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This article reports on the results of a nested cohort group-randomized trial of 6 training sessions of Foundations of Dementia Care, a national training curriculum for nursing home and residential care/assisted living staff. Staff from 9 nursing homes and 7 residential care/assisted living settings in 4 states, including 491 direct care staff and 171 supervisors, participated in the project. Entire facilities were randomly assigned to receive either the 6-week training or not. Primary findings included improved knowledge in 2 of 6 areas immediately posttraining and in 1 area 3 months posttraining, an increase in supervisors' reported likelihood to work with other staff (the key teaching of another of the 6 sessions) but also a perception of less support from their own supervisors, and an increase in work stress.