Feasibility of Implementing the Individualized Positive Psychosocial Interaction (IPPI) Program in an Embedded Pragmatic Clinical Trial

Objectives: The Individualized Positive Psychosocial Intervention (IPPI) is an evidence-based program that engages people living with dementia (PLWD) in brief (i.e. 10 minute) one-to-one preference-based activities two times a week. This study evaluated the feasibility of pragmatically implementing a pilot embedded pragmatic clinical trial of the IPPI program in nine nursing homes. Methods: Feasibility was defined as the ability of NH communities to establish implementation champions and an implementation team, complete training, identify and enroll eligible residents, match IPPI protocols to residents’ stated preferences, complete an average of two IPPIs per week per resident for 6 months, and complete IPPIs with fidelity. Results: Seven NHs completed the project, enrolling a total of 130 eligible residents. Seventy staff were trained. Staff identified preferences, corresponding IPPIs, and a targeted symptom of distress for all enrolled residents. Staff completed an average of 44.71 IPPIs per person (over six months) for those that did not pass away or discharge, with an average of 3.91 days between IPPIs. All staff reached at least 80% intervention delivery fidelity. Conclusions and Clinical Implications: The IPPI program is a feasible nonpharmacologic intervention for PLWD that can be implemented with fidelity over time in nursing homes by staff.