Adapting the Germ Defence Web-Based Intervention to Improve Infection Prevention and Control in Care Homes: Interview Study Among Care Home Staff

BackgroundInfection prevention and control (IPC) is vital in care homes as it can reduce morbidity and mortality by 30%. Ensuring good IPC practice is a perennial challenge in the varied and complex context of care homes. Behavior change interventions delivered via digital te...

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Main Authors: Alex Hall, Johanna Aguilera-Muñoz, Lisa McGarrigle, Charlotte Eost-Telling, James Denison-Day, Christie Cabral, Merlin Willcox, Chris Todd
Format: Article
Language:English
Published: JMIR Publications 2025-02-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2025/1/e66706
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author Alex Hall
Johanna Aguilera-Muñoz
Lisa McGarrigle
Charlotte Eost-Telling
James Denison-Day
Christie Cabral
Merlin Willcox
Chris Todd
author_facet Alex Hall
Johanna Aguilera-Muñoz
Lisa McGarrigle
Charlotte Eost-Telling
James Denison-Day
Christie Cabral
Merlin Willcox
Chris Todd
author_sort Alex Hall
collection DOAJ
description BackgroundInfection prevention and control (IPC) is vital in care homes as it can reduce morbidity and mortality by 30%. Ensuring good IPC practice is a perennial challenge in the varied and complex context of care homes. Behavior change interventions delivered via digital technology may be effective in improving IPC among care home staff. ObjectiveThis study aimed to evaluate how an evidence-based, digital behavior change intervention called Germ Defence can be rapidly adapted to meet the needs of care homes. MethodsThis study applied the person-based approach, which emphasizes iterative approaches to optimizing interventions via individual user feedback. Phase 1 involved initial edits to the website by the research team to create Germ Defence for Care Homes (GDCH) version 1. Phase 2 consisted of stakeholder consultation on GDCH version 1 followed by edits to create GDCH version 2. The formal research (phases 3 and 4) involved individual think-aloud interviews with 21 staff members from management, care, and ancillary positions in 4 care homes providing real-time feedback as they worked through GDCH. Edits were made to create GDCH version 3 between phases 3 and 4. During the development of GDCH versions 2 and 3, it became clear that the intervention would need more fundamental changes beyond the pragmatic, incremental changes that would be possible within the scope of this study. Analysis was completed via a rapid, qualitative descriptive approach to develop a high-level summary of key findings from the interview data. ResultsThere were mixed results about the attractiveness of GDCH and its suitability to the care home context. Participants felt that the images needed to be aligned much more closely with the meaning of adjacent text. Many participants felt that they would not have time to read a text-based website, and some suggested that more engaging content, including audio and video, may be preferable. Most participants felt that the overall concept of Germ Defence was clearly relevant to their context. Some felt that it might be a useful introduction for new staff members or a refresher for current staff, but others felt that it did not add anything to their existing IPC training. There were mixed opinions about the level of detail provided in the information offered by the site. While the goal-setting behavior change mechanism may have potential, the findings suggested that it may be unsuitable for care homes and more work is needed to refine it. ConclusionsMuch more work needs to be done to make Germ Defence more engaging, accessible, and relevant to the care home workforce. Our study highlights the challenges of rapidly adapting an existing intervention to a new context. Future research in this area will require a pragmatic methodological approach with a focus on implementation.
