Evaluation of Housing Adaptations and Mobility Devices

Study Overview
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Brief Summary
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The rationale underlying this project is the fact that HA is a very common compensatory interven¬tion within municipality health care, undertaken to support an independent living in the own home. In addition, MD are frequently prescribed and used among HA clients in order to compensate for declined body functions. In spite of this, knowledge of their effects for the individual and the society is still scarce. In particular, systematic, evidence-based strategies based on clear-cut conceptual definitions and descriptions of procedures are lacking. Such strategies are crucial in order to evaluate the effects of HA and MD. In addition, longterm cost-effectiveness evaluations are crucial for policy implementation. The overarching aim is to investigate outcomes of HA on aspects of home and health for sub-groups of persons with disabilities. The specific aims are to: Investigate the effects of HA on home and health related outcomes, i.e. usability, fear of falling, activity/participation and health-related quality of life for different subgroups of persons, e.g. MD users and non MD-users Investigate the use of a new practice strategy for HA on home and health related outcomes for subgroups of persons with disabilities in terms of differences between municipalities Investigate societal level outcomes of HA and MD, i.e. costs and quality adjusted life years Gain a deeper understanding of the processes behind changes in outcomes We hypothesise that using a structure strategy for housing adaptation and mobility devices case management in ordinary practice in Swedish municipalities increase activity, participation, the usability of the home, and reduces societal costs.

Detailed Description
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The ultimate goal of the project is to improve the housing situation of older people and people with disabilities, by determining the long term effects of housing adaptations (HA) for clients and society, and transferring this knowledge into guidelines for practitioners in the housing and building planning sector. Specific research questions are: RQ1. What are the long-term effects of HA for clients (individual goals achievement, activity, participation, health-related quality of life, usability, falls, functional capacity and use of mobility devices (MD), mortality, health care and social services consumption, and relocation)? RQ2. What are the long-term effects of HA for society (costs and cost- effectiveness)? RQ3. What are the barriers and facilitators to knowledge transfer in the area of HA? RQ4. How can evidence based knowledge be transferred into practical guidelines for housing and building planning in Sweden?

Official Title
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Housing Adaptations and Mobility Devices - Evaluation of a New Practice Strategy

Conditions
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Housing, Activities of Daily Living, Cost Effectiveness

Intervention / Treatment
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* Behavioral: New Practice Strategy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Persons receiving housing adaptation Above 20 years Exclusion Criteria: Persons with language deficits and/or cognitive decline

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: New Practice Strategy<br>Structured strategy for assessment and evaluation before and after intervention | Behavioral: New Practice Strategy<br>* Application of a structured case management strategy on housing adaptation cases<br>|
| No Intervention: Ordinary practice<br>Ordinary practice, not structured | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ADL Staircase | The ADL Staircase measures dependence on other persons in daily activities. Combined interview and observation | Differences in changes between intervention and control sites at baseline and 3, 6,12, 24 and 36 months after | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Falls Efficacy Scale- FES-I | FES-I measures perceived fear of falling | Differences in changes between intervention and control sites at baseline and 3, 6, 12, 24 and 36 months after | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Housing adaptation, Independence, Costs