BACKGROUND:Intrinsic capacity (IC), defined as the composite of physical and mental capacities, is a dynamic indicator of healthy ageing. Understanding its longitudinal patterns may improve risk stratification and inform care planning among home care recipients. METHODS:This population-based retrospective cohort study used routinely collected interRAI Home Care data in Canada. IC was derived across five domains and modelled using group-based trajectory modelling to identify distinct patterns over time. Associations between trajectory membership and key outcomes, including mortality and long-term care (LTC) admission, were examined. RESULTS:The study included 302 467 home care recipients; 62.2% were female, with a median age of 81 years (IQR 14). Five distinct IC trajectories were identified, demonstrating substantial heterogeneity in functional ageing. Most individuals followed declining trajectories, while smaller groups remained stable or showed improvement. Cognitive impairment was strongly associated with adverse trajectories, whereas gains were most evident in locomotion and psychological domains. Importantly, baseline IC level alone did not fully capture subsequent outcome heterogeneity. For example, individuals with moderate baseline IC had higher LTC admission than those with low IC who improved (48.4% vs 38.1%), underscoring the importance of longitudinal assessment. CONCLUSION:IC trajectories capture clinically meaningful differences in ageing pathways that are not apparent from single assessments. These findings support the use of routinely collected interRAI data to enable scalable, trajectory-informed care, with implications for earlier intervention, targeted service allocation and improved planning across the continuum of care. Further work is required to translate these findings into practical clinical tools to support early risk stratification at admission and guide future care planning.

OBJECTIVES:To measure the association between initiating palliative care using the combined criteria of short survival expectations and increased care needs with acute healthcare utilization among community-dwelling people living with dementia. DESIGN:A population-level propensity-based overlap-weighted cohort study. SETTING:Ontario, Canada. PARTICIPANTS:50,961 community-dwelling people living with dementia between 2010 and 2023, with 1-year follow-up until 2024. We used moderate to severe dementia and the initiation of homecare services as proxies for short survival expectations and increased care needs, respectively. We used linked health administrative data with propensity-based overlap weighting on sociodemographic and clinical factors to address confounding by the indication to receive palliative care. EXPOSURES:Receipt of home-based palliative care within 30 days of homecare initiation. MAIN OUTCOME MEASURES:Individual 1-year cause-specific hazards of emergency department (ED) use, hospitalization, and intensive care unit (ICU) admission. RESULTS:Palliative care was associated with a higher risk of hospitalization in the first 90 days (e.g., hazard ratio (HR) 1.43 at 30 days; 95% confidence interval (CI) 1.25-1.64), which was driven predominantly by hospitalization with palliative intent, but was no longer significantly different beyond 180 days, compared to not receiving palliative care. [Correction added on 31 January 2026, after first online publication: The preceding sentence has been revised in this version.] At 90 days, the cumulative incidence of hospitalization, death, or admission to a nursing home was approximately 20% among those receiving palliative care, compared to 15% in those not receiving palliative care. Although the overall absolute rate of ICU admission was low (0.01 ± 0.1 admissions per month), palliative care initiation was associated with a 186% higher risk in the first 30 days (HR 2.86; 95% CI 1.75-4.69) but not beyond 90 days. Palliative care was not associated with ED use over the following year (HR 1.02; 95% CI 0.72-1.45). CONCLUSIONS:The current approach to delivering palliative care services for community-dwelling people living with dementia in Canada may paradoxically increase early acute care use, likely reflecting system gaps and unmet needs. Given the high prevalence of dementia, there is an urgent need to re-examine homecare delivery models.

