Developing a culturally appropriate core competency training curriculum for eating support healthcare aides: a modified Delphi study

The “Eating Support Healthcare Aides” concept, originating from Japan, focuses on aides who assist individuals with special dietary needs. In Taiwan, this role is still developing, and no formal training or certification system exists. Healthcare aides need skills to support safe feeding, meal preparation, and oral hygiene for older adults, disabilities or functional impairments. This study aims to create a culturally appropriate training curriculum using a modified Delphi process to define core competencies and occupational standards in long-term care. This study adopted a two-round modified Delphi method, based on Murry and Hammons (1995), replacing the first open-ended round with a structured questionnaire derived from a literature review. A panel of 26 experts (20 women, 6 men) was purposively selected, including professionals in long-term care, nutrition, oral hygiene, speech and swallowing therapy, nursing and core competencies. The process included three stages: (1) A literature review to draft core competencies; (2) two Delphi survey rounds; and (3) a consensus meeting to finalize the items. Data were analyzed using descriptive statistics. Items with mean scores above 4.0 were retained, and the Consensus Deviation Index (CDI) was used to assess expert agreement, with lower CDI values indicating higher consensus. Two rounds of questionnaires were distributed to 26 experts to achieve an effective response rate of 100%. Across all domains, the average mean exceeded 4.69, and the Consensus Deviation Index ranged from 0.06 to 0.10. This process produced 13 sub-items that were organized into six main items across four categories. The identified core competencies serve as a solid foundation for Taiwan’s long-term care training framework. Each competency aligns with essential skills and practices, facilitating integration into competency-based training programs. This study established a set of core competencies for Eating Support Healthcare Aides tailored to Taiwan’s long-term care context. These competencies provide a foundation for developing standardized education and improving the quality of care for older adults and individuals with disabilities who have dietary and oral health needs.