Building Core Competencies of Taiwanese Care Food Specialists: Curriculum Design and Outcome Assessment

Nursing Department Assistant Professor

Background: As Taiwan faces an aging population, the demand for long- term care services continues to rise, increasing the need for skilled care workers. Care Food Specialists, focusing on food preparation and oral health in long-term care, are essential for improving care quality.

Objective: This project aims to develop a core competency training curriculum for Care Food Specialists in Taiwan and assess its effectiveness in enhancing care worker skills.

Methods: Over two years, participants were recruited from various regions for training, with pre- and post-course assessments and qualitative interviews to evaluate changes in knowledge, attitude, and behavior.

Conclusion/Practical Applications: The project successfully designed and implemented a training curriculum, providing evidence of its positive impact on long-term care quality and offering a practical framework for future competency-based training.

Study Overview

• Status: Recruiting
• Conditions: Healthy
• Intervention / Treatment: Other: Core Competency Training Course for Eating Support Healthcare Aides (20-Hour Course)

Detailed Description

This study aims to evaluate the effectiveness of a Core Competency Training Course for Eating Support Healthcare Aides on knowledge and skills related to safe feeding practices, oral care, dysphagia diet management, and nutrition support for individuals with chewing or swallowing difficulties. The study employs a three-arm waitlist control trial (WCT) design, including both students and industry professionals, to comprehensively assess learning outcomes across different participant populations.

Study Design and Groups:

Participants are assigned to one of three groups:

1. Student Immediate Intervention Group (IG): Students receive the 20-hour training program at the beginning of the study.
2. Student Waitlist Control Group (WG): Students receive the same training after the initial study period, serving as a delayed intervention control.
3. Industry Group (RG): Current professional healthcare aides who receive the training concurrently with the student immediate intervention group.

This design allows comparison of pre- and post-intervention changes in the student immediate group, assessment of delayed intervention effects in the waitlist group, and evaluation of differences between students and industry professionals.

Participant Recruitment:

Student Group: Fifth-year junior college and third-year technical program students in long-term care-related programs, aged 19 years or older, who have completed a "Basic Care Practice and Laboratory" course and are able to attend the full 20-hour training. Students who are unwilling or have prior swallowing-related training are excluded.

Industry Group: Current professional healthcare aides aged 20 years or older with at least one year of experience in community or institutional long-term care settings, able to communicate in Mandarin and Taiwanese, and able to attend the full 20-hour course. Exclusion criteria include non-current employment, lack of language proficiency, or inability to complete the training.

Intervention (Training Program): The 20-hour Core Competency Training Course

Outcomes and Evaluation:

Participants' knowledge, practical skills, and competence in safe feeding and nutrition support are assessed pre- and post-intervention. Comparisons among groups allow evaluation of the training's immediate effects, delayed intervention impact, and differences between students and experienced professionals.

This comprehensive study design ensures both rigorous evaluation of the intervention's effectiveness and ethical inclusion of all student participants while providing practical insights for improving long-term care training programs.

• Study Type: Interventional
• Enrollment (Estimated): 150
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: ChiaHui Lin; Phone Number: +886-912748610; Email: clh9031@gmail.com

Study Locations

• Taiwan
  • Taiwan
    • Tainan, Taiwan, Taiwan, 721
      • Recruiting
      • Chang Gung Medical Foundation
      • Contact: CHIAHUI LIN; Phone Number: +886-0912749610; Email: clh9031@gmail.com
      • Contact: chiahui Lin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Student Group Inclusion Criteria

• Enrolled in a long-term care-related educational program (either a five-year junior college program or a four-year technical program).
• In the year immediately preceding graduation (fifth-year junior college students or third-year technical program students).
• Aged 19 years or older.
• Had completed the Basic Care Practice and Laboratory course.
• Able to attend the full 20-hour training course.

Exclusion Criteria:

• Unwilling to participate or unable to complete the full 20-hour course (e.g., due to other academic commitments)
• Industry Healthcare Aide Group

Inclusion Criteria:

• Currently employed as a professional healthcare aide in community-based or institutional long-term care settings.
• Actively working in a care aide role with at least one year of relevant experience.
• Possess a valid Taiwan Care Worker Training Certificate.
• Aged 20 years or older.
• Able to communicate in both Mandarin and Taiwanese.
• Able to attend the full 20-hour training course.

Exclusion Criteria:

• Younger than 20 years of age.
• Unable to communicate in Mandarin and Taiwanese.
• Not currently employed as a community or institutional care aide.
• Unable to complete the full 20-hour course

