Clinical trial NCT04267484: What Are my Options to Stay Safe at Home: Technology For Aging at Home
Official title: Technology to Support Decision Making About Aging at Home (COORDINATEs)
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Memory Problems
Aging
Mild Cognitive Impairment
Shared Decision Making
Keywords: Shared decision making
Mild Cognitive Impairment
Technology
aging in place
memory problem
Lead sponsor: CHU de Quebec-Universite Laval
Sponsor class: OTHER
Collaborators: name: Laval University
name: Dalarna University
name: University of Groningen
name: University of Alberta
First posted: 2020-02-13
Enrollment: 294
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Elderly (\>65 years) with mild cognitive impairment or self reported memory problems.

Brief summary: Most older people want to stay at home as long as possible. Effective self-management for people losing autonomy depends on reliable monitoring of their mobility, health and safety and active implication in decision-making. New technologies have the potential to provide information about changing patterns that reflect changing care needs. This information could help older adults, caregivers and health professionals to participate in decision-making about housing options when a change in living environment needs to be considered.

Detailed description: This is a multi-phase study to be conducted in 3 countries: Canada (Quebec and Alberta), Sweden and Netherlands. The primary objective is to provide e-decision support technology that will facilitate self-management in the context of aging in place and foster informed value congruent decisions about options to age safely at home.

The aim of the project is to develop and validate a e-technology based on already existing components (e.g. GPS devices, diverse e-platforms and decision support interventions) to 1) help older adults with mild cognitive impairment/memory problems to stay safely at home as long as possible and 2) to provide older adults with decision support tools to help them make informed value congruent decisions (e.g. foster a shared decision-making process) regarding aging at home in a safe manner.

The secondary objectives are:

1. Assess autonomy and mobility of older adults with mild cognitive impairment/memory problems living at home.
2. Inform shared decision-making processes about options to safely age in place for all those involved.

The investigators will apply an integrated Knowledge Translation (iKT), comparative, mixed-methods approach to explore, older adults living at home with mild cognitive impairment/memory problems, their use of space in their homes and neighbourhoods.

The project is divide into 4 work package (WP). In more details, during WP1, the investigators will collect spatial data (e.g. using GPS) and self-reported data (e.g. travel diaries, walking interviews, in-depth interviews, surveys). At WP2, the investigators will use iterative end-user feedback and end-user consultation discussion group to tailor a decision support technology to knowledge-users. At WP3, investigators will assess user opinion regarding factors that could influence their use of the newly adapted e-decision support technology. Finally, at WP4 the investigators will triangulate data and take into account differences between jurisdictions.

This collaboration and our cross-country comparisons will contribute to scaling up e-decision support solutions in the future for the older adults with mild cognitive impairment/memory problems who want to age safely at home.

Eligibility criteria: Inclusion Criteria:

* Aged ≥ 65 years
* Living at home
* Diagnosed with mild cognitive impairment or experiencing memory issues
* Able to read, understand and write
* Can provide informed consent

Exclusion Criteria:

* Older adults who are not able to provide informed consent
* Living in nursing home or hospital

Primary outcomes:
measure: Autonomy and mobility assessment using GPS
timeFrame: Participant will wear a GPS for a total of two weeks. As data collection will occur in parallel at all four sites (Quebec, Alberta, Sweden, Netherlands) data collection will happen over a period of 1 year
measure: Iterative assessment to tailor the e-decision support technology
timeFrame: Immediately after group discussion. 3 sequential group discussion are plan to occur, one in each country (Canada, Sweden, Netherlands) data collection will happen over a period of 1 year.
measure: User experience assessment of the newly adapted technology
timeFrame: Immediately after testing the new platform. As data collection will occur in parallel at all four sites (Quebec, Alberta, Sweden, Netherlands), it will happen over a period of 6 months
Secondary outcomes:
measure: Inform SDM processes about housing option
timeFrame: 9 months
measure: Open-ended questionnaire of participant global health status and their experience of using the GPS and filling the travel diary
timeFrame: Immediately before and after carrying the GPS at WP1. As data collection will occur in parallel at all four sites (Quebec, Alberta, Sweden, Netherlands) data collection will happen over a period of 1 year
Other outcomes:
Locations:
city: Québec
country: Canada
facility: CERSSPL
state: Quebec
city: Edmonton
country: Canada
facility: University of Alberta
city: Groningen
country: Netherlands
facility: University of Groningen
city: Falun
country: Sweden
facility: Dalarna University
Study officials:
affiliation: Laval University
name: France Légaré, PhD
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Meijering L, Weitkamp G. Numbers and narratives: Developing a mixed-methods approach to understand mobility in later life. Soc Sci Med. 2016 Nov;168:200-206. doi: 10.1016/j.socscimed.2016.06.007. Epub 2016 Jun 8.
citation: Sturge J, Meijering L, Jones CA, Garvelink M, Caron D, Nordin S, Elf M, Legare F. Technology to Improve Autonomy and Inform Housing Decisions for Older Adults With Memory Problems Who Live at Home in Canada, Sweden, and the Netherlands: Protocol for a Multipronged Mixed Methods Study. JMIR Res Protoc. 2021 Jan 21;10(1):e19244. doi: 10.2196/19244.