Trial Outcomes & Findings for Implementation of CAPABLE in the Michigan Medicaid Waiver (NCT NCT03634033)

NCT ID: NCT03634033

Last Updated: 2022-11-30

Results Overview

Adoptions and sustainability of the intervention using the Stages of Implementation Completion (SIC) at a site (18). SIC is a tool that tracks achievement of key activities when implementing an evidence-based intervention. SIC has 6 stages with multiple implementation activities; each activity had an assigned numeric value and when a activity was completed, a score was assigned. The \*total\* SIC score ranges from 0-100. Stage 1 score range 0-12. Stage 2 0-16. Stage 3 0-24. Stage 4 0-16. Stage 5 0-16. Stage 6 0-16. The \*total\* score was calculated by summing the points of each stage. The higher the \*total\* score, the more implementation activities were completed. For the below reported \*total\* score, each waiver site had their \*total\* SIC score numerically calculated. Then, the mean and standard deviation were calculated by group/arm.

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 7777 participants
• Primary outcome timeframe: 9 months
• Results posted on: 2022-11-30

Participant Flow

MAIN STUDY. Group allocation-randomized 18 waiver sites, 9 to MiCAP with IF; and 9 to MiCAP with IF and EF. Recruited 2 groups of participants at each site: clinicians employed by the sites to provide the intervention to waiver beneficiaries to receive the intervention. ADMINISTRATIVE SUPP. No group allocation: Recruited 3 groups of participants at 3 sites from Main Study; clinicians employed at sites, caregivers to provide the intervention, and beneficiaries to receive it; plus MiCAP IF.

COUNT OF PARTICIPANTS: for ARMS/GROUPS- Some clinicians/beneficiaries in MiCAP with IF Main Study may be represented in Administrative Supplement: clinicians/beneficiaries; counted more than once/signed more than 1 Consent Form. MAIN STUDY: UNITS- MiCAP with IF/IF+EF Beneficiaries and Clinicians use the same 18 sites. ADMINISTRATIVE SUPPLEMENT: Some caregivers dropped out of study after beneficiary passed away or transferred to a facility; the caregiver was not deceased or in a facility.

Unit of analysis: Sites (Main Study only)

Participant milestones

Measure	MiCAP With IF (Main Study: Beneficiaries) MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF (Main Study: Beneficiaries) MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	MiCAP With IF (Main Study: Clinicians) MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF (Main Study: Clinicians) MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Administrative Supplement: Clinicians Clinicians who were employed at the waiver sites and were trained in using CAPABLE with caregivers of beneficiaries with Alzheimer's Disease or Dementia; plus MiCAP with IF from Main Study.	Administrative Supplement: Caregivers Caregivers of beneficiaries diagnosed with Alzheimer's Disease or Dementia who agreed to assist with providing CAPABLE to their beneficiary; plus MiCAP with IF from Main Study.	Administrative Supplement: Beneficiaries Beneficiaries enrolled at the waiver who were diagnosed with Alzheimer's Disease or Dementia and needed to receive CAPABLE; ; plus MiCAP with IF from Main Study.
Overall Study STARTED	3497 9	3533 9	282 9	257 9	106 3	50 3	52 3
Overall Study COMPLETED	3113 9	3242 9	168 9	96 9	101 3	37 3	37 3
Overall Study NOT COMPLETED	384 0	291 0	114 0	161 0	5 0	13 0	15 0

Reasons for withdrawal

Measure	MiCAP With IF (Main Study: Beneficiaries) MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF (Main Study: Beneficiaries) MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	MiCAP With IF (Main Study: Clinicians) MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF (Main Study: Clinicians) MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Administrative Supplement: Clinicians Clinicians who were employed at the waiver sites and were trained in using CAPABLE with caregivers of beneficiaries with Alzheimer's Disease or Dementia; plus MiCAP with IF from Main Study.	Administrative Supplement: Caregivers Caregivers of beneficiaries diagnosed with Alzheimer's Disease or Dementia who agreed to assist with providing CAPABLE to their beneficiary; plus MiCAP with IF from Main Study.	Administrative Supplement: Beneficiaries Beneficiaries enrolled at the waiver who were diagnosed with Alzheimer's Disease or Dementia and needed to receive CAPABLE; ; plus MiCAP with IF from Main Study.
Overall Study Did not have a post-assessment	384	291	114	161	5	0	0
Overall Study Death	0	0	0	0	0	7	7
Overall Study In Assisted Living/Nursing Home/Hospice	0	0	0	0	0	5	5
Overall Study Lost to Follow-up	0	0	0	0	0	1	2
Overall Study Withdrawal by Subject	0	0	0	0	0	0	1

Baseline Characteristics

ED data was not collected for MiCAP with IF (Main Study: Clinicians), MiCAP with IF and EF (Main Study: Clinicians), Administrative Supplement: Clinicians, and Administrative Supplement: Caregivers.

