Fisher, Emily, Mograbi, Daniel C., Ferri, Cleusa P, Santos, Raquel L, Naylor, Renata, Brum, Paula Schimidt, Bertrand, Elodie, Benevides, Pedro, Vaitheswaran, Sridhar, Venkatesan, Shreenila, Natarajan, Nirupama, Krishna, Murali, Chandra, Mina, Shaji, K S, Mkenda, Sarah, Urasa, Sarah, Walker, Richard, Dotchin, Catherine, Paddick, Stella‐Maria, and Walker, Jess
Background: There is a pressing need for effective and affordable interventions to support quality of life and cognition in people with dementia. Many psychosocial interventions are developed but few are delivered at scale and in routine practice. Group Cognitive Stimulation Therapy (CST) is the only non‐pharmacological treatment recommended by the National Institute for Health and Care Excellence (NICE) to improve cognition and wellbeing in mild to moderate dementia, and its global implementation has been recommended by Alzheimer's Disease International. CST has been culturally adapted for use in at least 36 countries, but this has not resulted in widespread delivery in routine practice. Methods: Methodology consisted of four phases 1) Exploring barriers to implementation through stakeholder engagement with clinicians, policy‐makers, people with dementia and caregivers; 2) Development of implementation plans for each country; 3) A mixed‐methods pre‐post study of CST in each country (total n = 103), exploring feasibility, acceptability, cost and outcomes including cognition and quality of life; and 4) Refinement of implementation strategies, with an aim of creating ongoing and sustainable CST programmes. Results: Implementation plans were developed for each country based on stakeholder engagement. CST delivery took place virtually in Brazil and India due to the Covid‐19 pandemic. We will present the barriers and facilitators to CST implementation in different settings based on the Consolidated Framework for Implementation Research (CFIR), and reflect on the success of implementation strategies. These include subsidising cost and travel, establishing a caseload of participants to receive CST, promotion and marketing of CST groups, educating family caregivers on the role of psychosocial interventions and enlisting their endorsement, and developing a 'train the trainer' model for CST group leaders. We will discuss the feasibility and acceptability of in‐person and virtual CST in varied settings, drawing on quantitative and qualitative findings from the pre‐post study of CST. Conclusion: It is crucial to not only culturally adapt the content of a psychosocial intervention, but also tailor implementation strategies for unique settings, considering economic realities, health equity and healthcare access. Key next steps to widespread CST implementation are long‐term funding arrangements and endorsement from regional or local guidelines. [ABSTRACT FROM AUTHOR]