Implementing interpreter training for dementia assessments at national scale using the RE-AIM framework: a mixed-methods evaluation

BMC Geriatr. 2026 Mar 5;26(1):516. doi: 10.1186/s12877-026-07238-8.

Abstract

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.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12877-026-07238-8.

Keywords: Cognitive assessment; Dementia; Ethnic diversity; Healthcare equity; Interpreter training.