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Introduction: Longer lifespans and living with multiple chronic conditions are driving necessary change in healthcare systems. There is an increasing shift towards team-based integrated care, that is accessible, continuous, and of high quality. Health professional roles are changing rapidly; traditional educational approaches no longer suffice. The World Health Organization and the Institute of Medicine acknowledge that preparation of the healthcare workforce has not kept pace with these changes. Interprofessional education (IPE) and professional development training that includes partnering with patients, providers, and communities are identified as key solutions. However, understanding how IPE supports workforce development for integrated care remains unclear. Aims Objectives Theory or Methods: We followed the Arksey and O'Malley method for conducting scoping reviews. The CINAHL, MEDLINE, ProQuest Nursing and Allied Health, and Scholars Portal databases were searched using key search terms (interprofessional education, interdisciplinary education, integrated care, integrated health care delivery). Articles included were peer-reviewed, from all sectors, published in English, from the year 2000 to 2020 and comprised post-licensure health care workers. Study selection and data extraction were conducted by two independent reviewers using a standardized data extraction form. Data were collated, summarized, and key themes were identified. Highlights or Results or Key Findings: A total of 32 papers were included in the review consisting of primary research studies (16), reviews (10), and reports/position papers (6). Integrated care was described as having multiple definitions, various models, key principles, and competencies. Key Themes: The role of IPE in training health care professionals to work in integrated care was elucidated through qualitative thematic analysis. Four key themes were identified: 1) laying the foundation, 2) providing a building block, 3) acting as a catalyst, and 4) generating practice change. Conclusions: IPE has a critical role in training health and social care providers to work in various models of integrated care and increasingly complex healthcare systems. However, IPE is only one part of a larger program of training that is necessary. Extending IPE beyond traditional roles and settings is crucial. Implications for applicability/transferability sustainability and limitations: IPE should begin in academic programs and continue as workplace learning that is context specific. Evidence and theory-based multi-component interventions are required to reinforce learning in the practice setting. A formal evaluation of the quality of the evidence was not conducted and only papers written in English were included. [ABSTRACT FROM AUTHOR]

Introduction: Citizen participation in caring is important not only they can be service provider, but also they are citizen of community that they care about and try to solve matter of health and care in their community. Citizens' role as caregiver is widely discussed, but their role as democratic citizen in care perspective has not been considered much. Moreover, activists' role to empower and support participants to be democratic citizen has not been much known. Aims Objectives Theory or Methods: The aim of this paper is to reveal activists' role to empower people to be democratic citizen and to support their caring activities. This will be discussed in view of care. From philosophers' perspective who dealt with caring ethics, such as Eva Kittay and Virginia Held, caring is matter of interdependency and relations. I'm going to focus on relationship among activists, participants, and other actors of community. Interviews with 9 activists and 9 citizens from 9 communities in Seoul, South Korea, were conducted. Highlights or Results or Key Findings: The main subjects of this initiative to promote people's engagement was activists, community based organizations(CBOs), and health committee which was composed of participants. In relations with participants, activists were recruiting participants by meeting people in the communities, supporting to empower recruited people in diverse ways, and they had peoplecentered attitude all over the initiative. In relations with community, activists were helping participants' activities with linking community resources and other activities in the community. The CBOs were being the base of all these citizens and activists works. Health committees were being the field that participants can discuss health and care issues of their communities and can raise holistic view of those issues. All these process were relational process. It can be also said that activists' works to support participants are caring work. Conclusions: All these process were relational process. It can be also said that activists' works to support participants are caring work. Implications for applicability/transferability sustainability and limitations: This paper contributes in that it revealed that the facilitator is needed to promote citizen engagement. The more focus on activists role as facilitator, the more citizen engagement could be activated. Limitation is that during covid-19, I couldn't interview diverse stakeholders of communities. [ABSTRACT FROM AUTHOR]

