DEVELOPING REHABILITATIVE BEHAVIORAL INTERVENTIONS FOR LONG-TERM-CARE- TECHNOLOGY-TRANSFER, ACCEPTANCE, AND MAINTENANCE ISSUES

Rehabilitative behavioral interventions that are documented in clinica l trials to improve nursing home resident outcomes and are recommended by practice guidelines are often not adapted for daily use in nursing homes and other Icing-term care (LTC) facilities. Failure to evaluate issues other than clinical efficacy when developing interventions con tributes to this gap between efficacy and effectiveness in practice. A potential solution is a research model that supplements traditional c linical intervention research with methodology designed specifically t o evaluate the ability of LTC facilities to implement the intervention s. This paper discusses several critical issues of intervention and im plementation that should be addressed, including targeting interventio ns, advocacy, cost-effectiveness, training, and quality control. We al so describe how clinical trials could be designed and staged to increa se the probability that effective interventions will be implemented in the day-to-day care of frail older patients in LTC facilities.