Clinical trial NCT01960582: Evaluation of Housing Adaptations and Mobility Devices
Official title: Housing Adaptations and Mobility Devices - Evaluation of a New Practice Strategy
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Activities of Daily Living
Cost Effectiveness
Housing
Keywords: Housing adaptation
Independence
Costs
Lead sponsor: Lund University
Sponsor class: OTHER
First posted: 2013-10-10
Enrollment: 340
Sex: ALL
Minimum age (years): 20
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: 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: 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?

Eligibility criteria: Inclusion Criteria:

* Persons receiving housing adaptation
* Above 20 years

Exclusion Criteria:

* Persons with language deficits and/or cognitive decline

Primary outcomes:
measure: ADL Staircase
timeFrame: Differences in changes between intervention and control sites at baseline and 3, 6,12, 24 and 36 months after
Secondary outcomes:
measure: Falls Efficacy Scale- FES-I
timeFrame: Differences in changes between intervention and control sites at baseline and 3, 6, 12, 24 and 36 months after
Other outcomes:
measure: Usability of the home, UIMH
timeFrame: Differences in changes between intervention and control sites between baseline and 3, 6,12,24 and 36 months after
measure: Costs of housing adaptations
timeFrame: 3,6, 12, 24 and 36 months after, for the whole sample
measure: Cost-benefit for client and society
timeFrame: At 24 and 36 months after the housing adaptation, for the whole sample
Locations:
city: Lund
country: Sweden
facility: Department of Health Sciences, Lund University
Study officials:
affiliation: Lund University
name: Agneta M Fänge, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Malmgren Fange A, Carlsson G, Axmon A, Thordardottir B, Chiatti C, Nilsson MH, Ekstam L. Effects of applying a standardized assessment and evaluation protocol in housing adaptation implementation - results from a quasi-experimental study. BMC Public Health. 2019 Nov 4;19(1):1446. doi: 10.1186/s12889-019-7815-9.
citation: Ekstam L, Carlsson G, Chiatti C, Nilsson MH, Malmgren Fange A. A research-based strategy for managing housing adaptations: study protocol for a quasi-experimental trial. BMC Health Serv Res. 2014 Nov 29;14:602. doi: 10.1186/s12913-014-0602-5.