Introduction: The healthcare journey to create integrated care in Ontario, Canada, was bolstered in 2019 by the creation of Ontario Health Teams(OHTs). These newly formed meso-level networks of providers are collectively responsible for providing appropriate, coordinated, effective and efficient health services for an attributable population. These "self-determined and fit for purpose" OHTs are developing governance structures to enable partnership among community-based organizations, patients/caregivers, primary care and home and hospital providers. This study describes the different governance structures and pathways adopted by three OHTs, detailing factors that enable OHTs to take steps towards their maturity and highlighting the lessons learned from the experience. Methods: This paper is aimed to assess the diverse governance models, their pathways to maturity and intended advantages and challenges across the OHTs. This study aims to understand how OHTs set up their governance structures based on their population need and context. The study follows a mixed-methods design. An initial survey was used to collect data across all 50 OHTs to describe governance structures and processes adopted (council membership, joint decisionmaking, separate legal entities). The qualitative study will use a cross-case comparative design amongst three OHTs to compare and study the different governances adopted by OHTs. The three OHTs were selected to allow variability in governance structures; for example, OHTs formed a separate legal entity or enacted a joint-decision making or a collaborative agreement. This phase will collect data from interviews (leadership/collaborative council and management team members) and document review (key documents, meeting minutes) across three OHTs and will be analyzed using thematic network analysis. Highlights: We intend to interview 7-9 decision-makers across each selected OHT, who are council members or have been involved in the governance setup. Using a three-stage network development and change cycle, we will assess initial readiness and activation, current stabilization and routinization practices and finally, efforts towards stability and sustainability across each OHT. The key governance themes that will be explored with the OHTs are partner composition and engagement, legal form, role and functioning of governing bodies, decision-making authority and dynamics funding and accountability. A thematic network analysis will enable a methodical systematization of the textual data and help depict graphical web-like nets of the themes. Enabling a richer understanding of an issue and facilitating disclosure on researchers' analysis process and a more precise understanding for the reader. [ABSTRACT FROM AUTHOR]

Introduction: Despite the lack of evidence supporting its practice, antipsychotic polypharmacy (APP), is widely used1,2,3,. To change the outcomes that are directly related to doctors' decisions, it is important to understand the decision-making process and the factors which affect it. Behavioral Economics is a field that blends social psychology and economics, and it seeks to understand how biases affecting the human decision-making process. Strategies based on Behavioral Economics principles have been successful in addressing many issues in healthcare. This paper describes a quality improvement project designed with the aim of reducing APP prescribing behavior in a large psychiatric hospital in Brazil. Aims Objectives Theory or Methods: Nineteen units participated in this case study. The intervention targeted all prescribers and it involved the use of norms and peer comparison, behavioral economics principles which indicate that individuals are more likely to adjust their behavior if they perform below the average performance of their peers. After baseline, where the APP prescribing rate for the whole hospital and for each unit in particular were assessed, a weekly email was sent to each prescriber with information about the hospital-wide APP prescribing rate, feedback related to the APP prescribing rates in their units, and how they compared to other units. Highlights or Results or Key Findings: The intervention was successful in reducing hospital-wide APP prescribing rate. After the second e-mail, we observed a steep drop in the APP prescribing rate, and the rate never returned to preintervention levels. The weekly emails with feedback and peer comparisons yielded an average statistically significant difference of about 8.02% (t(10) = 4.7491, p < 0.008) over a brief 11-week period. This study demonstrated that e-mails designed according to a Behavioral Economics strategy can affect prescribing behavior. Conclusions: Information about the lack of evidence for the use of antipsychotic combinations, about the rates in other parts of the world, and information about the rates in hospitals with a similar population within their own state was enough to yield statistically significant results.. Implications for applicability/transferability sustainability and limitations: Future quality improvement projects targeting prescribing behavior should consider a combined use of guidelines and training with norms and peer comparison. [ABSTRACT FROM AUTHOR]