Musculoskeletal conditions, particularly osteoarthritis, account for >40 million disability-adjusted life years worldwide among persons aged 60 years and above. Research has also demonstrated that up to half of older adults have multimorbidity, which requires optimization for positive surgical outcomes. The World Health Organization introduced the concept of intrinsic capacity, which refers to the physical, mental, and psychosocial capacities that a person can draw upon to maintain their health and that are foundational components of healthy aging. Intrinsic capacity includes 5 domains: locomotion, vitality, cognition, sensory function, and psychological well-being. Two of these domains, locomotion and vitality, are directly relevant to orthopaedic surgery, as they focus on neuromuscular function, skeletal muscle mass, bone health, and related metabolic and nutritional factors. Substantial increases in the rates of primary arthroplasty worldwide create an important opportunity to incorporate interventions into existing orthopaedic surgical care processes in order to optimize locomotion and vitality and keep older adults healthy and out of the hospital. Orthopaedic surgeons are uniquely positioned to influence healthy aging well beyond the operating room. Three simple and effective interventions that can be championed by orthopaedic surgeons are (1) encouraging locomotion by giving patients a written prescription for muscle strengthening and balance training, (2) supporting vitality through malnutrition screening and reinforcing optimal nutrient intake, and (3) being a leader in bone health optimization. Addressing these factors can optimize intrinsic capacity, reduce falls and fragility fractures, improve surgical outcomes, and keep older adults out of the hospital long after the surgical episode has ended.

Objectives Falls remain a significant public health concern given both the person-level and system-level effects of experiencing a fall, namely decreased function, decreased intrinsic capacity, social isolation, and increased health care utilization. The World Health Organization has prioritized falls as a health outcome indicator in evaluating the impact of policy, strategy, and programming. The objective was to establish cross-sectoral fall rates across health care sectors in Canada and identify key risk factors as candidate risk adjustment variables for a falls quality indicator. Design A retrospective, cross-sectional study. Setting and Participants Seven hundred thousand two hundred four Canadian health care recipients, across multiple health care sectors, aged 60 years and older, were included. Methods This study analyzed data from interRAI assessments. Frequencies and χ2 analyses were used in descriptive analysis. Multivariable logistic regression analyses were used to establish key fall risk adjustors for a quality indicator. The independent variables considered in development included measures, such as function, cognition, health instability, balance impairment, and demographic variables. This model was then applied to a cohort with no serious mobility impairment. Mobility impairment included being completely dependent with ambulation, using a wheelchair or a scooter, or being bedbound. Results A higher prevalence of falls was observed in community settings. Regression analysis showed a protective effect of those receiving care in a designated care facility (odds ratio range across facilities with mandated assessments, 0.36-0.55). Those with balance impairment, bladder incontinence, health instability, cognitive impairment, and activities of daily living impairment were more likely to fall. Similar trends were observed in the subgroup with no mobility impairment. Conclusions and Implications These findings provide a national cross-sectoral landscape of falls in settings not generally considered in population surveys. The rates of falls are highly variable across settings, and key fall risk factors identified in this study provide a foundation for risk adjustment in global comparisons of falls in older adults.

Older adults experiencing social marginalization may face inequitable access to publicly funded home care services. In Ontario, Canada, the Ontario Marginalization Index (ON-Marg) provides a multidimensional measure of area-level marginalization. This study examined whether ON-Marg dimensions were associated with access to publicly funded home care among community-dwelling adults aged 75 years and older. We conducted a population-based retrospective cohort study using linked administrative health data from Ontario, Canada, for the year 2019. The cohort included individuals aged 75 + residing in the community (excluding those in long-term care). Home care access was stratified by ON-Marg dimensions: residential instability, material deprivation, dependency, and ethnic concentration. The primary outcomes were receipt of long-stay (≥ 90 days) and short-stay (< 90 days) home care aggregated at the community level (Aggregated Dissemination Areas -ADAs). Multivariable regression models adjusted for age, sex, hospitalization, and health complexity. Among 1,071,899 older adults, 14

