Reducing Disability Via a Bundled Bio-Behavioral-Environmental Approach

Study Overview
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Brief Summary
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The purpose of the study is to determine whether a combination of occupational therapy visits, nursing visits, and handyman repair are effective in helping low income older adults avoid costly health care services

Detailed Description
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We will recruit low-income age 65 or older -principally African-American, adults from the Baltimore Department of Housing Energy Assistance Program. -We will interview them at home and randomize participants to either the treatment (CAPABLE intervention) or control (attention-control) group. Participants in the treatment group will receive up to 10 in-home sessions -- 6 visits with an occupational therapist and 4 visits from a nurse - and $1200 in safety and modification services from a licensed handyman. Each treatment participant will receive each intervention component but interventionists will systematically tailor content to the participants' risk profile and goals based on protocols.

Official Title
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Reducing Disability Via a Bundled Bio-Behavioral-Environmental Approach

Conditions
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Quality of Life

Intervention / Treatment
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* Behavioral: CAPABLE
* Behavioral: Attention visits


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: at least 65 years old cognitively intact difficulty with at least one activity of daily living or two instrumental activities of daily living less than 175% of the Federal Poverty level be able to stand with or without assistance agree to study participation Exclusion Criteria: hospitalized more than three times in the last year receiving in home rehabilitation have a terminal diagnosis with less than one year life expectancy plan to move in less than one year

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
Interventional Model Description: Time limited home based intervention of a Nurse, Occupational Therapist, and a handyman to work with low income older adults to assess, prioritize and meet their functional goals.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CAPABLE<br>Experimental group participants received up to 10 sessions; up to 6 with an OT, and up to 4 sessions with an RN, and ≤ $1200 of safety and functional modifications from a licensed handyman. These sessions happened in coordinated fashion over the course of 4 months. | Behavioral: CAPABLE<br>* Occupational therapy visits plus nursing visits plus handyman repair<br>|
| Active Comparator: Attention visits<br>Participants in the attention visit arm received 10 visits of one hour length spaced across 16 weeks. These visits included sedentary activities of their choice based on their goals and interests. | Behavioral: Attention visits<br>* Participants in the attention control arm will receive 10 one hour visits over the course of 16 weeks. These visits will consist of sedentary activities<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Activities of Daily Living (ADLs) |  | 5 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Quality of Life