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Related Concept Videos

Hazard Ratio01:12

Hazard Ratio

661
The hazard ratio (HR) is a widely used measure in clinical trials to compare the risk of events, such as death or disease recurrence, between two groups over time. It reflects the ratio of hazard rates—the instantaneous risk of the event occurring—between a treatment group and a control group. This measure provides valuable insights into the relative effectiveness of a treatment by assessing how the risk of an event differs between the two groups.
For example, in a clinical trial...
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Hazard Rate01:11

Hazard Rate

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The hazard rate, also known as the hazard function or failure rate, is a statistical measure used to describe the instantaneous rate at which an event occurs, given that the event has not yet happened. From a probabilistic perspective, it represents the likelihood that a subject will experience the event in a very small time interval, conditional on surviving up to the beginning of that interval. In terms of frequency, the hazard rate can be viewed as the ratio of the number of events to the...
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Related Experiment Video

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Protocol for the home hazards removal program (HARP) study: a pragmatic, randomized clinical trial and implementation

Susan Stark1, Emily Somerville2, Marian Keglovits2

  • 1Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Avenue, Campus Box 8505, St. Louis, MO, 63108, USA. sstark@wustl.edu.

BMC Geriatrics
|April 22, 2017
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Summary

Home modifications by occupational therapists can significantly reduce falls in older adults. The Home Hazard Removal Program (HARP) study aims to implement this evidence-based intervention through an aging services network to prevent falls.

Keywords:
FallsHome hazardsImplementation trialMedically underservedOlder adultsRandomized controlled trial

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Area of Science:

  • Gerontology and Geriatric Medicine
  • Public Health and Epidemiology
  • Occupational Therapy and Rehabilitation

Background:

  • Falls are a primary cause of injury, disability, and mortality in older adults.
  • Occupational therapist-led home modifications reduce falls by 39% but are not standard practice in the U.S.
  • The Home Hazard Removal Program (HARP) aims to implement an evidence-based home modification intervention for fall prevention in older adults.

Purpose of the Study:

  • To implement and evaluate an evidence-based home modification intervention for older adults at risk of falls.
  • To reduce the incidence of falls in community-dwelling older adults through an aging services network.
  • To assess the effectiveness and implementation of home modifications in a real-world setting.

Main Methods:

  • A hybrid effectiveness-implementation trial involving 300 older adults randomized over 12 months.
  • Intervention group receives home modifications from an occupational therapist plus usual care.
  • Primary outcome: time to first fall; secondary outcomes: daily activity, fall self-efficacy, quality of life; implementation outcomes: fidelity, dose, adherence, safety, cost, healthcare utilization.

Main Results:

  • This section is not yet available as the study is ongoing.
  • The study will compare the effectiveness of home modifications plus usual care against usual care alone.
  • Implementation outcomes will provide insights into the feasibility and scalability of the intervention.

Conclusions:

  • The HARP study targets an underserved population with a tailored, individualized intervention to improve adherence.
  • The effectiveness-implementation design facilitates rapid dissemination and integration into social services agencies.
  • This approach has the potential to significantly reduce fall incidence and improve health outcomes for older adults.