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Published on: April 27, 2017
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Feasibility Trial of Tailored Home Modifications: Process Outcomes
Susan Stark1, Emily Somerville2, Jane Conte3
1Susan Stark, PhD, OTR/L, is Assistant Professor of Occupational Therapy, Neurology, and Social Work, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO; sstark@wustl.edu.
Summary
Home modifications effectively improved daily activity performance in older adults, demonstrating high adherence and feasibility. This intervention is a promising strategy for enhancing independence and reducing fall risks in community settings.
Area of Science:
- Gerontology
- Rehabilitation Science
- Public Health
Background:
- Falls are a major risk for community-dwelling older adults, leading to reduced independence and increased healthcare costs.
- Home modifications are a potential intervention to mitigate fall risks and enhance functional abilities in this population.
- Process evaluations are crucial for understanding the implementation and effectiveness of complex interventions.
Purpose of the Study:
- To evaluate the implementation of a randomized controlled trial (RCT) for home modifications.
- To assess the effectiveness of home modifications in improving daily activity performance and reducing fall risk.
- To examine the feasibility, adoption, and maintenance of home modifications in frail, community-dwelling older adults.
Main Methods:
- A blinded, randomized sham-controlled trial (RCT) involving 92 participants was conducted.
- A process evaluation utilized the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.
- Participants were followed for 1 year post-intervention.
Main Results:
- The home modification intervention group showed significant improvement in daily activity performance compared to the sham control group (p = .024).
- Intervention elements and dosage were delivered with over 90% accuracy.
- Participant adherence to the intervention remained high at 91% after 12 months.
Conclusions:
- Home modifications are an acceptable and feasible intervention for frail, community-dwelling older adults.
- The intervention can be delivered with high fidelity, suggesting successful implementation.
- This study supports home modifications as a viable strategy for improving functional outcomes in older adults.
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