Baseline characteristics by cohort

Measure	Main Study: MiCAP With IF (Beneficiaries) n=3497 Participants MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	Main Study: MiCAP With IF+EF (Beneficiaries) n=3533 Participants MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Main Study: MiCAP With IF (Clinicians) n=282 Participants MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	Main Study: MiCAP With IF+EF (Clinicians) n=257 Participants MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Administrative Supplement: Clinicians n=106 Participants Clinicians who were employed at the waiver sites and were trained in using the toolkit when implementing CAPABLE with caregivers of beneficiaries with Alzheimer's Disease or Dementia.	Administrative Supplement: Caregivers n=50 Participants Caregivers of beneficiaries diagnosed with Alzheimer's Disease or Dementia who will receive the toolkit to assist in taking care of their beneficiary.	Administrative Supplement: Beneficiaries n=52 Participants Beneficiaries enrolled at the waiver who were diagnosed with Alzheimer's Disease or Dementia.	Total n=7777 Participants Total of all reporting groups
Age, Continuous	69.5 years STANDARD_DEVIATION 14.58 • n=3497 Participants	71.19 years STANDARD_DEVIATION 14.02 • n=3533 Participants	43.07 years STANDARD_DEVIATION 11.57 • n=282 Participants	47.00 years STANDARD_DEVIATION 11.59 • n=257 Participants	45.78 years STANDARD_DEVIATION 10.48 • n=106 Participants	63.28 years STANDARD_DEVIATION 11.29 • n=50 Participants	81.23 years STANDARD_DEVIATION 9.27 • n=52 Participants	70.35 years STANDARD_DEVIATION 14.32 • n=7777 Participants
Sex/Gender, Customized Sex · Male	1137 Participants n=3497 Participants	1130 Participants n=3533 Participants	16 Participants n=282 Participants	22 Participants n=257 Participants	3 Participants n=106 Participants	10 Participants n=50 Participants	12 Participants n=52 Participants	2330 Participants n=7777 Participants
Sex/Gender, Customized Sex · Female	2360 Participants n=3497 Participants	2403 Participants n=3533 Participants	266 Participants n=282 Participants	231 Participants n=257 Participants	103 Participants n=106 Participants	40 Participants n=50 Participants	40 Participants n=52 Participants	5443 Participants n=7777 Participants
Sex/Gender, Customized Sex · Unknown	0 Participants n=3497 Participants	0 Participants n=3533 Participants	0 Participants n=282 Participants	4 Participants n=257 Participants	0 Participants n=106 Participants	0 Participants n=50 Participants	0 Participants n=52 Participants	4 Participants n=7777 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	108 Participants n=3497 Participants	97 Participants n=3533 Participants	13 Participants n=282 Participants	5 Participants n=257 Participants	5 Participants n=106 Participants	1 Participants n=50 Participants	1 Participants n=52 Participants	230 Participants n=7777 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	3357 Participants n=3497 Participants	3401 Participants n=3533 Participants	267 Participants n=282 Participants	247 Participants n=257 Participants	101 Participants n=106 Participants	49 Participants n=50 Participants	51 Participants n=52 Participants	7473 Participants n=7777 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	32 Participants n=3497 Participants	35 Participants n=3533 Participants	2 Participants n=282 Participants	5 Participants n=257 Participants	0 Participants n=106 Participants	0 Participants n=50 Participants	0 Participants n=52 Participants	74 Participants n=7777 Participants
Race (NIH/OMB) American Indian or Alaska Native	25 Participants n=3497 Participants	9 Participants n=3533 Participants	5 Participants n=282 Participants	1 Participants n=257 Participants	0 Participants n=106 Participants	1 Participants n=50 Participants	1 Participants n=52 Participants	42 Participants n=7777 Participants
Race (NIH/OMB) Asian	25 Participants n=3497 Participants	25 Participants n=3533 Participants	1 Participants n=282 Participants	4 Participants n=257 Participants	0 Participants n=106 Participants	0 Participants n=50 Participants	1 Participants n=52 Participants	56 Participants n=7777 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	3 Participants n=3497 Participants	4 Participants n=3533 Participants	0 Participants n=282 Participants	0 Participants n=257 Participants	0 Participants n=106 Participants	0 Participants n=50 Participants	0 Participants n=52 Participants	7 Participants n=7777 Participants
Race (NIH/OMB) Black or African American	541 Participants n=3497 Participants	1228 Participants n=3533 Participants	14 Participants n=282 Participants	39 Participants n=257 Participants	2 Participants n=106 Participants	4 Participants n=50 Participants	4 Participants n=52 Participants	1832 Participants n=7777 Participants
Race (NIH/OMB) White	2735 Participants n=3497 Participants	2122 Participants n=3533 Participants	248 Participants n=282 Participants	202 Participants n=257 Participants	99 Participants n=106 Participants	44 Participants n=50 Participants	46 Participants n=52 Participants	5496 Participants n=7777 Participants
Race (NIH/OMB) More than one race	49 Participants n=3497 Participants	33 Participants n=3533 Participants	10 Participants n=282 Participants	4 Participants n=257 Participants	0 Participants n=106 Participants	1 Participants n=50 Participants	0 Participants n=52 Participants	97 Participants n=7777 Participants
Race (NIH/OMB) Unknown or Not Reported	119 Participants n=3497 Participants	112 Participants n=3533 Participants	4 Participants n=282 Participants	7 Participants n=257 Participants	5 Participants n=106 Participants	0 Participants n=50 Participants	0 Participants n=52 Participants	247 Participants n=7777 Participants
Region of Enrollment United States	3497 participants n=3497 Participants	3533 participants n=3533 Participants	282 participants n=282 Participants	257 participants n=257 Participants	106 participants n=106 Participants	50 participants n=50 Participants	52 participants n=52 Participants	7777 participants n=7777 Participants
Emergency Department Visits	450 Number on scale n=3497 Participants • ED data was not collected for MiCAP with IF (Main Study: Clinicians), MiCAP with IF and EF (Main Study: Clinicians), Administrative Supplement: Clinicians, and Administrative Supplement: Caregivers.	421 Number on scale n=3533 Participants • ED data was not collected for MiCAP with IF (Main Study: Clinicians), MiCAP with IF and EF (Main Study: Clinicians), Administrative Supplement: Clinicians, and Administrative Supplement: Caregivers.	—	—	—	—	12 Number on scale n=52 Participants • ED data was not collected for MiCAP with IF (Main Study: Clinicians), MiCAP with IF and EF (Main Study: Clinicians), Administrative Supplement: Clinicians, and Administrative Supplement: Caregivers.	883 Number on scale n=7082 Participants • ED data was not collected for MiCAP with IF (Main Study: Clinicians), MiCAP with IF and EF (Main Study: Clinicians), Administrative Supplement: Clinicians, and Administrative Supplement: Caregivers.

