In this study, we are interested in assessing whether it is feasible for care workers to deliver an adapted version of DIALOG+ (aDIALOG+) to service users with mild or moderate learning disability who have behaviours that challenge (such as self-injurious behaviour, physical or verbal aggression, anger / frustration outbursts, or damage to property). 

Our aim is to establish whether it is possible to recruit care homes, care workers and service users into the study. We will also examine the number of sessions of aDIALOG+ that are delivered over 6 months, the quality of the sessions, and the experiences and views of care workers and service users about the intervention, what worked well and what needs to be improved.

Additionally, we will look at whether there are any potential benefits of the intervention by looking at changes in outcome measures such as behaviour, community participation, quality of life and service use.

What will happen?

For service users that agree to take part and provide consent, their care workers will administer the aDIALOG+ intervention using the app during a face-to-face session. Delivery will involve a ‘team approach’, potentially involving more than one care worker. There will be flexibility in the number of aDIALOG+ sessions that are delivered, with an expectation that it is delivered at least once a month over 6 months. We recommend, if possible, that aDIALOG+ is used as part of routine meetings that care workers would usually have with the service user (e.g. at key worker meetings, to reduce burden on the care worker and the service user). The intervention will take about 30 minutes but it might take less time or more time depending on the needs of the person.

Service users will complete questionnaires at baseline and at 6 months, and care workers will also be asked to complete some questionnaires about themselves and the service user. After the 6-month period, some service users and care workers will be asked to share their views on the experience of using aDIALOG+ through participating in a focus group or interview, which will last about 30-45 minutes. We will obtain feedback on what aspects of the intervention (including the DIALOG scale, app, training and manual) worked well or did not work well, and suggestions for improvement. The interviews will be audio-recorded and analysed so that we can determine which aspects of the intervention need further modifications, which will inform changes to the intervention.

Who can take part?

Service users will be eligible to take part if they are aged 18 or over, have mild or moderate learning disability based on service records / clinical notes, have a current history of behaviour that challenges (at least one incident of self-injurious behaviour, physical or verbal aggression, anger / frustration outbursts, or damage to property in the last 3 months), are residing in supported living or residential care, and can provide informed verbal or written consent.

Care workers will be eligible to take part if they are aged 18 or over, have worked in the care home for at least three months, provide at least one day of support per week to service users, and consent to participate. 

Care homes will be eligible to take part if they are supported living or residential placements for service users with learning disability in the participating areas and the service manager has agreed for the care home to take part.

When is it running?

The care homes feasibility study started in May 2026 and is expected to run for 13 months.