{ "generatedAt": "2026-06-16T12:00:00.000Z", "monitorRunAt": null, "registryVersion": "2026-06-16.seed", "mode": "contract-preview", "outcomes": [ { "id": "fc_burden", "name": "Family caregiver burden", "owner": "FC", "pillars": [ "H" ], "instrument": "Zarit Burden Interview (ZBI-12)", "instrumentSource": "Bédard 2001 (ZBI-12)", "channel": "self-survey", "cadences": [ "enroll", "90d" ], "tier": "pilot", "designRole": "lagging", "threshold": "ZBI MCID", "notes": "core caregiver-wellbeing outcome", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "fc_depression", "name": "Family caregiver depressive symptoms", "owner": "FC", "pillars": [ "H" ], "instrument": "Patient Health Questionnaire (PHQ-9)", "instrumentSource": "Kroenke 2001 (PHQ-9)", "channel": "self-survey", "cadences": [ "enroll", "90d" ], "tier": "pilot", "designRole": "lagging", "threshold": "PHQ-9 ≥5-point change (MCID)", "notes": "depression is the most consistent caregiver harm; co-primary wellbeing endpoint", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "fc_anxiety", "name": "Family caregiver anxiety", "owner": "FC", "pillars": [ "H" ], "instrument": "Generalized Anxiety Disorder scale (GAD-7)", "instrumentSource": "Spitzer 2006 (GAD-7)", "channel": "self-survey", "cadences": [ "enroll", "90d" ], "tier": "pilot", "designRole": "lagging", "threshold": "GAD-7 ≥4-point change (MCID)", "notes": "anxiety tracks alongside burden; cheap to co-administer with PHQ-9", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "fc_confidence", "name": "Family caregiver confidence / self-efficacy", "owner": "FC", "pillars": [ "E" ], "instrument": "Revised Scale for Caregiving Self-Efficacy (RSCSE)", "instrumentSource": "Steffen 2002 (RSCSE) [verify]", "channel": "self-survey", "cadences": [ "enroll", "post" ], "tier": "pilot", "designRole": "leading", "threshold": "≥0.5 SD within-person gain", "notes": "Economic pillar = capability/cost-of-care: self-efficacy is the trained capability that lowers avoidable cost; early signal the course is working before 90d burden shifts", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "fc_competence", "name": "Family caregiver dementia knowledge / competence", "owner": "FC", "pillars": [ "E" ], "instrument": "Dementia Knowledge Assessment Scale (DKAS)", "instrumentSource": "Annear 2017 (DKAS) [verify]", "channel": "self-survey", "cadences": [ "enroll", "post" ], "tier": "pilot", "designRole": "leading", "threshold": "≥20% items gained vs baseline", "notes": "Economic pillar = capability/cost-of-care: competence is the credential's core claim; pre/post proves learning, not just exposure", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "fc_reaction", "name": "Family caregiver reaction to behavioral symptoms", "owner": "FC", "pillars": [ "H" ], "instrument": "Neuropsychiatric Inventory caregiver distress subscale (NPI-D)", "instrumentSource": "Cummings 1994 (NPI) / Kaufer 1998 (NPI distress) [verify]", "channel": "action-survey", "cadences": [ "enroll", "90d" ], "tier": "pilot", "designRole": "lagging", "threshold": "≥30% reduction in distress score", "notes": "caregiver distress = wellbeing (Health); separates the person's symptoms from the caregiver's reaction to them; the trainable target", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "cr_qol", "name": "Care-recipient quality of life", "owner": "CR", "pillars": [ "H" ], "instrument": "Quality of Life-Alzheimer's Disease (QoL-AD), proxy-rated", "instrumentSource": "Logsdon 1999 (QoL-AD)", "channel": "action-survey", "cadences": [ "enroll", "90d" ], "tier": "confirmatory", "designRole": "lagging", "threshold": "QoL-AD ≥3-point proxy change", "notes": "proxy-rated to honor 'no PHI in v1' / cared-for person is never a user; the ultimate person-centered claim", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "cr_agitation", "name": "Care-recipient agitation / aggression", "owner": "CR", "pillars": [ "H" ], "instrument": "Cohen-Mansfield Agitation Inventory (CMAI), proxy-rated", "instrumentSource": "Cohen-Mansfield 1989 (CMAI)", "channel": "action-survey", "cadences": [ "enroll", "90d" ], "tier": "confirmatory", "designRole": "lagging", "threshold": "≥30% reduction in CMAI frequency", "notes": "agitation is the highest-frequency driver of caregiver crisis and antipsychotic use", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "cr_neuropsych", "name": "Care-recipient neuropsychiatric symptom severity", "owner": "CR", "pillars": [ "H" ], "instrument": "Neuropsychiatric Inventory severity (NPI-Q), proxy-rated", "instrumentSource": "Kaufer 2000 (NPI-Q) [verify]", "channel": "action-survey", "cadences": [ "enroll", "90d" ], "tier": "pilot", "designRole": "lagging", "threshold": "≥1 fewer symptom domain clinically present", "notes": "NPI-Q is the brief proxy version; broader symptom view than agitation alone", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "cr_avoidable_distress", "name": "Avoidable distress episodes (care-recipient)", "owner": "CR", "pillars": [ "H" ], "instrument": "Distress-Episode Action Log (platform action-survey)", "instrumentSource": "Cogtraining platform metric (no standard instrument)", "channel": "action-survey", "cadences": [ "90d" ], "tier": "pilot", "designRole": "causal", "threshold": "≥25% fewer date-anchored episodes vs baseline window", "notes": "care-recipient wellbeing (Health); date-anchored