Effectiveness of the RISE Intervention for Elder Abuse and Self-Neglect: A Pragmatic Randomized Controlled Trial
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Published on: May 31, 2021
David Burnes1, Andie MacNeil1, Marta Hajek2
1University of Toronto, Toronto, Canada.
Background:
Elder abuse and self-neglect (EASN) are prevalent and associated with significant adverse health and psychosocial outcomes, yet evidence on effective interventions remains limited. RISE is a community-based intervention designed to address EASN. This study evaluated the effectiveness and acceptability of RISE in a real-world community setting.
Methods:
We conducted a pragmatic, parallel-group, superiority randomized controlled trial with blinded outcome assessment. Older adults screened as at risk of or experiencing EASN were randomized following an initial consultation to receive either RISE plus consultation (intervention group) or consultation and referral provision only (control group). Blinded outcome assessment occurred at baseline, 3-month, and 6-month follow-up using telephone-based surveys. Primary outcomes included psychosocial measures of life satisfaction, perceived stress, self-efficacy, social support, and problem concern. Linear mixed-effects models were used to evaluate group differences over time. Program satisfaction at 6 months was assessed using multiple linear regression.
Results:
114 participants entered the baseline analysis cohort; 93 completed three-month and 79 completed six-month assessments. RISE participants showed significantly greater improvement over time in life satisfaction (p < 0.001), perceived stress (p = 0.001), general self-efficacy (p = 0.023), social-interaction self-efficacy (p < 0.001), emotional support (p = 0.002), and informational support (p < 0.001). Problem concern did not show differential change (p = 0.404). Adjusted six-month program satisfaction was 4.61 points significantly higher with RISE (95% CI 3.25-5.97; p < 0.001).
Conclusions:
RISE was associated with improvements across multiple psychosocial domains and high participant satisfaction among EASN older adults. Findings provide evidence supporting a scalable, community-based response to EASN in jurisdictions lacking centralized protective service systems.