The impact of elder abuse training on subacute health providers and older adults: study protocol for a randomized control trial

Background Elder abuse often goes unreported and undetected. Older people may be ashamed, fearful, or otherwise reticent to disclose abuse, and many health providers are not confident in asking about it. In the No More Shame study, we will evaluate a co-designed, multi-component intervention that aims to improve health providers' recognition, response, and referral of elder abuse.Methods This is a single-blinded, pragmatic, cluster randomised controlled trial. Ten subacute hospital sites (i.e. clusters) across Australia will be allocated 1:1, stratified by state to a multi-component intervention comprising a training programme for health providers, implementation of a screening tool and use of site champions, or no additional training or support. Outcomes will be collected at baseline, 4 and 9 months. Our co-primary outcomes are change in health providers' knowledge of responding to elder abuse and older people's sense of safety and quality of life. We will include all inpatients at participating sites, aged 65 + (or aged 50 + if Aboriginal or Torres Strait Islander), who are able to provide informed consent and all unit staff who provide direct care to older people; a sample size of at least 92 health providers and 612 older people will provide sufficient power for primary analyses.Discussion This will be one of the first trials in the world to evaluate a multi-component elder abuse intervention. If successful, it will provide the most robust evidence base to date for health providers to draw on to create a safe environment for reporting, response, and referral.Trial registration ANZCTR, ACTRN12623000676617p. Registered 22 June 2023. - Underreporting of elder abuse is significant due to barriers to disclosure.- Health providers may not feel confident in asking about or responding to elder abuse.- Hospital-based health providers are in a unique position to detect and respond to elder abuse.- We report our protocol for No More Shame, a pragmatic cluster randomised control trial that aims to train health providers to recognise and respond to elder abuse.- Our outcomes include health providers' knowledge and management of elder abuse, older people's quality of life and sense of safety, and rates of elder abuse detection and referrals at hospital sites.