BACKGROUND:Each year, half of all long-term care (LTC) residents will sustain a fall, and many will sustain a fall-related fracture. Fifty percent of all fractures in this vulnerable cohort occur at the hip, which is a life-changing health event leading to hospitalization, impaired physical functioning, and increased risk of premature mortality. National osteoporosis guidelines for the prevention of fractures are not consistently used in LTC homes. Improving osteoporosis guideline implementation may prevent hip fractures and other fractures. This study will examine whether the PREVENT (Person-centered Routine fracture prEVENTion) model can reduce hip fracture rates over one year compared to usual care in LTC homes. METHODS:Our study design is a pragmatic, cluster, randomized controlled trial. We will recruit 122 for-profit and not-for-profit LTC homes across Ontario, Canada. Homes will be randomized in a 1:1 ratio to intervention (PREVENT model) or control (usual care) arms. Eligibility criteria include a minimum of 50 occupied beds and access to the PointClickCare (PCC) electronic medical record system. One or two local opinion leader(s) and a leadership team consisting of five to ten healthcare providers will be recruited within each LTC home to support the implementation of the fracture prevention knowledge translation (KT) intervention. Generalized estimating equations (GEE) will be used to examine the effect of the PREVENT intervention vs usual care on hip fracture incidence (primary outcome), adjusting for important resident and LTC home characteristics; and secondary outcomes, including new osteoporosis medication prescriptions, non-hip fracture rates, falls, hospitalizations, death, LTC quality indicators, pain, mobility, responsive behaviors, and healthcare utilization costs. The Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement was used to guide the development of this study protocol. DISCUSSION:Preventing hip fractures in LTC has significant health, economic, and personal benefits. To our knowledge, the PREVENT trial is the first KT study of its kind in LTC to measure hip fracture as the primary outcome. If the PREVENT trial successfully improves hip fracture rates, it may lead the way for implementing a standardized approach to preventing hip fractures in LTC homes across Canada and internationally. TRIAL REGISTRATION:ClinicalTrials.gov NCT04947722. Registered on July 1, 2021.

Health research often categorizes “South Asians” as a homogeneous group despite significant linguistic, cultural, religious, socioeconomic, and generational diversity among South Asian immigrant communities in high-income countries. Migration experiences, systemic barriers, and varying levels of language ability further shape healthcare access, health behaviours, and participation in research. Such broad classifications may limit the relevance and responsiveness of health research and policy. This commentary examines how culturally anchored co-design may offer a more nuanced and inclusive approach to health research with South Asian immigrant communities. Drawing on interdisciplinary literature and illustrative examples, we examine how linguistic diversity, culturally embedded illness beliefs, family roles, health literacy, dietary practices, and socioeconomic status influence healthcare experiences. We then use the Health Equity Implementation Framework to illustrate how co-design can be integrated across the research continuum, from study development to dissemination, while attending to structural, organizational, and participant-level factors. Standardized approaches that overlook within-group diversity risk reinforcing inequities and limiting intervention uptake. Culturally anchored co-design, grounded in reciprocity, shared authority, and sustained community partnership, may support the development of linguistically accessible, culturally responsive, and contextually grounded research tools and interventions. Embedding co-design within an implementation framework positions it not as a one-time consultation, but as an ongoing process attentive to equity and system context. Moving beyond broad ethnic classifications toward community-engaged, implementation-informed research approaches may enhance cultural humility, relevance, and equity in healthcare research and delivery for South Asian immigrant communities.

Care models integrating geriatrics into primary care are emerging across Ontario. Referred to as Primary Care Integrated Geriatric Teams (PCIGTs), their evidence-based approaches improve access to specialized care and support for older adults. Seven Ontario models were highlighted through webinars held in spring 2025, attended by nearly 200 participants. Presenters and participants identified promising design features, key learnings and supports needed to advance goal-aligned care for older adults. Relevant to primary care transformation, health system redesign and policy efforts in Ontario and beyond, PCIGTs can support primary care attachment, reduce pressure on acute services and promote aging in place.

interRAI instruments consist of clinical information systems able to support integrated care. Through a scoping review, we describe how interRAI instruments are used: (1) as interventions (implementation category) and (2) to evaluate interventions (efficacy category) in older adults. In accordance with the PRISMA-ScR framework, we searched 6 databases and conducted dual-independent screening, with conflicts resolved by a third reviewer. Data extraction followed an identical procedure. The review yielded 64 manuscripts, including 43 and 21 categorized as studies of efficacy or implementation, respectively. Findings indicate that interRAI systems are consistently utilized to evaluate or enhance participant-centred outcomes across diverse healthcare settings in 17 countries, with a particular emphasis on home and long-term care. interRAI is a versatile system with the potential to form the foundation of an integrated clinical information system. This review provides a basis for future research testing novel intervention strategies with interRAI systems.

