Removing Home Hazards for Older Adults in Affordable Housing

Study Overview
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Brief Summary
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The investigators will conduct a hybrid effectiveness/implementation trial to simultaneously establish the effectiveness of home hazard removal in affordable housing in order to reduce falls, and conduct a process evaluation of how the intervention works in the context of low-income senior apartments.

Detailed Description
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The investigators, in collaboration with the community partner, will offer the program to all building residents in select low-income senior apartments. The eligibility criteria include a self-report of one or more falls in the preceding 12 months, a fear of falling, or unsteadiness while standing or walking. The investigators will screen residents and determine their risk for falling. Residents who are high risk will be referred to licensed occupational therapy practitioners for baseline assessments and home hazard removal. Residents will be re-assessed at 3 months. All assessments will be conducted in the residents' apartment buildings. Outcomes (falls, program evaluation) will be collected by our community partner.

Official Title
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Removing Home Hazards for Older Adults in Affordable Housing

Conditions
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Accidental Fall

Intervention / Treatment
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* Behavioral: Home Hazard Removal


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Residents who live in any of the eligible section 202 low-income senior apartment units managed by our community partner Exclusion Criteria: Individuals who do not reside in any of the eligible units

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Home Hazard Removal Group<br>A tailored home-modification (home-hazard removal) intervention for residents with a high fall risk, delivered in the home by occupational therapists over one to two visits and with a booster session at three months. | Behavioral: Home Hazard Removal<br>* Removal of home barriers or hazards<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Resident enrollment in home hazard removal intervention | Participation measured by percentage of eligible building residents enrolled | 609 days | 
| Program fidelity | Visit-by-visit checklist and calculation of the dose of the intervention received (number of minutes delivered) | 609 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of falls | Prospective monthly reporting of falls using an automated phone system | 609 days | 
| Cost per fall prevented | Final prescription and invoice (materials) | 609 days | 
| Adherence to home hazard removal intervention recommendations | Recommendations used/total at 3 months or cause of abandonment | 609 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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older adult falls, home hazards, home barriers