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Background As Australia’s ethnically diverse population ages, dementia prevalence is rising. Professional interpreter support is essential to ensure equitable access to accurate dementia diagnosis and care. To address this need, a nationally specialised online, self-paced training on dementia and cognitive assessments was developed for interpreters. Guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, this article reports on the training’s implementation. Specifically, it explores the training’s reach, barriers and facilitators to adoption, perceived effectiveness in improving interpreter-mediated assessments, and potential for long-term maintenance. Methods Between 24 November 2023 and 12 December 2024, the online self-paced training was rolled out to interpreters nationally across Australia. Implementation was supported by industry study partners, including interpreter agencies, advocacy organisations, a technology partner, and the national accreditor for interpreters. A mixed-methods evaluation was undertaken. Quantitative monitoring captured the training’s reach, uptake, and successful completion. In parallel, qualitative interviews were conducted with 24 interpreters who completed the training, 6 managers from interpreter agencies, and 16 clinicians who worked with interpreters to undertake cognitive assessments. Quantitative data were descriptively analyzed, and qualitative data were analyzed using the framework method. Results Eight hundred sixty-five interpreters, representing 14.5% of Australia’s active interpreter workforce, completed the training. Interpreters and agency managers reported that the training improved interpreter practice and confidence. In contrast, clinicians were unaware of the training. Barriers to uptake included time constraints, technical issues and limited computer literacy, and the perceived difficulty of the content for some participants. Key facilitators included ease of access (being online and no cost), incentive of professional development points, a straightforward final assessment, and administrative support. The training has now been made freely and permanently available on the national accreditation authority’s website. Conclusions This world-first study demonstrates a scalable approach to delivering interpreter training for dementia assessments, with the potential to enhance the accuracy and timeliness of diagnosis for ethnically and linguistically diverse people living with dementia.

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. Key points - 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.

Background The Improving Interpreting for Dementia Assessments (MINDSET) study aimed to upskill interpreters through an online co‐designed course in dementia and cognitive assessments. Methods A single‐blinded randomized controlled digital trial conducted between June 2022 and November 2023. Interpreters were randomized to training or waitlist control conditions with 3‐ and 6‐month follow‐up. The primary outcome was a composite Z‐score comprising dementia and cross‐cultural knowledge, translation and ethical knowledge, and observed interpreting skills. Preliminary analyses were conducted using a mixed ANOVA with assessment period as the within‐subjects factor and intervention group as the between‐subjects factor, controlling for age. Results 126 interpreters (Mage = 44.13 years (SD = 12.71) completed baseline (22 Arabic, 14 Cantonese, 6 Greek, 14 Italian, 64 Mandarin, 6 Vietnamese), 3m follow‐up (n = 100) and 6m follow‐up (n = 101). For the primary outcome, there were no significant main effects for assessment period F (2, 178) = 0.21, p = .814 nor intervention group F (1, 89) = 0.31, p = .548, and no significant interaction between intervention group and assessment period, F (2, 178) = 0.64, p = .526. Secondary outcomes revealed significant main effects for dementia knowledge (DKAS) for the assessment period, F (2, 98) = 8.80, p <.001, and intervention group F (1, 99) = 4.59, p = .035, with significantly higher scores at the 3‐ (mean difference = 1.308, SE = .31, p <.001, 95% CI .692, 1.924) and 6‐month follow‐up (mean difference = .814, SE = .31, p = .010, 95% CI .203, 1.425); and significantly higher scores in the intervention compared to control (mean difference = .842, SE = .393, p = .035, 95% CI .062, 1.621). A significant interaction between assessment period and intervention group F (2, 98) = 3.33, p = .040 indicated that the increase in scores at the 3‐ and 6‐month periods were greater for the intervention group. Conclusions This is the first time a dementia training resource for interpreters has been trialled. Preliminary analyses revealed an improvement in interpreter’s dementia knowledge.

The Improving Interpreting for Dementia Assessments (MINDSET) study aimed to upskill interpreters through an online co-designed course in dementia and cognitive assessments. A single-blinded randomized controlled digital trial conducted between June 2022 and November 2023. Interpreters were randomized to training or waitlist control conditions with 3- and 6-month follow-up. The primary outcome was a composite Z-score comprising dementia and cross-cultural knowledge, translation and ethical knowledge, and observed interpreting skills. Preliminary analyses were conducted using a mixed ANOVA with assessment period as the within-subjects factor and intervention group as the between-subjects factor, controlling for age. 126 interpreters (Mage = 44.13 years (SD = 12.71) completed baseline (22 Arabic, 14 Cantonese, 6 Greek, 14 Italian, 64 Mandarin, 6 Vietnamese), 3m follow-up (n = 100) and 6m follow-up (n = 101). For the primary outcome, there were no significant main effects for assessment period F (2, 178) = 0.21, p = .814 nor intervention group F (1, 89) = 0.31, p = .548, and no significant interaction between intervention group and assessment period, F (2, 178) = 0.64, p = .526. Secondary outcomes revealed significant main effects for dementia knowledge (DKAS) for the assessment period, F (2, 98) = 8.80, p <.001, and intervention group F (1, 99) = 4.59, p = .035, with significantly higher scores at the 3- (mean difference = 1.308, SE = .31, p <.001, 95% CI .692, 1.924) and 6-month follow-up (mean difference = .814, SE = .31, p = .010, 95% CI .203, 1.425); and significantly higher scores in the intervention compared to control (mean difference = .842, SE = .393, p = .035, 95% CI .062, 1.621). A significant interaction between assessment period and intervention group F (2, 98) = 3.33, p = .040 indicated that the increase in scores at the 3- and 6-month periods were greater for the intervention group. This is the first time a dementia training resource for interpreters has been trialled. Preliminary analyses revealed an improvement in interpreter's dementia knowledge.