PRIMARY outcome

Timeframe: 9 months

Population: The participants analyzed were the 18 waiver sites from the MAIN STUDY that were then randomized to either MiCAP with IF (n=9) or MiCAP with IF and EF (n=9). The Administrative Supplement Arms/Groups are not included in this outcome as data were only collected during the main study.

Adoptions and sustainability of the intervention using the Stages of Implementation Completion (SIC) at a site (18). SIC is a tool that tracks achievement of key activities when implementing an evidence-based intervention.

SIC has 6 stages with multiple implementation activities; each activity had an assigned numeric value and when a activity was completed, a score was assigned. The *total* SIC score ranges from 0-100. Stage 1 score range 0-12. Stage 2 0-16. Stage 3 0-24. Stage 4 0-16. Stage 5 0-16. Stage 6 0-16. The *total* score was calculated by summing the points of each stage. The higher the *total* score, the more implementation activities were completed.

For the below reported *total* score, each waiver site had their *total* SIC score numerically calculated. Then, the mean and standard deviation were calculated by group/arm.

Outcome measures

Measure	MiCAP With IF n=9 waiver sites MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=9 waiver sites MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Main Study: Effect of MiCAP With IF Alone Versus MiCAP With IF+EF on Site-level Outcomes of Adoption and Sustainability of CAPABLE	72.22 score on a scale Standard Deviation 16.98	61.33 score on a scale Standard Deviation 19.29	—	—	—

SECONDARY outcome

Timeframe: Exit (9-months)

Population: Participants analyzed were the beneficiaries at sites (18); arms included randomized to either MiCAP with IF (n=9) or MiCAP with IF and EF (n=9).

Activities of Daily Living (ADLs) data were collected from the Minimum Data Set-Home Care (MDS-HC) in the Electronic Health Record (EHR). MDS-HC is a person-centered assessment for the collection of minimum essential nursing data, with reliability and validity, and used in the Michigan Medicaid Waiver program.

The score is a summed score of 11 items on the MDS-HC; with a score range of 0-88. The lower the summed score, the more independent the beneficiary is at performing ADLs. For the 11 items, the available scores are 0= Independent, 1= Set-up help only, 2= Supervision, 3= Limited assistance, 4= Extensive assistance, 5= Maximal assistance, 6= Total dependence, 8= Activity did not occur during entire period.

