CHOICE+ Quality Improvement for Long Term Care Homes

CHOICE+ is an eLearning program that empowers staff to improve the mealtime experience of long-term care (LTC) residents. This program is based on principles that align with relationship-centered care and promote resident quality of life and food intake. In a prior study, the investigators have showed that this program can improve the mealtime experience; eLearning has been created to promote spreading of this training. The investigators have created an implementation model that supports uptake of this eLearning. Designated home staff Champions will complete the eLearning, be provided four virtual training sessions to reinforce key concepts and be mentored in monthly virtual community of practice sessions around making improvements. Champions will work with a small team of staff, residents, and family to identify and make improvements (e.g., less rushed mealtime). This study will evaluate this model of implementation in 13-18 LTC homes. Homes in the region of research centres are invited to apply, and where required, will be randomly selected. Investigators will also determine if the mealtime experience, resident health (body weight and food intake), resident/family food and care satisfaction, and staff job satisfaction improve. This implementation study is designed to sustain improvements that the Champions and their team make and build capacity to improve the quality of care in their home. The research team will track implementation activities and influences on implementation through champion diaries, monthly meetings, and end of study interviews. Researchers will measure the mealtime experience with a standardized observational tool and aggregate food waste (to assess food intake). Resident body weight to determine nutritional status will be collected monthly. Questionnaires will be used with staff, residents, and family members for other outcomes. Outcomes will be measured six months before, during, and six months after the one year of implementation. Findings and learnings about implementation will support the scaling of CHOICE+ to other LTC homes.

NCT Number	NCT07505407
Lead Sponsor	University of Waterloo Collaborators: University of Saskatchewan, University of Manitoba, St. Francis Xavier University
Conditions	Long Term Care Homes, Malnutrition Elderly, Malnutrition Risk in Elder
Enrollment	800 participants
Start Date	2026-06-01
Primary Completion	2028-12-30 (estimated)
Study Completion	2028-12-30 (estimated)
Updated on ClinicalTrials.gov	2026-08-06