Objectives This study examines the complex transitions between the different mood states and absorbing states out of long-term care settings, as well as the factors affecting those transitions. Design A retrospective longitudinal analysis of older residents in Canadian long-term care homes in 3 provinces. Setting and Participants Residents residing in long-term care homes in 3 Canadian provinces (Alberta, British Columbia, and Ontario) over a 10-year period from January 2010 to February 2020, with an age of at least 65. Methods We used a 1-step Markov multistate transition model to examine transitions in mood over time as well as the factors affecting those transitions using the standardized interRAI MDS 2.0 comprehensive health assessment. The MDS 2.0 assessments are completed by trained assessors within 2 weeks of the resident's admission. Results Our results showed that 46% of residents initially present with no mood disturbance on admission and 31% with mild mood disturbance on admission and 23% with moderate/severe mood disturbance on admission. Factors associated with worsening of mood include aggressive behavior; health instability; impaired cognition; major comorbidities; pain or poor sleep; conflict with family, friends, or other residents; and anxiety. Of the facility-level attributes, Alberta was associated with worsening of mood. Conclusions and Implications Our study identified key factors influencing mood transitions, highlighting pain and aggressive behavior as significant contributors to worsening mood, both of which are modifiable through targeted interventions. The findings suggest substantial opportunities for mood improvement in long-term care settings.

Objective To evaluate the impact of the COVID-19 pandemic on the risk of experiencing new symptoms of depression among Canadian long-term care (LTC) home residents. Design and setting Retrospective longitudinal study of interRAI MDS 2.0 comprehensive health assessments completed in Alberta, British Columbia, Manitoba, Ontario, and Newfoundland, Canada between March 1, 2019, and June 30, 2020. Participants 22,441 residents without a diagnosis of depression and a Depression Rating Scale score of zero on their baseline assessment completed in the pandemic (March 2020) and pre-pandemic (March 2019) comparison period. Outcomes Incidence and severity of new depressive symptoms recorded on routine three-month follow-up assessment. Results The likelihood of developing new depressive symptoms was greater during the pandemic period (adjusted proportional odds ratio [aOR] 1.16 (95% CI 1.08 - 1.24)). In province-specific models, residents in Alberta (aOR 1.26, 95% CI 1.05 - 1.51), British Columbia (aOR 1.33, 95% CI 1.15 - 1.55), and Ontario (aOR 1.11, 95% CI 1.02 - 1.21) were more likely to develop new depressive symptoms during the pandemic period. Conclusion and Implications The initial waves of the pandemic likely contributed to increased mental health challenges due to various factors. Our findings highlight the need for comprehensive interventions to support all residents’ mental well-being during outbreaks.

Background: Health system fragmentation contributes to poor health and social outcomes for older adults with multimorbidity and their care partners. Integrated team-based models of care are recommended to improve health service delivery to older adults with complex needs. Standardized assessment instruments deployed on digital platforms are considered a necessary component of integrated care, as they can facilitate information sharing and development of a shared care plan. Previous research in community services and geriatric medicine settings found that using standardized self-report instruments is feasible and has the potential to support system integration, however suboptimal collaboration between sectors persists, highlighting the need for intentional planning around instrument use. The aim of this study was to develop implementation strategies for a digital wellness instrument, the interRAI Check Up Self Report, to support integrated health and social care for older adults and their care partners in a community in Ontario, Canada. Methods: A steering committee of older adults, co-investigators, and primary care, home care, and community service providers provided study oversight. Group concept mapping, a participatory mixed-methods approach, was conducted. Participants included older adults, care partners, and representatives from: home care, community services, specialized geriatric services, primary care, and health informatics. In a series of virtual meetings, participants generated ideas to support the use of the interRAI Check Up as part of a care approach with older adults and rated the relative importance of these ideas. Hierarchical cluster analysis was used to map the ideas into clusters of similar statements. Participants reviewed and interpreted the map to co-create an action plan. Results: Forty-one participants contributed to creation of a cluster map of ten action areas: engagement of older adults and care partners, instrument’s ease of use, accessibility of the assessment process, person-centred process, how to use the Check Up, training and education for providers, provider coordination, health information integration, health system decision support and quality improvement, and privacy and confidentiality. Health system decision support was rated as the lowest relative importance and health information integration was rated as the highest relative importance. The action plan included implementation strategies for the optimal use of the Check Up, for example, developing workflow plans for using the Check Up in care processes, including providers’ roles and responsibilities. Strategies were also developed to foster health and social care provider coordination, such as providing education on how to work as a team on a shared care plan, informed by a standardized self-report instrument. Conclusion: The introduction of digital instruments requires preparation, intervention, and evaluation at person, provider, and system levels. An instrument’s thoughtful selection is as important as developing an implementation plan that supports development of necessary processes and skills for older adults and care providers to adopt the tool into routine practice and evaluate the impact. Next steps: As communities implement digital instruments, such as the interRAI Check Up, this co-designed plan of ten action areas can be used to inform implementation planning and evaluation of practical strategies to support community, team-based integrated care.

