The long-term objective of this R34 proposal is to develop Resident Assisted Montessori-based Programming RAMP tm as an intervention that is implemented by staff in long-term care LTC settings to promote the mental health of residents with dementia. If RAMP tm shows promise in this developmental project, support will be sought for a randomized clinical trial to demonstrate the public health benefits of this intervention over other group activities for persons with dementia in LTC. RAMP tm is a novel intervention in which residents with early dementia are trained as activity leaders for small groups of residents with more advanced dementia. In a small-scale trial, RAMP tm has been shown to increase engagement and positive affect during activities. The purpose of the present study is to further develop and pilot test RAMP tm. The study is designed with two phases to develop, test and compare an staff-implemented approach with intervention as implemented by research personnel. Both phases will involve the same design, sample sizes, measures and analyses. In each phase, training and implementation will occur at four distinct long-term care facilities in the Greater Cleveland area. In each phase, a RAMP tm condition in which persons in early stage dementia will serve as group leaders for Montessori-based activities and a control condition in which persons in early stage dementia will serve as group leaders for non-Montessori-based group activities will be used. Both conditions will occur at two sites in parallel, then in another two sites in parallel.
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