Introduction: Discussions of integrated care have ranged in focus from large-scale health system transformations, to discrete interventions intended to enhance local continuity of care. Beyond these variations in scale and focus, literature on integrated care has used a variety of conceptual frameworks to explain various activities and elements necessary to achieve integrated care. Existing frameworks have helped to advance research and practice; yet the complexity of changing practice required to achieve integrated care across the policy, organizational, and clinical levels complicates efforts to represent or implement these innovations in straightforward ways. Aims Objectives Theory or Methods: In this paper, we present a novel strategy for conceptualizing integrated care as developing through a series of milestones observable at the organizational level. Based on analysis of four integrated care organizational case studies in Canada and New Zealand, we outline how this approach to conceptualizing integrated care both resolves the tension of crossing the macro, meso, and micro levels of analysis, and generates new practical insights to guide policy and practice. Methods consist of qualitative interviews, observation, and document analysis across cases, and qualitative data were analyzed temporally to identify milestones as indicated by participants over time. Highlights or Results or Key Findings: We define a milestone as the occurrence of a salient event that is perceived by respondents to facilitate or disrupt efforts towards the development of integrated care. We synthesize these events at the organizational level, suggesting that the organizational level of analysis is the most appropriate level to represent the significance of these milestones. Our analysis identified six categories of milestone: (1) Strategic relational milestones, referring to building relationships between stakeholders. (2) Strategic process change milestones, referring to efforts to improve quality in practice. (3) Structural (intra-organizational) milestones, referring to changes in organizational structure. (4) Structural (inter-organizational) milestones, referring to changes in the legal, operational, or leadership structures that facilitate relationships between organizations. (5) Environmental milestones, referring to changes in the social or natural environment. (6) Political milestones, referring to changes in the control and allocation of resources. Conclusions: Our results generate a new conceptual framework for understanding the achievement of integrated care as occurring through a series of milestones. This approach enhances the focus on achieving integrated care "in the wild", in the actual environments in which leaders, clinicians, policymakers, patients, and caregivers work to implement integrated care. Implications for applicability/transferability sustainability and limitations: Our model emphasizes two practical points. First, that there is no single series of sequential steps that must be taken to achieve integrated care. Second, that policy efforts to support integrated care ought to encourage organizations and their collaborators to work toward milestones that facilitate the development of integrated care. [ABSTRACT FROM AUTHOR]

Introduction: Transfers between acute facilities and the community (namely long-term care homes) have long suffered from challenges to integrated care, often stemming from the current reliance on paper documentation, follow up phone calls, and discussions with the patient to enable transitions in care. Current processes are inefficient for staff and hinder quality care by increasing the risk of errors and readmissions. PointClickCare, the leading electronic health record (EHR) provider for senior's care, is working to support this challenge through digital innovation. Their new product, Harmony, creates a two-way, digital integration between a hospital EMR and the EHR in long-term care. Aims Objectives Theory or Methods: This presentation will provide an overview of Harmony, and its capabilities. It will focus on Harmony's benefits by highlighting the first implementation of Harmony in Canada, at St. Joseph's Healthcare Hamilton (SJHH). SJHH implemented Harmony beginning in the Spring of 2020. Their focus was on validating the potential of an acute-LTC integration, using the hospital's Epic HIS system, and St. Joseph's Villa, a healthcare system partner LTC home that uses PointClickCare. Key areas of focus for project evaluation included validating the clinician experience, timeliness of information being shared, and ease of access to the information within clinical workflows. Highlights or Results or Key Findings: Results from the project evaluation will be shared, including positive results from clinician surveys and interviews, as well as efficiency and time savings resulting from data integration incorporated into the admission and discharge processes. The presentation will also provide insights on the potential for tools like Harmony to enable integrated care coordination and population health management, which are key enablers of successful models of integrated care. Real-time population health dashboards can support the success of innovative approaches to integrated care, such as the Ontario Health Teams (OHTs) and Accountable Care Organizations (ACOs) in the United States. Conclusions: The ability to digitally integrate acute and long-term care can provide numerous benefits, including workflow efficiencies and improved clinical decision-making across the continuum. It also supports strengthening the relationship between hospitals and community providers, which are foundational to quality care as we begin to apply lessons from the COVID-19 pandemic. Implications for applicability/transferability sustainability and limitations: Compared to other digital innovations, this innovation has a unique opportunity to scale and spread across Ontario, particularly in support of the new OHT integrated care model. Harmony is also EMR 'agnostic' so it can be implemented at both Epic and non-Epic hospitals. [ABSTRACT FROM AUTHOR]