Fragmented healthcare systems worldwide struggle to support patient populations with complex health and social needs. System integration requires a standardized clinical health information system to better care for these populations. This review describes how interRAI systems evolved into powerful solutions to support healthcare system integration. In response to a care quality crisis in long-term care homes in the United States, Congress mandated a standardized Minimum Data Set (MDS) from which multiple outputs were derived to support care planning, care quality, and case-mix assessment. This work drew international attention, leading to the creation of interRAI. Three decades of extensive international research, stakeholder engagement, and implementation have led to the creation of comprehensive cross-sectoral assessment systems for diverse populations, including older adults, mental health patients, and children and youth. The interRAI assessment systems, widely used in Canada and internationally, constitute comprehensive clinical assessment systems capable of supporting health system integration.

INTRODUCTION:interRAI is a global collaboration of clinicians, researchers and policy-makers who have developed a suite of assessment tools to assess the health status and care needs of older adults in various settings (ie, home, long-term care, etc). We aim to determine how interRAI tools have been used as an intervention and to evaluate intervention efficacy in older adults (65+) across diverse healthcare settings. Importantly, given the deployment of interRAI primarily in high-income countries, we anticipate that the findings may have minimal relevance to low- and middle-income nations, where there is an immediate and urgent need for equity in geriatric assessment. METHODS AND ANALYSIS:To be included, all studies must satisfy our inclusion criteria, outlined by the population (ie, older adults and/or individuals providing some element of care to older adults), intervention (ie, randomised or non-randomised), comparator (ie, with or without one) and outcome (ie, how the interRAI formed the basis of a study intervention). Our search strategy is based on previous reviews of interRAI tools, our research and clinical experience, and the expertise of a specialised librarian. In addition to PubMed, we will conduct our search without date or language restrictions in Scopus, Embase,Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Premier and PsycInfo. Study screening will employ a team-based approach, with Kappa statistics >0.8 indicating 'substantial' agreement and an acceptable threshold. Data extraction will capture the study ID and design, as well as sample characteristics and outcomes. Reporting will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, with findings presented graphically and narratively. ETHICS AND DISSEMINATION:Ethics approval is not required. Our knowledge dissemination strategies include traditional research avenues (ie, manuscript publications). We will also create an infographic to disperse widely and leverage existing partnerships to provide community presentations. REGISTRATION DETAILS:https://doi.org/10.17605/OSF.IO/BGJKP.