Outcome measures

Measure	MiCAP With IF n=9 Waiver Sites MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=9 Waiver Sites MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Main Study: Beneficiary's ADLs Summed Score	26.13 Score on scale Standard Error 0.20	25.85 Score on scale Standard Error 0.19	—	—	—

SECONDARY outcome

Timeframe: Exit (9-months)

Population: The participants analyzed were the 18 waiver sites from the MAIN STUDY that were then randomized to either MiCAP with IF (n=9) or MiCAP with IF and EF (n=9). Arms /Groups MiCAP with IF (Main Study: Clinicians), MiCAP with IF and EF (Main Study: Clinicians), Administrative Supplement: Clinicians, and Administrative Supplement: Caregivers, and Administrative Supplement: Beneficiaries were not included as data was not collected.

Instrumental Activities of Daily Living (IADLs) was collected from the Minimum Data Set-Home Care (MDS-HC) in the Electronic Health Record (EHR). MDS-HC is a person-centered assessment for the collection of minimum essential nursing data, with reliability and validity, and used in the Michigan Medicaid Waiver program.

The below reported score is a summed score of 8 items on the MDS-HC; summed score range is 0-64. The lower the summed score, the more independent the beneficiary is at performing IADLs. For the 8 items, the available scores are 0= Independent, 1= Set-up help only, 2= Supervision, 3= Limited assistance, 4= Extensive assistance, 5= Maximal assistance, 6= Total dependence, 8= Activity did not occur during entire period.

Outcome measures

Measure	MiCAP With IF n=9 Waiver Sites MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=9 Waiver Sites MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Main Study: Beneficiary's IADLs	29.54 Score on scale Standard Error 0.17	29.24 Score on scale Standard Error 0.17	—	—	—

SECONDARY outcome

Timeframe: Exit (9-months)

Population: The participants analyzed were the 18 waiver sites from the MAIN STUDY that were then randomized to either MiCAP with IF (n=9) or MiCAP with IF and EF (n=9). Arms /Groups MiCAP with IF (Main Study: Clinicians), MiCAP with IF and EF (Main Study: Clinicians), Administrative Supplement: Clinicians, and Administrative Supplement: Caregivers, and Administrative Supplement: Beneficiaries were not included as data was not collected.

Pain data were collected from the Minimum Data Set-Home Care (MDS-HC) in the Electronic Health Record (EHR). MDS-HC is a person-centered assessment for the collection of minimum essential nursing data, with reliability and validity, and used in the Michigan Medicaid Waiver program.

The score is a summed score of 4 self-reported items on the MDS-HC; the summed score range is 0-11. The lower the summed score, the less pain the beneficiary reported. The four items included: pain frequency (range 0-3); pain intensity (0-4); pain consistency (0-3); and breakthrough pain (0-1).

Outcome measures

Measure	MiCAP With IF n=9 Waiver Sites MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=9 Waiver Sites MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Main Study: Beneficiary's Pain	7.52 Score on scale Standard Error 0.13	7.44 Score on scale Standard Error 0.13	—	—	—

SECONDARY outcome

Timeframe: Exit (9-months)

Population: The participants analyzed were the 18 waiver sites from the MAIN STUDY that were then randomized to either MiCAP with IF (n=9) or MiCAP with IF and EF (n=9). Arms /Groups MiCAP with IF (Main Study: Clinicians), MiCAP with IF and EF (Main Study: Clinicians), Administrative Supplement: Clinicians, and Administrative Supplement: Caregivers, and Administrative Supplement: Beneficiaries were not included as data was not collected.

Depression was collected from the Minimum Data Set-Home Care (MDS-HC) in the Electronic Health Record (EHR). MDS-HC is a person-centered assessment for the collection of minimum essential nursing data, with reliability and validity, and used in the Michigan Medicaid Waiver program.

The below reported score is a summed score of 3 self-reported items on the MDS-HC; the summed score range is 0-24. The lower the summed score, the less depressed the beneficiary reported. The 3 items included: little interest in things; anxious, restless, or uneasy; and sad, depressed, or hopeless. For the 3 items, the available scores are 0= Not in last 3 days, 1= Not in last 3 days, but often feels that way, 2= In 1-2 days of last 3 days, 3= Daily in last 3 days, 8= Person could not (would not) respond.

Outcome measures

Measure	MiCAP With IF n=9 Waiver Sites MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=9 Waiver Sites MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Main Study: Beneficiary's Depression	1.3 Score on scale Standard Error 0.05	1.17 Score on scale Standard Error 0.05	—	—	—

SECONDARY outcome

Timeframe: Exit (9-months)

Beneficiary falls data were collected from the Minimum Data Set-Home Care (MDS-HC) in the Electronic Health Record. MDS-HC is a person-centered assessment for the collection of minimum essential nursing data, with reliability and validity, and used in the Michigan Medicaid Waiver program.

Falls were reported as proportions of occurrences on the MDS-HC; and calculated for this study based on the occurrence of a fall where yes=1 and no=0 divided by the number of participants.

