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Published on: April 23, 2014
Removing environmental barriers to independent living: A feasibility randomised controlled trial targeting people
Szu-Wei Chen1, Melissa J Krauss1, Emily Somerville1
1Washington University in St. Louis, School of Medicine, Program in Occupational Therapy, St. Louis, MO, USA.
Introduction:
People ageing with long-term physical disabilities face unique challenges to maintaining independence. We developed a novel, evidence-based intervention - Removing Environmental Barriers to Independent Living - to support participation and reduce falls.
Methods:
To examine Removing environmental barriers to independent living's feasibility and estimate its magnitude of efficacy, we conducted a single-blinded randomised controlled trial. Fifty participants who were aged 45-65 years with a physical disability for at least 5 years were randomised to intervention (n = 24) or control (n = 26). Activity performance, environmental barriers to performance, community participation, environmental fall hazards and fall prevention behaviours were assessed at baseline and at 6-month follow-up. Dose, adherence, fidelity and cost were examined. Linear mixed-effects models for repeated measures were used to assess the effects of time, group and group by time interaction on the continuous outcomes.
Results:
Removing environmental barriers to independent living had high fidelity and adherence and a low implementation cost. There were trends for greater improvements in activity limitations and activity performance among intervention versus control participants.
Conclusion:
Removing environmental barriers to independent living is a feasible intervention with high fidelity and adherence. Findings trended towards greater improvements in activity performance for intervention participants. Results could inform future planning for a larger pragmatic trial.