Introduction: Around the world, people are living longer in their communities. To support aging in place, understanding a person’s holistic care needs, including information about caregiver support, is essential to develop meaningful plans for integrated care centered around preferences, strengths, and needs. Using evidence-based assessment instruments to support these discussions are essential for meaningful engagement and shared decision-making between patients, caregivers, and providers. The interRAI Check Up (CU) and Self-Reported Carer Needs (SCaN) are validated self-report instruments which allow patients and caregivers to describe needs from their perspective, and express concerns which may be overlooked in traditional health and social care interactions. Upon completion, these instruments produce outputs that can help identify client risks and needs. Integrating self-report outputs into clinical conversations to build the client narrative and understand their unique context supports a collaborative care planning process. Workshop purpose: In this workshop participants will gain exposure to, and experience working with, outputs of self-reported comprehensive assessment instruments to support shared decision-making and a person-centred care planning process. Participants will engage with a client case to consider how assessment outputs can be used as part of a clinical interview process to identify goals, prioritize care needs, facilitate patient and caregiver engagement in decision-making, and share information across care-settings, enabling integrated care. Information will be shared on how person-level information can be used to support organization-level insights on service needs and care quality. Workshop Structure and Objectives: This 90-minute workshop will leverage presentation, case study and group discussion to meet workshop objectives. First, a brief introductory presentation (~15min) will provide attendees with necessary background on the self-report instruments and their global use. Following this, details of a client case (~5min), to be leveraged for workshop activities and discussions, will be presented. Participants will then obtain hands-on exposure to completing the assessments based on the case presented (~20min). A brief overview of assessment outputs (~10min) will be followed by a facilitated discussion of how assessment results can be used to engage clients and caregivers in care planning and how information may be shared across settings to facilitate integrated care (~20min). Tables will share their insights (~10min) with the group before a final presentation on how person-level data can support organization-level planning and decision making (~10 min). By the end of this workshop, participants will be able to: 1)Describe the value of self-report instruments for person-centred, goal-oriented care 2)Explain how to use assessment summaries to support prioritization and shared decision-making 3)Integrate self-report instrument outputs with open-ended questioning to build the client narrative 4)Recognize the importance of both the client and caregiver perspective when designing client care plans Audience: The content of this interactive workshop is appropriate all conference attendees, regardless of their role (including patients/caregivers, direct care providers, health system leaders and researchers). Using clinical cases and role-play, all necessary information to participate in workshop activities and discussions will be included. No prior knowledge of or experience with shared decision making and care planning is necessary.

OBJECTIVES:This study examined the transitions between different mood (depressive symptoms) states among residents of long-term care (LTC) homes during the first 2 waves of COVID-19. It also examined the transitions from these mood states to terminal clinical outcomes. DESIGN:A retrospective longitudinal analysis of older residents in Canadian LTC homes in 3 provinces from January 2010 to February 2021. SETTING AND PARTICIPANTS:Canadian LTC residents aged 65+ assessed in Alberta, British Columbia, and Ontario were divided into 2 cohorts: pre-COVID-19 (January 2010-February 2020) and COVID-19 (March 2020-February 2021), further divided into 2 subgroups: Wave 1 (March-August 2020) and Wave 2 (September-December 2020). Inclusion required admission during each period, a stay of at least 90 days, and either 2 assessments or 1 with discharge details. Residents admitted for fewer than 90 days or with only 1 assessment and no discharge data were excluded. METHODS:We used a 1-step Markov multistate transition model to examine probabilities in mood transitions and the associated factors with each transition. Our primary outcome of interest was transition in mood measured by the Depression Rating Scale, which is a proxy measure for mood. RESULTS:Our results suggest improved mood among surviving residents during the first 2 waves of COVID-19. Compared with the pre-pandemic period, residents were more likely to transition from mild depressive symptoms to no symptoms during wave 1 [odds ratio (OR), 1.06] and wave 2 (OR, 1.08), and from moderate-severe symptoms to no symptoms during wave 1 (OR, 1.14) and wave 2 (OR, 1.14). Regardless of baseline mood, residents were more likely to be discharged home or die, and less likely to be discharged to hospital during waves 1 and 2, compared with the pre-pandemic period. CONCLUSION AND IMPLICATIONS:COVID-19 may not have worsened LTC home residents' mood, contrary to other findings.