behavior recall links a specific taught skill to a specific avoided crisis", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "pc_competence", "name": "Paid caregiver demonstrated competence", "owner": "PC", "pillars": [ "E" ], "instrument": "Proctored skills checkoff + exam pass (DEMENTIA-READY/CDCP)", "instrumentSource": "Cogtraining platform metric (no standard instrument)", "channel": "telemetry", "cadences": [ "post" ], "tier": "pilot", "designRole": "leading", "threshold": "≥80% exam + 100% required checkoffs (human-gated)", "notes": "Economic pillar = workforce capability; the credential's verifiable competence claim; human-gated grade, server-authoritative exam", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "pc_wage_premium", "name": "Paid caregiver wage premium realized", "owner": "PC", "pillars": [ "E" ], "instrument": "Reported post-credential wage / differential (action-survey + site-record)", "instrumentSource": "Cogtraining platform metric (no standard instrument)", "channel": "action-survey", "cadences": [ "90d" ], "tier": "pilot", "designRole": "lagging", "threshold": "≥5% realized wage or shift-rate premium", "notes": "proves the credential pays the learner back; corroborated by partner site-record where available", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "pc_retention", "name": "Paid caregiver retention / intent to stay", "owner": "PC", "pillars": [ "E" ], "instrument": "Intent-to-Stay item + 90d employment status (site-record)", "instrumentSource": "Cogtraining platform metric (no standard instrument)", "channel": "site-record", "cadences": [ "90d" ], "tier": "pilot", "designRole": "lagging", "threshold": "≥10% higher 90d retention vs facility baseline", "notes": "turnover is the sector's core pain; partner-uploaded roster is the trusted source", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "sys_avoidable_transfers", "name": "Avoidable ED visits / hospital transfers (site)", "owner": "SYS", "pillars": [ "E" ], "instrument": "Facility ED-transfer rate per resident-month (site-record)", "instrumentSource": "Cogtraining platform metric (no standard instrument)", "channel": "site-record", "cadences": [ "90d" ], "tier": "confirmatory", "designRole": "causal", "threshold": "≥15% reduction in avoidable transfers vs pre-period", "notes": "the headline system ROI; confirmatory because it needs partner data + a control period", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "sys_antipsychotic_use", "name": "Antipsychotic use among residents (site)", "owner": "SYS", "pillars": [ "E" ], "instrument": "% residents on antipsychotics without qualifying dx (site-record / QM-style)", "instrumentSource": "Cogtraining platform metric, CMS QM-aligned (no standard instrument) [verify]", "channel": "site-record", "cadences": [ "90d" ], "tier": "confirmatory", "designRole": "lagging", "threshold": "≥10% relative reduction vs facility baseline", "notes": "non-pharmacological skill is the trained mechanism; antipsychotic rate is the regulated proxy", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "sys_survey_readiness", "name": "Staff dementia-care survey readiness (site)", "owner": "SYS", "pillars": [ "E" ], "instrument": "% in-scope staff currently credentialed (telemetry roster coverage)", "instrumentSource": "Cogtraining platform metric (no standard instrument)", "channel": "telemetry", "cadences": [ "continuous" ], "tier": "pilot", "designRole": "leading", "threshold": "≥90% of in-scope staff credentialed & current", "notes": "the buyable, always-current compliance metric facilities can show a surveyor", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "eq_completion_parity", "name": "Credential completion parity across populations", "owner": "SYS", "pillars": [ "Eq" ], "instrument": "Completion-rate ratio across self-reported strata (rural/urban, primary language, facility type)", "instrumentSource": "Cogtraining platform metric (no standard instrument); four-fifths (80%) adverse-impact rule as parity threshold [verify]", "channel": "telemetry", "cadences": [ "continuous" ], "tier": "pilot", "designRole": "lagging", "threshold": "completion-rate ratio ≥0.80 across reported strata (four-fifths rule)", "notes": "EQUITY of ACCESS — declared, not-yet-collecting. Does the free→paid ladder convert equally across populations? Demographics are optional + privacy/IRB-gated, never required to learn or be credentialed (#9). Monitor renders this red until live.", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null }, { "id": "eq_outcome_parity", "name": "Outcome parity — caregiver burden reduction across populations", "owner": "FC", "pillars": [ "Eq" ], "instrument": "ZBI-12 change stratified by population stratum (reuses the fc_burden instrument)", "instrumentSource": "Bédard 2001 (ZBI-12), stratified analysis [verify analysis plan]", "channel": "self-survey", "cadences": [ "enroll", "90d" ], "tier": "pilot", "designRole": "causal", "threshold": "no >0.5 SD gap in burden reduction across strata", "notes": "EQUITY of OUTCOME — declared, not-yet-collecting. The benefit must not concentrate in already-advantaged groups; same instrument as fc_burden, analyzed by stratum. Monitor renders this red until live.", "published": false, "status": "Not-yet-collecting", "coveragePct": null, "freshnessDays": null, "lastRecordAt": null, "directionalResult": null } ] }