Outcome measures

Measure	MiCAP With IF n=3397 Participants MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=3533 Participants MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Main Study: Beneficiary's Fall Rate	0.15 percentage of participants Standard Error 0.01	0.14 percentage of participants Standard Error 0.01	—	—	—

SECONDARY outcome

Timeframe: Exit (9-months)

Beneficiary-level outcome emergency department (ED) data were collected from the Minimum Data Set-Home Care (MDS-HC) in the Electronic Health Record. MDS-HC is a person-centered assessment for the collection of minimum essential nursing data, with reliability and validity, and used in the Michigan Medicaid Waiver program.

ED visits were reported as proportion calculated based on the occurrence of an ED visit where yes=1 and no=0 out of the number of participants.

Outcome measures

Measure	MiCAP With IF n=3387 Participants MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=3533 Participants MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Main Study: Beneficiary's Emergency Department (ED) Visits Occurrences Out of Total Number of Participants.	0.92 percentage of participants Standard Error .01	0.91 percentage of participants Standard Error .01	—	—	—

SECONDARY outcome

Timeframe: Exit (9-months)

Beneficiary-level outcomes hospitalizations data were collected from the Minimum Data Set-Home Care (MDS-HC) in the Electronic Health Record. MDS-HC is a person-centered assessment for the collection of minimum essential nursing data, with reliability and validity, and used in the Michigan Medicaid Waiver program.

Hospitalizations were reported based on the occurrence and calculated for this study as rates of hospitalization where yes=1 and no=0 out of total number of participants.

Outcome measures

Measure	MiCAP With IF n=3387 Participants MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=3553 Participants MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Main Study: Beneficiary's Hospitalization Occurrences Out of Total Number of Participants.	0.01 percentage of participants Standard Error .01	.01 percentage of participants Standard Error .01	—	—	—

OTHER_PRE_SPECIFIED outcome

Timeframe: Exit (9-months)

Evidence-Based Practice Attitude Scale (EBPAS-50) is a 50-item tool that assesses clinician attitudes toward adopting evidence into practice. EBPAS-50 has 50 items on the tool which includes 10 sub-scales: limitations, openness, monitoring, requirements, employability, feedback, burden, appeal, divergence, balance; and the questions are negatively framed. The 10 sub-scales are summed into a higher order total scale score representing respondent's attitude toward adopting evidence into practice.

EBPAS-50 total scale score ranges from 0-200 with higher being a better attitude towards use of evidence in practice. Each of the 10 sub-scales ranges from 0-20; with higher being a better attitude towards use of evidence.

Items are reversed scored, and the mean sub-scale scores are recomputed, before a mean score for the total EBPAS-50 item score is computed.

A higher total score indicate a more positive attitude towards adoption of evidence-based practice use.

Outcome measures

Measure	MiCAP With IF n=282 Participants MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=257 Participants MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Main Study: Clinician Attitude Towards Evidence Based Practice Use Attitude limitations	0.00 units on a scale Standard Error 0.11	-0.06 units on a scale Standard Error 0.11	—	—	—
Main Study: Clinician Attitude Towards Evidence Based Practice Use Attitude openness	0.08 units on a scale Standard Error 0.08	0.00 units on a scale Standard Error 0.08	—	—	—
Main Study: Clinician Attitude Towards Evidence Based Practice Use Attitude monitoring	0.01 units on a scale Standard Error 0.14	0.18 units on a scale Standard Error 0.14	—	—	—
Main Study: Clinician Attitude Towards Evidence Based Practice Use Attitude requirements	0.15 units on a scale Standard Error 0.09	0.18 units on a scale Standard Error 0.14	—	—	—
Main Study: Clinician Attitude Towards Evidence Based Practice Use Attitude employabilty	-0.17 units on a scale Standard Error 0.07	-0.04 units on a scale Standard Error 0.11	—	—	—
Main Study: Clinician Attitude Towards Evidence Based Practice Use Attitude feedback (higher is better)	0.10 units on a scale Standard Error 0.11	-0.01 units on a scale Standard Error 0.12	—	—	—
Main Study: Clinician Attitude Towards Evidence Based Practice Use Attitude burden	0.13 units on a scale Standard Error 0.15	0.04 units on a scale Standard Error 0.14	—	—	—
Main Study: Clinician Attitude Towards Evidence Based Practice Use Attitude appeal	0.06 units on a scale Standard Error 0.08	-0.11 units on a scale Standard Error 0.08	—	—	—
Main Study: Clinician Attitude Towards Evidence Based Practice Use Attitude divergence	0.07 units on a scale Standard Error 0.09	0.14 units on a scale Standard Error 0.09	—	—	—
Main Study: Clinician Attitude Towards Evidence Based Practice Use Attitude balance	0.11 units on a scale Standard Error 0.11	0.21 units on a scale Standard Error 0.10	—	—	—
Main Study: Clinician Attitude Towards Evidence Based Practice Use Overall Attitude (total summed mean score)	-103.49 units on a scale Standard Error 0.92	-103.52 units on a scale Standard Error 0.92	—	—	—

OTHER_PRE_SPECIFIED outcome

Timeframe: Exit (9-months)

Population: Clinicians.