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spelling doaj-art-2972fa9c19164296bc7c9152a38957692025-08-20T03:11:46ZengJMIR PublicationsJMIR Formative Research2561-326X2025-02-019e6670610.2196/66706Adapting the Germ Defence Web-Based Intervention to Improve Infection Prevention and Control in Care Homes: Interview Study Among Care Home StaffAlex Hallhttps://orcid.org/0000-0002-8849-744XJohanna Aguilera-Muñozhttps://orcid.org/0000-0001-8865-2764Lisa McGarriglehttps://orcid.org/0000-0002-0533-3029Charlotte Eost-Tellinghttps://orcid.org/0000-0002-9568-3195James Denison-Dayhttps://orcid.org/0000-0003-0223-0005Christie Cabralhttps://orcid.org/0000-0002-9884-0555Merlin Willcoxhttps://orcid.org/0000-0002-5227-3444Chris Toddhttps://orcid.org/0000-0001-6645-4505 BackgroundInfection prevention and control (IPC) is vital in care homes as it can reduce morbidity and mortality by 30%. Ensuring good IPC practice is a perennial challenge in the varied and complex context of care homes. Behavior change interventions delivered via digital technology may be effective in improving IPC among care home staff. ObjectiveThis study aimed to evaluate how an evidence-based, digital behavior change intervention called Germ Defence can be rapidly adapted to meet the needs of care homes. MethodsThis study applied the person-based approach, which emphasizes iterative approaches to optimizing interventions via individual user feedback. Phase 1 involved initial edits to the website by the research team to create Germ Defence for Care Homes (GDCH) version 1. Phase 2 consisted of stakeholder consultation on GDCH version 1 followed by edits to create GDCH version 2. The formal research (phases 3 and 4) involved individual think-aloud interviews with 21 staff members from management, care, and ancillary positions in 4 care homes providing real-time feedback as they worked through GDCH. Edits were made to create GDCH version 3 between phases 3 and 4. During the development of GDCH versions 2 and 3, it became clear that the intervention would need more fundamental changes beyond the pragmatic, incremental changes that would be possible within the scope of this study. Analysis was completed via a rapid, qualitative descriptive approach to develop a high-level summary of key findings from the interview data. ResultsThere were mixed results about the attractiveness of GDCH and its suitability to the care home context. Participants felt that the images needed to be aligned much more closely with the meaning of adjacent text. Many participants felt that they would not have time to read a text-based website, and some suggested that more engaging content, including audio and video, may be preferable. Most participants felt that the overall concept of Germ Defence was clearly relevant to their context. Some felt that it might be a useful introduction for new staff members or a refresher for current staff, but others felt that it did not add anything to their existing IPC training. There were mixed opinions about the level of detail provided in the information offered by the site. While the goal-setting behavior change mechanism may have potential, the findings suggested that it may be unsuitable for care homes and more work is needed to refine it. ConclusionsMuch more work needs to be done to make Germ Defence more engaging, accessible, and relevant to the care home workforce. Our study highlights the challenges of rapidly adapting an existing intervention to a new context. Future research in this area will require a pragmatic methodological approach with a focus on implementation.https://formative.jmir.org/2025/1/e66706
spellingShingle Alex Hall
Johanna Aguilera-Muñoz
Lisa McGarrigle
Charlotte Eost-Telling
James Denison-Day
Christie Cabral
Merlin Willcox
Chris Todd
Adapting the Germ Defence Web-Based Intervention to Improve Infection Prevention and Control in Care Homes: Interview Study Among Care Home Staff
JMIR Formative Research
title Adapting the Germ Defence Web-Based Intervention to Improve Infection Prevention and Control in Care Homes: Interview Study Among Care Home Staff
title_full Adapting the Germ Defence Web-Based Intervention to Improve Infection Prevention and Control in Care Homes: Interview Study Among Care Home Staff
title_fullStr Adapting the Germ Defence Web-Based Intervention to Improve Infection Prevention and Control in Care Homes: Interview Study Among Care Home Staff
title_full_unstemmed Adapting the Germ Defence Web-Based Intervention to Improve Infection Prevention and Control in Care Homes: Interview Study Among Care Home Staff
title_short Adapting the Germ Defence Web-Based Intervention to Improve Infection Prevention and Control in Care Homes: Interview Study Among Care Home Staff
title_sort adapting the germ defence web based intervention to improve infection prevention and control in care homes interview study among care home staff
url https://formative.jmir.org/2025/1/e66706
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