Introduction: With each month of the COVID-19 pandemic, unmet health and social needs increased. Unfortunately, maintaining up-to-date information on available resources to meet those needs was a challenge. As public health guidance evolved weekly, existing resources, such as food pantries and pharmacies, experienced reduced capacity, shifts to virtual service delivery, and frequent changes in their hours of operations. New resources, such as emergency financial assistance programs, also emerged to mitigate the consequences of the pandemic. In Durham, North Carolina, there was a need for a centralized platform to access accurate resource information. Aims Objectives Theory or Methods: Our team of university student volunteers partnered with a social services non-profit to create, maintain, and disseminate an online directory of health and social care resources in Durham County between May 2020 and October 2020 during the COVID-19 pandemic. Our goals were to ensure the resource directory was (1) publicly accessible, (2) available in English and Spanish, (3) up-todate, (4) amenable to community feedback, and (5) tailored to community needs. For included resources, we captured the name, target recipients, purpose, description, website links, contact info, language access, status during COVID-19, and the date resource information was last updated. Highlights or Results or Key Findings: We sourced and consolidated existing county-level resource directories to centralize information on 370+ resources across 12 health and social care domains (e.g., transportation, housing, medical care). 51+ students across our two organizations worked in small teams by resource domain to update information every few days in spreadsheet format in a Google Sheets platform. The public also contributed updates through a comments feature. Our directory was hosted online by the county public health department and distributed widely via social media, email, and other trusted websites. Our partner non-profit operated a hotline to provide directory navigation support. Targeted dissemination efforts further included (1) integrating the directory into the local health system's intranet, (2) synthesizing resources for paper handouts for in-person distribution at health centers and food pantries, and (3) curating a population-focused directory serving the needs of older adults. Our directory served as the local foundation for a statewide platform now available. Conclusions: Promoting integrated health and social care through cross-sector referrals requires providers to access accurate resource information. Student volunteers mobilized quickly and efficiently to support the information needs of the community when needs were high and resources were constrained. Volunteers are a low-cost, high-value resource to support integrated care efforts. Implications for applicability/transferability sustainability and limitations: Our community resource directory model, facilitated by student volunteers, can be replicated to serve emerging health and social care integration efforts. Essential components included strong relationships with community partners, faculty oversight and guidance, and a defined student leadership structure. Students invested in public and population health make this model sustainable. [ABSTRACT FROM AUTHOR]

Introduction: Despite a wealth of strong evidence on the effectiveness of exercise and education for hip and knee osteoarthritis (OA), implementation of these interventions in healthcare settings is currently sub-optimal. An international physiotherapist-supervised education and exercise programme for hip and knee OA (Good Life with osteoArthritis from Denmark (GLA:D)) was chosen for implementation due to evidence on effectiveness for patient outcomes, the inclusion of a patient registry to collect outcomes and the ability to adapt to other cultural contexts.2 This paper captures the key methodologies used in the co-design, implementation, and evaluation of the IMPACT project to confront the problem. Aims Objectives Theory or Methods: Using a type III hybrid implementation-effectiveness design, work packages include: (1) ENGAGE key stakeholders to form a steering committee and survey stakeholders to inform development of the IMPACT implementation strategy based on the Consolidated Framework for Implementation Research (CFIR), (2) IMPLEMENT GLA:D Ireland by training physiotherapists across health settings (primary care, secondary care, private practice) during pilot testing, (3) EVALUATE short and long-term qualitative and quantitative implementation indicators, and patient outcomes related to pain, function, quality of life and healthcare utilisation from the patient registry up to 12-months post-programme, (4) SHARE results with engaged stakeholders and rollout the programme nationally. Highlights or Results or Key Findings: Key stakeholders including two patient representatives and one advocacy group member, five researchers, four physiotherapists, one GP and one orthopaedic consultant have been engaged to the form the IMPACT steering committee and co-design the implementation strategy. Key sources that informed this strategy include (1) theoretical framework adapted from CFIR constructs (patient, physiotherapist and intervention characteristics, inner and outer setting, process), (2) best evidence from a literature review of barriers, enablers and strategies for implementation of OA programmes, (3) local context from surveys distributed to Irish GPs, physiotherapists and patients with OA, (4) expert consensus from steering committee members. Some of the main strategies identified include development of learning tools for health care professionals and patients to improve referral pathways to exercise and education and dispel myths related to exercise safety for joint disease. To reduce barriers related to patient accessibility, evidence-based programmes should be available across multiple health settings. Conclusions: GLA:D Ireland delivery will result from comprehensive implementation strategy development using theory, evidence, knowledge of context and stakeholder consensus. Incorporating a participatory approach and including end-users in planning, co-design, implementation and evaluation is a critical approach to overcoming barriers and ensuring appropriate care is delivered to patients who need it. Implications for applicability/transferability sustainability and limitations: This model can act as a template for implementation of clinical practice guidelines for other chronic conditions across healthcare settings. This research has the potential to change practice and promote a policy of exercise and physical activity referral for chronic disease that utilises community engagement effectively and enacts change 'together'. [ABSTRACT FROM AUTHOR]

