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Table 3 ACHRU-CPP Intervention Fidelity Guide

From: The Aging, Community and Health Research Unit Community Partnership Program (ACHRU-CPP) forĀ older adults with diabetes and multiple chronic conditions: study protocol for a randomizedĀ controlled trial

Program Components

Data Source(s)

Staffing and Supervision

ā€¢ Intervention team receives training targeted to learning need

Record of attendance

Learning needs assessment

ā€¢ Monthly outreach meetings between the intervention team and investigators

Meeting notes

Home visits (in-home, telephone or videoconference)

ā€¢ Up to 3 home/telephone/videoconference visits conducted by the Registered Nurse/Registered Dietitian/Nutritionist

Home visit record

ā€¢ Screening for diabetes-related complications and comorbidities

ā€¢ Review of medications

Home visit record

Standardized clinical assessment tools

Medication record

Alerts (e.g., medication, diabetes complications)

ā€¢ Assessment of self-management of diabetes and other chronic conditions and identification of clientā€™s needs and goals

ā€¢ Assessment of caregiver needs (if applicable)

ā€¢ Motivational interviewing to foster behavioural change and encourage self-care

Home visit record

My action plan

Client-centred care plan

Caregiver Strain Index

Monthly Group Wellness Sessions

ā€¢ Attend up to 6 monthly sessions led by the intervention team

ā€¢ Individual consultations with community program coordinator

Group wellness session record

Record of individual consultations with community program coordinator

ā€¢ Provision of transportation (if needed)

Group wellness session record

Care Coordination and System Navigation

ā€¢ Registered Nurse helps clients access supports and services in the community as needed

Client-centred care plan

Monthly Case Conferences

ā€¢ Intervention team attends monthly case conferences

Case conference meeting record

ā€¢ Intervention team develops and re-evaluates a coordinated care plan for each participant

Client-centred care plan