General Self-efficacy (GSE) is a 10-item tool (Cronbach .79-.90) with a 4-point scale summed to 10-40, with a higher score indicating more self-efficacy.

Outcome measures

Measure	MiCAP With IF n=282 Participants MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=257 Participants MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Main Study: Clinician Self-efficacy	-2.34 Score on scale Standard Error 0.21	-2.57 Score on scale Standard Error 0.30	—	—	—

OTHER_PRE_SPECIFIED outcome

Timeframe: Recruitment period of 9-months.

Population: Caregivers: \>21 years of age, an Informal Caregiver for a beneficiary in Medicaid waiver program. Clinicians: \>21 years of age employed as RN or SW in waiver program where study conducted. Beneficiary: \>21 years of age and enrolled in waiver program, and diagnosed with Alzheimer's disease or other dementia. NOTES: * 1 Overall Number of Participants Analyzed: is the total number recruited. * 2 The Measure Type in Outcome Measure Data Table is the number enrolled of the number recruited.

Feasibility of use of intervention with caregivers use of toolkit with beneficiaries with Alzheimer's Disease or dementia following implementation of CAPABLE.

Feasibility was measured as: the percentage of those who consented and enrolled of those who were recruited who were eligible.

Outcome measures

Measure	MiCAP With IF n=58 Participants MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=135 Participants MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. n=60 Participants A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Administrative Supplement: Feasibility of Use of Intervention With Clinicians, Caregivers and Beneficiaries.	50 Participants	106 Participants	52 Participants	—	—

OTHER_PRE_SPECIFIED outcome

Timeframe: 9-months

Population: Informal caregivers enrolled in study to care for beneficiaries in the waiver program.

Acceptability of Caregiver Use of Toolkit With Beneficiaries With Alzheimer's Disease or Dementia Following Implementation of CAPABLE. Acceptability: counts of toolkit use and sections used.

Outcome measures

Measure	MiCAP With IF n=50 Participants MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Administrative Supplement: Acceptability of Caregiver Use of Intervention With Beneficiaries.	813 Count of caregiver use of toolkit	—	—	—	—

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline (0-months) compared to Exit (9-months)

Population: Beneficiaries with Alzheimer's Disease or other dementia in the waiver program.

Activities of Daily Living: 11 items each rated as 0=Independent, 1=Set-up help, 2=Supervision, 3=Limited assist, 4=Extensive assist, 5=Maximal assist, 6=Total dependence; summed score ranged 0-66; higher score=worse Activities of Daily Living

Instrumental Activities of Daily Living: 8 items each rated as 0=Independent, 1=Set-up help, 2=Supervision, 3=Limited assist, 4 Extensive assist, 5=Maximal assist, 6=Total dependence; summed score ranged 0-48; higher score=worse Instrumental Activities of Daily Living

Pain: 4 items; ranges for frequency 0-3, intensity 0-4, consistency 0-3, breakthrough 0-1; summed score ranged 0-11; lower score=less pain.

Depression: 3 items little interest in things; anxious, restless, or uneasy; and sad, depressed, or hopeless; scored as 0=Not in last 3 days, 1=Not in last 3 days, but often feels that way, 2=In 1-2 days of last 3 days, 3=Daily in last 3 days, 8=Person could/would not respond; summed score ranged 0-24; lower score=less depressed

Outcome measures

Measure	MiCAP With IF n=52 Participants MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=52 Participants MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Administrative Supplement: Beneficiaries Outcomes Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADLs), Pain and Depression) Pre-/Post-intervention From Minimum Data Set-Home Care MDS-HC. Depression	5.52 Score on scale Standard Deviation 8.75	4.52 Score on scale Standard Deviation 4.47	—	—	—
Administrative Supplement: Beneficiaries Outcomes Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADLs), Pain and Depression) Pre-/Post-intervention From Minimum Data Set-Home Care MDS-HC. IADLs	42.69 Score on scale Standard Deviation 9.67	42.22 Score on scale Standard Deviation 11.40	—	—	—
Administrative Supplement: Beneficiaries Outcomes Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADLs), Pain and Depression) Pre-/Post-intervention From Minimum Data Set-Home Care MDS-HC. ADLs	22.44 Score on scale Standard Deviation 17.09	23.49 Score on scale Standard Deviation 19.56	—	—	—
Administrative Supplement: Beneficiaries Outcomes Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADLs), Pain and Depression) Pre-/Post-intervention From Minimum Data Set-Home Care MDS-HC. Pain	2.85 Score on scale Standard Deviation 2.91	5.56 Score on scale Standard Deviation 3.36	—	—	—