Introduction: There is a change of landscape of health and social care in the community with the movement of Integrated Care Systems which is dependable on the key contribution of the health and care workforce. The purpose of this paper was to explore and capture workforce perceptions, experiences and insights of the phenomena of Integrated Care (IC) in a community health and care NHS Trust in England; including whether there any associated factors that are enablers, barriers, benefits or challenges; and the level of workforce engagement in the process of integrated health and care. DOI: https://doi.org/10.1108/JICA-10-2020-0061 Aims Objectives Theory or Methods A qualitative design based on an interpretivist research paradigm was used with a purposive sampling technique. This was a small localised study with five in-depth semi-structured interviews conducted with community nursing, social workers and allied health professionals to explore and elicit from their own words their direct exposure to IC in the community. Colaizzi's (1978) descriptive phenomenological seven-step method was applied to analyse data, with the emergence of 170 significant statements, 170 formulated meanings and 8 thematic clustering of themes to reveal 4 emergent themes and 1 fundamental structure capturing the essential aspects of the structure of the phenomenon IC. Highlights or Results or Key Findings: The study revealed four interdependent emergent themes: (1) Insight of IC and Collaboration: Affording the opportunity for collaboration, shared goals, vision, dovetailing knowledge, skills and expertise. Professional aspirations of person-centred and strength-based care to improve outcomes. (2) Awareness of Culture and Professionalism: Embracing inter-professional working whilst appreciating the fear of losing professional identity and values. Working relationships based on trust, respect and understanding of professional roles to improve outcomes. (3) Impact of Workforce Engagement: Participants felt strongly about their differing engagement experience in terms of restructuring and redesigning services. (4) Impact of Organisational Structure: Information Technology (IT) highlighted a barrier to IC as differing IT platforms prevent interoperability with one system to one patient. Shared positivity of IC, embracing new ways of working. Raising the importance for any IC strategies or policy to incorporate the "voice of workforce perceptions and experiences" as key enablers for a fully collaborative approach. Conclusions: The value and understanding of workforce perspectives through lived experience in practice and the inquisitiveness to seek to listen, understand and learn what matters to people with the "voice of the workforce" a powerful notion and a critical factor to support the scaling up and expansion of the IC agenda. Implications for applicability/transferability sustainability and limitations: Influencing societal change would warrant further insights, understanding and future research both locally, nationally and on a global platform to raise the equal profile of all professionals' unique contribution to IC to reach world health recognition and potential future health care sustainability. [ABSTRACT FROM AUTHOR]

Introduction: Receiving client feedback is crucial for providers to identify gaps and improve services. Surveys are typically used to collect client input for quality improvement (QI) consideration - but was this enough? We did not think so. The ASBHNHH conducted client surveys in 2019 and 2020 revealing that clients with YOD and their care partners have unique needs. Embracing client engagement as a framework allows clients to be empowered decision makers who direct what services they need. This paper will focus on our recent shift to empowerment through a co-design investigative project and outcomes for persons with YOD and care partners. Aims Objectives Theory or Methods: With improved client engagement as a QI Plan indicator, the objectives of this project were to engage persons living with YOD and their care partners to identify gaps in service using codesigned, investigative strategies that promote people as partners in care. Qualitative research methods, including focus group discussions and semi-structured interviews, were used to examine the potential use of the co-design method in designing and delivering improved services. A YOD Advisory Group was assembled and meetings then took place through Zoom with the use of guiding questions, open dialogue, and Google Jam Board. Highlights or Results or Key Findings: The YOD Advisory Group identified two service gaps to improve and increase: support needs for YOD in general, and resources at the time of receiving a diagnosis. The findings informed the subsequent development of a resource guide outlining "everything to know" when one is diagnosed; and a peer support group for persons with YOD and another for their care partners. Evaluation was also co-designed to better inform the success of these projects. The co-design process was reported to have been significantly empowering for the YOD Advisory Group and staff involved. All reported having benefited from the experience and contributing to the solutions from their own perspectives. Our client engagement efforts through co-design resulted in the development of new programs and resources that now fill the identified service gaps. Conclusions: This work demonstrates the importance and value of establishing meaningful partnerships with YOD clients through engagement to ensure quality and relevance of services. Lived experience is viewed as a form of expertise and client engagement that is reflected in performance indicators related to the QI Plan for the ASBHNHH. Implications for applicability/transferability sustainability and limitations: It was evident that client engagement contributed to enhanced quality improvement. Lessons learned from the experience of the ASBHNHH can inspire other service providers to engage their clients through co-design and QI projects. Anecdotal accounts of QI planning can be references to inform many other community service contexts. [ABSTRACT FROM AUTHOR]