Dementia care in Canada must address the unique needs of South Asian Canadians, a growing population facing cultural and systemic barriers. Cultural stigma, language challenges, and a lack of culturally appropriate resources delay dementia recognition, diagnosis, and access to services. These barriers burden care partners, who navigate caregiving within cultural expectations and limited formal support. While some experiences of individuals living with dementia and their care partners are shared across communities, South Asian Canadians face additional challenges, including stigma rooted in cultural beliefs and limited access to culturally aligned services. Despite strong caregiving traditions, there is limited research on shared and culturally specific aspects of their experiences. This research examines the experiences of individuals with dementia, their care partners, physicians diagnosing dementia, and community support organization employees to identify barriers, strengths, and strategies for improving culturally inclusive dementia care. A qualitative, interpretive phenomenological approach was used through three interconnected studies conducted in Alberta, British Columbia, and Ontario. Study 1 examines the experiences of 16 participants (14 care partners and two individuals living with dementia) across stages of recognizing symptoms, obtaining a diagnosis, and accessing services. Study 2 investigates the perspectives of 13 physicians on diagnosing dementia in South Asian Canadians. Study 3 captures the insights of 14 employees from community support organizations providing dementia services. Semi-structured interviews were conducted in English, Hindi, and Punjabi, and reflexive thematic analysis was applied to identify recurring and distinct themes. Study 1 found barriers to recognizing dementia, challenges in obtaining a diagnosis, and difficulties in accessing services post-diagnosis, which were exacerbated by cultural beliefs, stigma, and unfamiliarity with healthcare systems. Study 2 revealed barriers to diagnosis, cultural and generational influences, and language challenges. Study 3 emphasized cultural sensitivity, trust-building, and the importance of partnerships with cultural organizations while highlighting systemic funding gaps. This research demonstrates the need for cultural humility in dementia care practices and policies. Findings underscore the importance of early diagnosis, community engagement, and developing culturally tailored resources to support families. Addressing systemic barriers and increasing funding for culturally sensitive services is essential to providing equitable dementia care for Canada's diverse population.

Introduction: In recent years, governments from several countries have shown interest in integrated health information systems to support the delivery of integrated care. The interRAI suite of standardized, evidence-based assessments, validated across different care settings, was expressly designed for this purpose. The use of a core set of items facilitates information-sharing across sectors and continuity of care. In addition, they reduce duplication of assessment through the electronic transfer of information, facilitate care planning and quality assurance, and support service determination and allocation. Another key benefit of the interRAI system is the digital platform that offers clinicians, researchers, and policymakers a wealth of real-time and aggregated data. Workshop purpose: In this interactive workshop, we will discuss international experiences with implementing the interRAI system, including factors for success and mitigation strategies to overcome barriers. Attendees will be immersed in a simulated multi-stakeholder, multidisciplinary approach, using problem-solving skills to tackle the challenges of the implementation of this integrated digital health solution. Working on real case studies of large-scale implementations (e.g., Canada, Ireland, Belgium, USA, New Zealand) participants will assume the role of different stakeholders. Through an international lens, presenters from countries at different stages of implementation of interRAI, will show very concrete cases and explore challenges and benefits of the system. Workshop Structure and Objectives: This 90-minute workshop will begin with a short presentation (~15 min.) about the implementation of the interRAI-Suite in the Republic of Ireland, Canada, the USA, New Zealand, and Belgium, focusing on how the interRAI digital platform is being implemented in each country. After the presentation, attendees will split into small groups, receiving a concrete case detailing one topic from the implementation in one of the five countries. Participants will receive different roles (managers of care organizations, policymakers, professional caregivers, patients) and will discuss the challenges exposed in the case studies and how they might solve these issues (~40 min.). One example of a topic could be: What is the ideal balance between bottom-up and top-down implementation of an integrated health assessment such as the interRAI? Co-authors experienced in large-scale implementation of this integrated health information system will guide the group discussions. At the end, groups will share their insights (~20 min.) with all participants. The session will end with a short presentation to summarize the main implementation challenges and the actions taken that led to successful outcomes (~15 min). By the end of this workshop, participants will be able to: Describe how an electronic health information system, such as the interRAI Suite, can facilitate integrated care Compare strategies used to mitigate barriers in the implementation of integrated health information systems Explain how a multi-stakeholder approach can help to achieve change management, engaging with the people involved for more participation and acceptance. Audience: This interactive workshop will be suitable for all participants of the conference, from researchers to care providers, as well as policymakers. Participants do not need to have any specific prior knowledge. The goal is to collaborate in the group toward a successful implementation.