OTHER_PRE_SPECIFIED outcome

Timeframe: Self-efficacy: baseline (month-0) and Exit (month-4). Satisfaction: Monthly for month 0 (baseline), 1, 2, 3, 4 (exit)

Population: Informal caregivers who care for beneficiaries with Alzheimer's Disease or other dementia's in waiver program. Data not collected on the following items. Self-efficacy at Month 1, Month 2 or Month 3 (only collected at baseline month-0 and exit month-4). Satisfaction with Content of Intervention, Format of Intervention, and Helpfulness of Intervention was not collected at Baseline Month-0 (only collected at Month 1-Month-2, Month-3, Month-4 Exit).

Self-efficacy and satisfaction of Caregiver Use of intervention With Beneficiaries With Alzheimer's Disease or Dementia Following Implementation of CAPABLE. Efficacy effect size of intervention use on beneficiary outcomes from Parent Trial.

SELF-EFFICACY TOOL: General Self-efficacy (GSE) is a 10-item tool (Cronbach .79-.90) with a 4-point scale summed to 0-40, with a higher score indicating more or higher self-efficacy. Cronbach's alpha at baseline was .91 for the caregiver GSE.

SATISFACTION TOOL: Developed by PI and Team. There were 3-items measured on a scale of 1 to 10 (reported as individual concepts; not summed), with 10 being the highest satisfaction. Question 1 Content: How satisfied were you with the Toolkit content? (range 1-10). Question 2 Format: How satisfied were you with the format of the Toolkit? (range 1-10). Question 3 Helpfulness: How helpful was the Toolkit? (range 1-10)".

Outcome measures

Measure	MiCAP With IF n=50 Participants MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF n=50 Participants MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. n=50 Participants A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) n=50 Participants Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) n=50 Participants Caregivers enrolled in study to care for beneficiaries in the waiver program.
Administrative Supplement: Caregiver Self Efficacy and Satisfaction With Use of Intervention. Self-efficacy	2.67 units on a scale Standard Deviation 0.62	3.42 units on a scale Standard Deviation 0.38	—	—	—
Administrative Supplement: Caregiver Self Efficacy and Satisfaction With Use of Intervention. Satisfaction with content of intervention	—	8.87 units on a scale Standard Deviation 1.70	9.03 units on a scale Standard Deviation 1.65	9.07 units on a scale Standard Deviation 1.44	8.60 units on a scale Standard Deviation 2.27
Administrative Supplement: Caregiver Self Efficacy and Satisfaction With Use of Intervention. Satisfaction with format of intervention	—	8.95 units on a scale Standard Deviation 1.77	9.58 units on a scale Standard Deviation 0.84	9.28 units on a scale Standard Deviation 1.25	9.33 units on a scale Standard Deviation 1.71
Administrative Supplement: Caregiver Self Efficacy and Satisfaction With Use of Intervention. Helpfulness of intervention	—	7.98 units on a scale Standard Deviation 2.16	8.79 units on a scale Standard Deviation 1.88	8.79 units on a scale Standard Deviation 1.88	8.23 units on a scale Standard Deviation 2.34

OTHER_PRE_SPECIFIED outcome

Timeframe: 9-months

Population: There are three groups in this study: Clinicians at 3 sites who work with the caregivers to help them care for the beneficiaries in the waiver program.

Clinician satisfaction with training and use of caregiver to assist with intervention. Satisfaction: was measured using a Likert scored tool evaluating level of satisfaction (scale 1-10 with 1 being poorest).

Outcome measures

Measure	MiCAP With IF n=106 Participants MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Beneficiaries Enrolled in the Study. A waiver participant who has an informal caregiver and a diagnosis of Alzheimer's disease or dementia.	Administrative Supplement: Group-Caregivers (Month-2) Caregivers enrolled in study to care for beneficiaries in the waiver program.	Administrative Supplement: Group-Caregivers (Month-3) Caregivers enrolled in study to care for beneficiaries in the waiver program.
Administrative Supplement: Clinician Satisfaction With Training and Use of Intervention. Satisfaction with content	8.09 Satisfaction rate (scale 1-10, 1=poorest Standard Deviation 1.60	—	—	—	—
Administrative Supplement: Clinician Satisfaction With Training and Use of Intervention. Satisfaction with format	7.55 Satisfaction rate (scale 1-10, 1=poorest Standard Deviation 2.06	—	—	—	—
Administrative Supplement: Clinician Satisfaction With Training and Use of Intervention. Satisfaction with newness of content for caregiver	8.35 Satisfaction rate (scale 1-10, 1=poorest Standard Deviation 1.50	—	—	—	—
Administrative Supplement: Clinician Satisfaction With Training and Use of Intervention. Satisfaction with newness of content for clinician	7.85 Satisfaction rate (scale 1-10, 1=poorest Standard Deviation 1.92	—	—	—	—
Administrative Supplement: Clinician Satisfaction With Training and Use of Intervention. Intent to use new information	8.23 Satisfaction rate (scale 1-10, 1=poorest Standard Deviation 1.71	—	—	—	—