Introduction: Co-design methods are increasingly employed to solve complex problems in health care in Australia and globally (1, 2, 3). Despite the proliferation of services developed through co-design methods, the term 'co-design' is used to describe a wide range of processes and practices with varying degrees of stakeholder engagement. In addition, studies often fail to explicate how existing research evidence, practice knowledge and lived experience come together in the co-design process. In this paper, we present our lessons from co-designing a Child and Family Hub in Wyndham Vale, a low socio-demographic and culturally diverse area of Western Melbourne, Australia. Aims Objectives Theory or Methods: The Child and Family Hub model was co-designed through a 10-week series of workshops and consultations with intersectoral practitioners and families. The process focused on the client journey through the Hub and the workforce infrastructure required for its implementation. A core team of seven stakeholders worked through the British Design Council's Double Diamond humancentred design process (4). The findings of evidence reviews, individual interviews and group discussions were incorporated into the 'Discover' and 'Define' stages. Prototypes were 'Developed' and iteratively tested with over 100 families and 30 practitioners. The workshops were evaluated using the Public and Patient Engagement Evaluation Tool. Highlights or Results or Key Findings: Strategies to create a common language and understanding of 'adversity', 'child mental health' and 'co-design' served as a crucial foundation for the process. Stakeholder engagement preceding, during and following the co-design process was important for generating trust in and local ownership of the Hub model. These engagement activities included mechanisms to tap into a diverse range of community and practitioner voices and experiences. Client personas were effective for incorporating research findings into the process and generating empathy for clients who will use the Hub. The evaluation outcomes and team reflections on the process highlighted the transformative potential of bringing community and practitioners together to generate mutual learning. Balancing the time commitment of core team members with the need to undertake user testing was a key challenge. Clearly articulating the parameters and fixed inputs to the co-design process based on the research evidence was also required to effectively manage stakeholder expectations. Conclusions: The Child and Family Hub model was successfully co-designed in partnership with families, intersectoral practitioners and community members with a key focus on the client journey and workforce infrastructure necessary to support families with children 0-8 years experiencing adversity as they navigate the health and social care systems. Implications for applicability/transferability sustainability and limitations: While this study was conducted in one metropolitan area of Australia, the key lessons related to language, stakeholder engagement, team composition and feasibility are useful for informing future research and service design with families experiencing adversity. The next phase of the project tests and evaluates the impact of the Hub. [ABSTRACT FROM AUTHOR]

Introduction: Persons living with dementia (PLWD), caregivers and care providers know the dementia journey is full of changes - in mental and physical function, care settings, care providers, and roles of caregivers and care providers in providing the "clinical" versus the more "emotional, relational" care. While "person-centred care" tools, practices and approaches are available for providers and PLWD to work together better, there are fewer tools to help caregivers and providers communicate and share their knowledge, progress and activities better so they are working better together at all times, and particular during these changes. Aims Objectives Theory or Methods: This study evolved over time using our Participatory Research to Action framework. After a specific need was identified by PLWD and caregivers in a focus group, we held six sessions with different caregivers and providers to co-design a prototype tool to help caregivers and care providers work together better. Next, multiple co-design workshops with different communities identified prototype elements that were not relevant and how they should be changed. Each workshop was tailored in collaboration with community representatives. Highlights or Results or Key Findings: Guided by caregivers and providers from long-term care homes and home care, a prototype tool, Our Dementia Journey Journal, was produced on paper and in an online app to respond to the identified need. We then engaged with PLWD and their caregivers in diverse communities across Canada, including First Nations communities, to see how the prototype would need to be adapted to be culturally, linguistically and geographically relevant and useful. Overall, we heard that the essential components of the prototype Journal, adapted to local needs, will be helpful to improve the care of persons living with dementia by improving caregiver-care provider relationships and shared knowledge through various changes over time. The Journal includes basic information about dementia and links to online resources, tools for encouraging exchange of questions and answers, opportunities to record changes in wellbeing of caregivers and the emotional journey of the potential Journal users surrounding a PLWD. Conclusions: Through iterations in serial co-design sessions with caregivers and providers, we identified core elements of a tool they believe will improve their partnerships over the dementia journey with its multifaceted changes, and the necessary adaptations to make it culturally, linguistically and geographical relevant. Implications for applicability/transferability sustainability and limitations: We have information about the different versions of Our Dementia Journey Journal to meet the needs of caregivers and providers in rural, remote, suburban, urban, francophone and First Nations communities. These various versions will now be distributed for use and evaluation of their impact on caregiver-provider relationships. [ABSTRACT FROM AUTHOR]