Table 1.

Study Aims and Hypotheses

Aims	Hypotheses
Aim 1. Evaluate the effectiveness of a pain management algorithm coupled with intense diffusion strategies (ALG) as compared with pain education (EDU) alone in improving pain, mobility, and depression among nursing home residents at the 14–16 weeks timepoint.	Hypothesis 1-1. At posttreatment (timepoint 2), ALG residents will demonstrate greater decreases in surrogate-reported pain than residents in the EDU group.
	Hypothesis 1-2. At posttreatment (timepoint 2), ALG residents will demonstrate less depression, less self-reported pain intensity and pain-related interference, and enhanced mobility compared with residents in the EDU group.
Aim 2. Determine the extent to which adherence to the ALG and organizational factors are associated with changes in residents’ mobility, pain, and depression and the extent to which changes in these variables are associated with changes in outcomes.	Hypothesis 2-1. Pain treatment plans for residents in ALG facilities will show greater pre- to posttreatment increases in adherence than will EDU facilities.
	Hypothesis 2-2. Pre- to posttreatment changes in residents’ mobility, pain, and depression will be associated with adherence to the algorithms and organizational factors.
Aim 3. Evaluate the persistence of changes in process and outcome variables at long-term follow-up (6 months postintervention).	Hypothesis 3-1. Differences between ALG and EDU residents’ outcomes will be maintained at 6-month follow-up (timepoint 3).
	Hypothesis 3-2. Differences in adherence to the ALG, pre- and post-ALG intervention, will be maintained at 6-month follow-up (timepoint 3).

ALG: algorithm intervention; EDU: education-only control.