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Non-Randomized
• Interventional Model: Crossover Assignment
• Masking: Triple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Student Immediate Intervention Group (IG): Students participated in the Core Competency Training Course for Eating Support Healthcare Aides, a 20-hour program designed to enhance knowledge and skills in providing safe and effective feeding support.	Other: Core Competency Training Course for Eating Support Healthcare Aides (20-Hour Course); Core Competency Training Course for Eating Support Healthcare Aides, a 20-hour program designed to enhance knowledge and skills in providing safe and effective feeding support. The course comprised the following modules: Oral Changes and Basic Care Concepts (2 hours); Assisting Clients with Safe Eating (2 hours); Oral Hygiene and Care (3 hours, including practical skills); Dysphagia Diet Standards and Meal Texture Modification (2 hours); Food Storage, Cleaning, and Pre-/Mid-Processing (3 hours); Client Nutrition Knowledge (3 hours); Soft Food Selection and Preparation for Clients with Chewing Difficulties (2 hours); Hands-on Soft Food Preparation and Selection for Clients with Chewing Difficulties (3 hours)
Active Comparator: Student Waitlist Control Group (WG); Student Waitlist Control Group (WG) Intervention: Participants in the Student Waitlist Control Group (WG) initially do not receive any training during the primary study period, serving as a delayed intervention control to account for time-related and external factors. After completion of all baseline and post-assessment measurements for the immediate intervention group (IG), the waitlist students then receive the same 20-hour Core Competency Training Course as the IG.	Other: Core Competency Training Course for Eating Support Healthcare Aides (20-Hour Course); Core Competency Training Course for Eating Support Healthcare Aides, a 20-hour program designed to enhance knowledge and skills in providing safe and effective feeding support. The course comprised the following modules: Oral Changes and Basic Care Concepts (2 hours); Assisting Clients with Safe Eating (2 hours); Oral Hygiene and Care (3 hours, including practical skills); Dysphagia Diet Standards and Meal Texture Modification (2 hours); Food Storage, Cleaning, and Pre-/Mid-Processing (3 hours); Client Nutrition Knowledge (3 hours); Soft Food Selection and Preparation for Clients with Chewing Difficulties (2 hours); Hands-on Soft Food Preparation and Selection for Clients with Chewing Difficulties (3 hours)
Active Comparator: Industry Group (RG); Industry Group (RG) Intervention: Participants in the Industry Group (RG) are current professional healthcare aides who receive the 20-hour Core Competency Training Course concurrently with the Student Immediate Intervention Group (IG). The timing ensures that the training is delivered during the same study period as the student intervention, allowing direct comparison of learning outcomes between students and experienced professionals.	Other: Core Competency Training Course for Eating Support Healthcare Aides (20-Hour Course); Core Competency Training Course for Eating Support Healthcare Aides, a 20-hour program designed to enhance knowledge and skills in providing safe and effective feeding support. The course comprised the following modules: Oral Changes and Basic Care Concepts (2 hours); Assisting Clients with Safe Eating (2 hours); Oral Hygiene and Care (3 hours, including practical skills); Dysphagia Diet Standards and Meal Texture Modification (2 hours); Food Storage, Cleaning, and Pre-/Mid-Processing (3 hours); Client Nutrition Knowledge (3 hours); Soft Food Selection and Preparation for Clients with Chewing Difficulties (2 hours); Hands-on Soft Food Preparation and Selection for Clients with Chewing Difficulties (3 hours)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Eating Support for Healthcare Aides (ESHA) Questionnaire	The scale is designed to assess caregivers' knowledge, attitudes, and behaviors regarding feeding and swallowing care. It was developed by Lin and Liu (2025) through literature review, expert Delphi consultation, and empirical testing, and comprises three domains with a total of 47 items. The knowledge domain includes 25 dichotomous items (correct/incorrect), with 1 point awarded for a correct answer and 0 points for an incorrect one; higher scores indicate more comprehensive knowledge. The reliability of this domain was examined using the KR-20 coefficient, yielding a value of 0.61. Item difficulty ranged from 0.60 to 0.99, and items demonstrated good discrimination, making the domain suitable as a baseline for comparing pre- and post-intervention educational outcomes. The attitudes and behaviors domains are assessed using a 5-point Likert scale, measuring caregivers' endorsement of feeding support and the frequency of its actual implementation, respectively.	Baseline, Immediately after the 20-hour intervention course

Collaborators and Investigators

• Sponsor: Chang Gung Memorial Hospital
• Collaborators: National Science and Technology Council, Taiwan

Publications and helpful links

General Publications

• Chen S, Kent B, Cui Y. Interventions to prevent aspiration in older adults with dysphagia living in nursing homes: a scoping review. BMC Geriatr. 2021 Jul 17;21(1):429. doi: 10.1186/s12877-021-02366-9.
• Waldron C, Nunn J, Mac Giolla Phadraig C, Comiskey C, Guerin S, van Harten MT, Donnelly-Swift E, Clarke MJ. Oral hygiene interventions for people with intellectual disabilities. Cochrane Database Syst Rev. 2019 May 31;5(5):CD012628. doi: 10.1002/14651858.CD012628.pub2.
• Newman R, Vilardell N, Clave P, Speyer R. Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD). Dysphagia. 2016 Apr;31(2):232-49. doi: 10.1007/s00455-016-9696-8. Epub 2016 Mar 25.
• Lin CH, Liu MY. Development and Validation of the Eating Support for Healthcare Aides (ESHA) Questionnaire in Long-Term Care. Nutrients. 2025 Oct 15;17(20):3235. doi: 10.3390/nu17203235.

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2025
• Primary Completion (Estimated): July 31, 2027
• Study Completion (Estimated): July 31, 2027

Study Registration Dates

• First Submitted: November 18, 2025
• First Submitted That Met QC Criteria: January 29, 2026
• First Posted (Actual): February 3, 2026

Study Record Updates

• Last Update Posted (Actual): February 3, 2026
• Last Update Submitted That Met QC Criteria: January 29, 2026
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: Entrusted Professional Activities
• Other Study ID Numbers: linchiahui

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No