierop","year":"2022","journal-title":"BMC Nurs"},{"key":"key2026060120510500_ref34-bib34","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1186\/s12875-024-02574-3","article-title":"Enhanced train-the-trainer program for registered nurses and social workers to apply the founding principles of primary care in their practice: a pre-post study","volume":"25","author":"Poitras","year":"2024","journal-title":"BMC Prim Care"},{"key":"key2026060120510500_ref35-bib35","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1111\/jan.12517","article-title":"The epidemiology of skin care provided by nurses at home: a multicentre prevalence study","volume":"71","author":"Kottner","year":"2015","journal-title":"J Adv Nurs"},{"key":"key2026060120510500_ref36-bib36","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.jtv.2024.02.005","article-title":"Skin care types, frequencies and products: a cross-sectional study in German institutional long-term care","volume":"33","author":"Amin","year":"2024","journal-title":"J Tissue Viability"},{"key":"key2026060120510500_ref37-bib37","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1177\/1740774512454243","article-title":"Addressing methodological challenges in implementing the nursing home pain management algorithm randomized controlled trial","volume":"9","author":"Ersek","year":"2012","journal-title":"Clin Trials"},{"key":"key2026060120510500_ref38-bib38","doi-asserted-by":"crossref","first-page":"16","DOI":"10.7748\/nop.28.5.16.s24","article-title":"Overcoming challenges of conducting research in nursing homes","volume":"28","author":"Jenkins","year":"2016","journal-title":"Nurs Older People"},{"key":"key2026060120510500_ref39-bib39","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1186\/s12877-018-0934-9","article-title":"Challenges of conducting research in long-term care facilities: a systematic review","volume":"18","author":"Lam","year":"2018","journal-title":"BMC Geriatr"},{"key":"key2026060120510500_ref40-bib40","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1093\/gerona\/60.4.524","article-title":"Feasibility and reliability of four pain self-assessment scales and correlation with an observational rating scale in hospitalized elderly demented patients","volume":"60","author":"Pautex","year":"2005","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"key2026060120510500_ref41-bib41","doi-asserted-by":"crossref","DOI":"10.1002\/gps.5830","article-title":"Psychometric evaluation of the Pain Assessment in Advanced Dementia scale in an acute general hospital setting","volume":"37","author":"Dunford","year":"2022","journal-title":"Int J Geriatr Psychiatry"},{"key":"key2026060120510500_ref42-bib42","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1186\/s40814-021-00931-y","article-title":"Are some feasibility studies more feasible than others? A review of the outcomes of feasibility studies on the ISRCTN registry","volume":"7","author":"Morgan","year":"2021","journal-title":"Pilot Feasibility Stud"},{"key":"key2026060120510500_ref43-bib43","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s12603-019-1288-5","article-title":"The Living lab in ageing and long-term care: a sustainable model for translational research improving quality of life, quality of care and quality of work","volume":"24","author":"Verbeek","year":"2020","journal-title":"J Nutr Health Aging"},{"key":"key2026060120510500_ref44-bib44","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.12968\/bjon.2018.27.22.1321","article-title":"Patients\u2019 perspectives on opt-out consent for observational research: systematic review and focus group","volume":"27","author":"Cardillo","year":"2018","journal-title":"Br J Nurs"},{"key":"key2026060120510500_ref45-bib45","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/1471-2288-11-40","article-title":"Opt-out as an acceptable method of obtaining consent in medical research: a short report","volume":"11","author":"Vellinga","year":"2011","journal-title":"BMC Med Res Methodol"},{"key":"key2026060120510500_ref46-bib46","doi-asserted-by":"crossref","first-page":"e0140203","DOI":"10.1371\/journal.pone.0140203","article-title":"Nurse-Led medicines\u2019 monitoring for patients with dementia in care homes: a pragmatic cohort stepped wedge cluster randomised trial","volume":"10","author":"Jordan","year":"2015","journal-title":"PLOS ONE"},{"key":"key2026060120510500_ref47-bib47","doi-asserted-by":"crossref","first-page":"e6140","DOI":"10.1002\/gps.6140","article-title":"Promoting independence through quality dementia care at home (PITCH): an australian stepped\u2010wedge cluster randomised controlled trial evaluating a dementia training program for home care workers","volume":"39","author":"Dow","year":"2024","journal-title":"Int J Geriatr Psychiatry"},{"key":"key2026060120510500_ref48-bib48","doi-asserted-by":"crossref","first-page":"1378932","DOI":"10.3389\/fpubh.2024.1378932","article-title":"Editorial: living labs and open innovation approaches to scale impact for human wellbeing","volume":"12","author":"Borda","year":"2024","journal-title":"Front Public Health"},{"key":"key2026060120510500_ref49-bib49","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1136\/ebmental-2019-300116","article-title":"Consent to discuss participation in research: a pilot study","volume":"23","author":"Walker","year":"2020","journal-title":"Evid Based Ment Health"},{"key":"key2026060120510500_ref50-bib50","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1186\/s40814-025-01729-y","article-title":"PREVENTion and treatment of Incontinence-Associated Dermatitis (IAD) through optimising care: development and feasibility cluster randomised trial of the IAD-Manual (PREVENT-IAD)","volume":"11","author":"Woodward","year":"2025","journal-title":"Pilot Feasibility Stud"},{"key":"key2026060120510500_ref51-bib51","volume-title":"Recruiting Participants for Adult Social Care Studies: Challenges and Mitigating Strategies","author":"Cyhlarova","year":"2020"},{"key":"key2026060120510500_ref52-bib52","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1093\/ageing\/afaa046","article-title":"A posture and mobility training package for care home staff: results of a cluster randomised controlled feasibility trial (the PATCH trial)","volume":"49","author":"Graham","year":"2020","journal-title":"Age Ageing"}],"container-title":["Health Technology Assessment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2051204","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/sites\/journalslibrary\/files\/journal_data\/LMAS8546\/LMAS8546.xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2051204","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T15:25:58Z","timestamp":1780327558000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/hta\/LMAS8546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":51,"alternative-id":["10.3310\/LMAS8546"],"URL":"https:\/\/doi.org\/10.3310\/lmas8546","relation":{},"ISSN":["2046-4924"],"issn-type":[{"value":"2046-4924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"This content has been made freely available to all.","name":"free","label":"Free to read"},{"value":"03-2020","name":"contractual_start_date","label":"contractual_start_date","group":{"name":"article_history","label":"Article History"}},{"value":"02-2025","name":"editorial_review_begun","label":"editorial review begun","group":{"name":"article_history","label":"Article History"}},{"value":"11-2025","name":"accepted_for_publication","label":"Accepted for publication","group":{"name":"article_history","label":"Article History"}}]}}