Document Type

Article

Publication Date

4-1-2026

Comments

This article is the author’s final published version in Journal of Evaluation in Clinical Practice, Volume 32, Issue 3, 2026, Article number e70451.

The published version is available at https://doi.org/10.1111/jep.70451. Copyright © 2026 The Author(s).

 

Abstract

RATIONALE: The consistent delivery of effective evidence into nursing home practice has been shown to enhance quality of care and residents' outcomes. Pragmatic trials enable the evaluation of efficacious interventions in a real-world context, including care of residents living with Alzheimer's Disease and Related Dementias (ADRD). Yet, there are limited pragmatic trials conducted in nursing homes and even less evidence on the strategies to successfully conduct such research in this setting.

OBJECTIVE: To identify the lessons learned from a pragmatic trial and provide recommendations for future successful studies in United States (US) nursing homes.

METHODS: Drawing on a case example of a recently completed pragmatic trial, we used the Comparative Effectiveness Research Framework to guide the thematic analysis of study documentation to identify challenges, strategies used, and recommendations for future pragmatic trials in US nursing homes.

RESULTS: Five themes emerged from this case example: 1) establish and sustain community partner collaboration, 2) context analysis and appropriate implementation plan, 3) study adaptability, 4) data collection in a 'real world' setting, and 5) broad dissemination. Within each theme, strategies we used, challenges we encountered, and recommendations for future studies were identified. Examples of recommendations include empowering community partners to be engaged in the research, co-design with community partners, account for the dynamic nature of the nursing home setting, and maintain communication with organization leaders.

CONCLUSIONS: Successful completion of pragmatic trials in US nursing homes requires active engagement of community partners throughout the research process. The emergent lessons learned and recommendations highlight the complex nature of this care setting, the need to be proactive in implementation planning, and the pivotal role of community partners. Moving forward, there is a need for greater emphasis on systematically sharing experiences more broadly to advance the science of pragmatic trials in US nursing homes.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

42021611

Language

English

Download

Share

COinS