Delivery challenges with the intervention
CMO
As mentioned above, difficulties with engagement and delivery were noted early on, and the CMO evaluation was applied. Difficulties noted in the researchers' logs implied a complex underlying situation in care homes vastly affected by e.g., the COVID-19 pandemic, wider policy environment and understaffing (Context). This could affect motivation and engagement to either deliver the programme or attend a session (Mechanism), affecting adherence rates and possibly implicating the psychosocial outcome measures. More details of these emerged in the qualitative adherence data below. However, Supplementary Table S