This study aims to evaluate the effectiveness and implementation outcomes of a dementia management competency training program for primary healthcare workers. A cluster randomized controlled trial will be conducted among primary healthcare institutions in Nanping, Fujian Province, China. Eligible primary health care providers will be recruited from community health service centers and township health centers.Participating institutions will be randomized in a 1:1 ratio to either a structured dementia management training group or a self-directed learning control group. The intervention group will receive a 12-week blended training program, including online learning, an in-person skills workshop, and case-based practice supervision. The control group will receive self-directed online learning materials. Outcomes will be assessed at baseline, immediately after the intervention, and 3 months after the intervention. The primary outcome is the change in dementia knowledge, measured using the Dementia Knowledge Assessment Scale. Secondary outcomes include dementia-related attitudes, dementia management practice competency, self-reported dementia management behaviors, objective screening and referral-related indicators, and implementation outcomes based on the RE-AIM framework.

This study uses a hybrid effectiveness-implementation design integrating a cluster randomized controlled trial and implementation evaluation. The trial will assess the effectiveness of a dementia management competency training program for primary health care providers at both the individual and organizational levels. At the individual level, the study will evaluate the effects of the training on dementia knowledge, attitudes, practice competency, and dementia management-related clinical behaviors. At the organizational level, the study will examine reach, adoption, implementation quality, and maintenance of the training program in real-world primary healthcare settings.The study will be conducted in community health service centers and township health centers in Nanping, Fujian Province, China. Primary healthcare institutions will serve as clusters. Approximately 16 institutions will be recruited and randomized to the intervention or control group at a 1:1 ratio, with approximately 20 primary health care providers recruited from each institution.The intervention group will receive a 12-week structured blended training program named "Hand in Hand Along the Memory Path". During weeks 1-4, participants will complete seven online learning modules, with a total learning duration of approximately 3 hours. At the end of week 4, participants will attend an in-person skills workshop of approximately 2 hours, focusing on standardized use of cognitive screening and assessment tools. During weeks 5-12, participants will take part in online case-based supervision every two weeks and complete practice tasks related to cognitive screening and dementia management.The control group will receive self-directed online learning materials, including the same knowledge module videos and text-based materials. However, the control group will not receive structured learning tasks, case analysis, knowledge tests, demonstration videos, forum-based support, learning reminders, expert support, toolkits, in-person workshops, or case-based supervision.Quantitative data will be collected at baseline, immediately after the intervention, and 3 months after the intervention. Semi-structured interviews will be conducted 3 months after the intervention to explore participants' experiences, implementation barriers and facilitators, and factors affecting maintenance. Quantitative and qualitative findings will be integrated according to the RE-AIM framework.

Inclusion Criteria:

Primary healthcare workers aged 18 years or older

Registered healthcare professionals holding a formal license issued by the national health authority

At least 1 year of work experience

Able to access the internet using a computer, tablet, or mobile phone

Currently working in a participating community health service center or township health center

Willing to participate in the study and provide written informed consent

Exclusion Criteria:

Personnel who do not directly participate in patient disease management, including logistics or auxiliary staff

Interns, trainees, or students

Individuals currently participating in other similar dementia training interventions

Individuals planning to leave their current institution within the next 12 months

Individuals who refuse to participate in the study or decline to provide written informed consent

Participants are blinded to group allocation. All participants are aware that both groups receive training, but do not know whether they are assigned to the intervention or control group. Outcome data are primarily collected via self-administered questionnaires. Personnel responsible for questionnaire distribution and data entry (outcomes assessors) are blinded to group allocation. The primary quantitative analysis is performed independently by a blinded analyst who has no access to qualitative data. Additionally, a semi-structured interview is conducted only with the intervention group for exploratory mixed-methods analysis. The integration of interview findings with quantitative data is performed separately by another individual who is not among the blinded roles described above. Therefore, the mixed-methods analysis does not compromise the blinding of the primary quantitative outcome assessment or analysis. Care providers are not blinded because they are aware of the differences bet