Adverse Events

MiCAP With IF (Main Study: Beneficiaries)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

MiCAP With IF and EF (Main Study: Beneficiaries)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

MiCAP With IF (Main Study: Clinicians)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

MiCAP With IF and EF (Main Study: Clinicians)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Administrative Supplement: Clinicians

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Administrative Supplement: Caregivers

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Administrative Supplement: Beneficiaries

Serious events: 0 serious events

Other events: 7 other events

Deaths: 7 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Measure	MiCAP With IF (Main Study: Beneficiaries) n=3497 participants at risk MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF (Main Study: Beneficiaries) n=3533 participants at risk MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	MiCAP With IF (Main Study: Clinicians) n=282 participants at risk MiCAP with Internal Facilitation will receive MiCAP (implementation strategies). Internal facilitators will be waiver site clinicians with exemplary clinical practice and/or supervisory experience, who are expected to be early adopters of CAPABLE; and will be selected by their supervisors. MiCAP with IF: Sites will conduct MiCAP strategies described as follows. Relationship Building; Assess readiness to implement of the site; Internal Facilitator (IF) Champion Coalition Building, which will include IFs training in CAPABLE and facilitation and online IF coalition meetings; Facilitation by the IF, which will include training the clinicians, reviewing home visits with the clinician to assure CAPABLE was provided; IF developing a clinical team for implementation of CAPABLE and leading interdisciplinary coordination of individual beneficiary care; Intervention and implementation strategy fidelity data will be placed in a dashboard for audit and provided to IFs. IFs will use the data to provide feedback to clinicians; and develop action plans for improvement in training or care	MiCAP With IF and EF (Main Study: Clinicians) n=257 participants at risk MiCAP with Internal Facilitation and External Facilitation will receive MiCAP (implementation strategies) and the addition of external facilitation. The external facilitators will be Super-Champion waiver program site clinicians from prior work who were trained and early adopters of CAPABLE; and will be selected by the research team to perform external facilitation. MiCAP with IF and EF: Sites will conduct MiCAP strategies described above in "MiCAP with IF" with an addition of External Facilitation. Centralized Oversight will be conducted by External Facilitators. External Facilitators will train in facilitation. The work of the External Facilitators will be tailored (i.e., type of discipline) to each site's needs. Intervention and implementation strategy fidelity data will be placed in a dashboard and will be provided to External Facilitators. External Facilitators will use the data to provide feedback to Internal Facilitators; and develop action plans for improvement in site clinician training or beneficiary care as needed.	Administrative Supplement: Clinicians n=106 participants at risk Clinicians who were employed at the waiver sites and were trained in using the toolkit when implementing CAPABLE with caregivers of beneficiaries with Alzheimer's Disease or Dementia.	Administrative Supplement: Caregivers n=50 participants at risk Caregivers of beneficiaries diagnosed with Alzheimer's Disease or Dementia who will receive the toolkit to assist in taking care of their beneficiary.	Administrative Supplement: Beneficiaries n=52 participants at risk Beneficiaries enrolled at the waiver who were diagnosed with Alzheimer's Disease or Dementia.
Cardiac disorders 3. Other (Not Including Serious) Adverse Events: anticipated and unanticipated events	0.00% 0/3497 • Main Study: adverse event data were collected baseline through month 9. Administrative Supplement: adverse event data were collected baseline through month 4.	0.00% 0/3533 • Main Study: adverse event data were collected baseline through month 9. Administrative Supplement: adverse event data were collected baseline through month 4.	0.00% 0/282 • Main Study: adverse event data were collected baseline through month 9. Administrative Supplement: adverse event data were collected baseline through month 4.	0.00% 0/257 • Main Study: adverse event data were collected baseline through month 9. Administrative Supplement: adverse event data were collected baseline through month 4.	0.00% 0/106 • Main Study: adverse event data were collected baseline through month 9. Administrative Supplement: adverse event data were collected baseline through month 4.	0.00% 0/50 • Main Study: adverse event data were collected baseline through month 9. Administrative Supplement: adverse event data were collected baseline through month 4.	13.5% 7/52 • Number of events 7 • Main Study: adverse event data were collected baseline through month 9. Administrative Supplement: adverse event data were collected baseline through month 4.

Additional Information

Dr. Sandra Spoelstra

Grand Valley State University

Phone: 616-331-5905

Email: spoelsts@gvsu.edu

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place