%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 9
%N 
%P e56586
%T A Digital Photo Activity Intervention for Nursing Home Residents With Dementia and Their Carers: Mixed Methods Process Evaluation
%A Tan,Josephine Rose Orejana
%A Neal,David P
%A Vilmen,Maria
%A Boersma,Petra
%A Ettema,Teake P
%A Gobbens,Robbert J J
%A Sikkes,Sietske A M
%A Dröes,Rose-Marie
%+ Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, location Vrije Universiteit, Oldenaller 1, Amsterdam, 1081 HJ, The Netherlands, 31 3316459170, j.r.tan@amsterdamumc.nl
%K dementia
%K psychosocial interventions
%K nursing home
%K process evaluation
%K social interaction
%K photos
%K art
%D 2025
%7 16.4.2025
%9 Original Paper
%J JMIR Form Res
%G English
%X Background: Within the framework of a randomized controlled trial investigating the impact of a digital, psychosocial photo activity intervention for residents living with dementia in nursing homes and their informal and formal carers, a process evaluation was conducted to determine factors that affected the implementation of the intervention and potentially influenced the intervention outcomes. Objective: By tracing facilitators and barriers to implementation, the study also aimed to inform future implementation of the photo activity intervention. Methods: Following Medical Research Council guidance, mixed methods were used to investigate context, implementation, and mechanism-of-impact factors during the photo activity intervention via the Fotoscope web application versus a general conversation activity (control). Google Analytics was set up to gain insight into how the Fotoscope web application was used in practice. For quantitative data, descriptive statistics were calculated and differences between groups tested. For qualitative data, thematic analysis was performed. Results: In total, 163 semistructured interviews were conducted with residents (photo activity group: n=29, 17.8%; control: n=29, 17.8%), formal carers (photo activity group: n=23, 14.1%; control: n=27, 16.6%), and informal carers (photo activity group: n=28, 17.2%; control: n=27, 16.6%). Regarding contextual factors, a minority of formal carers in both groups (photo activity group: 4/18, 22%; control: 9/24, 38%) mentioned time and workload as barriers to implementing the intervention. Regarding implementation, 86% (25/29) of the residents in the intervention group felt that the digital photo activity worked well on a tablet. Informal carers from both groups wanted more intervention updates from formal carers. The majority of formal carers from both groups were satisfied with how the training and activities were implemented. Regarding the mechanisms of impact, residents in the photo activity group (27/29, 93%) felt significantly more positive about the conversations with their carer (U=533.0, z=2.865, r=0.39; P=.004). Formal carers in the photo activity group (20/23, 87%) got to know the resident better (U=390.5, z=2.114, r=0.302; P=.04) compared to the formal carers in the control group (21/27, 78%). Formal carers in the photo activity group (23/50, 46%) gave a significantly higher rating to the digital photo activity as a way of getting to know the resident living with dementia better (median 9.00, IQR 7-9; U=419.0, z=2.169, r=0.307; P=.03) compared to formal carers in the control group (27/50, 54%; median 8.00, IQR 6-8). Finally, the majority of formal carers in the photo activity group (14/18, 78%) agreed that the Fotoscope app can be used as part of care activities in the nursing home. Conclusions: The work invested by formal carers in implementing the photo activity did not seem to differ greatly compared to implementing a general conversation activity, suggesting that the digital photo activity, as an easy-to-implement and enjoyable intervention, could be widely implemented and disseminated in nursing homes. International Registered Report Identifier (IRRID): RR2-https://doi.org/10.1186/s12877-021-02632-w 
%R 10.2196/56586
%U https://formative.jmir.org/2025/1/e56586
%U https://doi.org/10.2196/56586