Home Hazard Removal Program to Reduce Falls

Study Overview
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Brief Summary
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This study evaluates the effectiveness and implementation of a home-hazard removal program to reduce falls in older adults through a community program delivered through the aging services network. The investigators will conduct a hybrid effectiveness/implementation trial of 300 older adults at risk for a fall who will be randomized to a home-hazard removal program or usual care and then followed for 12 months. Investigators will look at the number of falls at 6 months and 12 months.

Detailed Description
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The investigators will randomly select a sample of older adults from the large observational cohort of older adults assessed annually by an Area Agendy on Aging via the National Aging Program Information System (NAPIS). The eligibility criteria include age 65 years or older and self-report of one previous fall or more in the preceding 12 months or self-report as worried about falling. We will conduct baseline assessments and randomize participants to receive an home hazard removal program or usual care. Outcomes (falls, fall self-efficacy) will be assessed by a blinded rater at baseline and 12 months after intervention. All assessments and study visits will occur in participants' homes.

Official Title
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Removing Home Hazards for Older Adults

Conditions
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Accidental Falls

Intervention / Treatment
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* Other: Home Modification


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Individuals aged 65 years or older and self-report of one previous fall or more in the preceding 12 months or self-report as worried about falling. Exclusion Criteria: Individuals residing in nursing homes or individuals with severe cognitive impairment who are unable to give consent to participate (as determined by a score of greater than 10 on the SBT for memory10).

Ages Eligible for Study
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Minimum Age: 65 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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Home Modification Group<br>A tailored home-modification (home-hazard removal) intervention delivered in the home by occupational therapists over three visits and with a booster session at six months. | Other: Home Modification<br>* Removal of home barriers or hazards.<br>|
| No Intervention: Usual Care Group<br>Usual care by an Area Agency on Aging | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of falls | Prospective daily reporting of falls using a calendar | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Daily activity performance. | Participant daily activity performance will be measured by the Older Americans Resources and Services (OARS) ADL Scale | 12 months | 
| Fall self-efficacy. | Participant self-efficacy in performing daily activities without falling will be measured by the Falls Efficacy Scale-International (FES-I). | 12 months | 
| Health-related quality of life. | Participant self-reported health will be measured using the SF-36. | 12 months | 

 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