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Process evaluation in a randomised controlled trial of DREAMS-START (dementia related manual for sleep; strategies for relatives) for sleep disturbance in people with dementia and their carers
Sarah Amador, Gill Livingston, Mariam Olaide Adeleke, Julie Barber, Lucy Anne Webster, Hang Yuan, Sube Banerjee, Ankita Bhojwani et al.. Age and Ageing, 2025-03-01
Topic: Risk, prevention and care in population studies
Attendance was good (82.8% attended ≥4/6 sessions). Mean fidelity score (95.4%; SD 0.08) and median score for all four process measures assessed (5/5; IQR 5-5) were high. We interviewed 43/188 family carers and 9/49 DREAMS-START facilitators. We identified three overarching themes aligned with our model: (i) knowledge and facilitation enable behaviour change, (ii) increasing sleep pressure and developing skills to manage sleep disturbances and (iii) Establishing a routine and sense of control. We were unable to collect sufficient data for pre-specified actigraphy analyses. Despite competing demands, carers attended DREAMS-START. It promoted behaviour change through supportive in-session reflection, increasing carer knowledge and skills. This was embedded between sessions and actions were positively reinforced as carers experienced changes. Results will inform future implementation in clinical services.
Key findings
- Attendance was good (82.8% attended ≥4/6 sessions).
- Mean fidelity score (95.4%; SD 0.08) and median score for all four process measures assessed (5/5; IQR 5-5) were high.
- We interviewed 43/188 family carers and 9/49 DREAMS-START facilitators.
- We identified three overarching themes aligned with our model: (i) knowledge and facilitation enable behaviour change, (ii) increasing sleep pressure and developing skills to manage sleep disturbances and (iii) Establishing a routine and sense of control.
- We were unable to collect sufficient data for pre-specified actigraphy analyses.
Why it matters
This process evaluation of the DREAMS-START trial found good attendance and high fidelity, and carers reported that the programme increased their knowledge and skills for managing sleep disturbance. It evaluates how a sleep support programme was delivered, not any treatment, cure, or prevention for Alzheimer's disease.
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Study details
- Study designrandomized controlled trial
- Effect size82.8%; 95.4%
- Evidence strengthHigh
How this study scored 60/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for sample size and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Age and Ageing) |
| Journal's citation record | 2 / 4 | Age and Ageing: journal h-index 231 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 2 / 7 | Cited 7 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 7.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 7 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Penny Rapaport: h-index 28 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Oxford: institution h-index 2,205 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 8 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40116618) |
| Free to read | 2 / 2 | Free to read |
| Total | 60 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Amador, S., Livingston, G., Adeleke, M. O., Barber, J., Webster, L. A., Yuan, H., et al. (2025). Process evaluation in a randomised controlled trial of DREAMS-START (dementia related manual for sleep; strategies for relatives) for sleep disturbance in people with dementia and their carers. Age and Ageing. https://doi.org/10.1093/ageing/afaf053
Vancouver
Amador S, Livingston G, Adeleke MO, Barber J, Webster LA, Yuan H, et al. Process evaluation in a randomised controlled trial of DREAMS-START (dementia related manual for sleep; strategies for relatives) for sleep disturbance in people with dementia and their carers. Age and Ageing. 2025. doi:10.1093/ageing/afaf053. PMID: 40116618.
BibTeX
@article{amador2025-40116618,
author = {Amador, Sarah and Livingston, Gill and Adeleke, Mariam Olaide and Barber, Julie and Webster, Lucy Anne and Yuan, Hang and Banerjee, Sube and Bhojwani, Ankita and others},
title = {{Process evaluation in a randomised controlled trial of DREAMS-START (dementia related manual for sleep; strategies for relatives) for sleep disturbance in people with dementia and their carers}},
journal = {Age and Ageing},
year = {2025},
doi = {10.1093/ageing/afaf053},
pmid = {40116618},
url = {https://doi.org/10.1093/ageing/afaf053}
}
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