Feasibility and effects of preventive home visits for at-risk older people: Design of a randomized controlled trial Public Deposited

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Creator
  • Catellier, Diane J.
    • Affiliation: Gillings School of Global Public Health, Department of Biostatistics
  • Talley, Vibeke
    • Other Affiliation: Orange County Department on Aging, Hillsborough, North Carolina, USA
  • Shank, Kendra
    • Affiliation: School of Medicine, Department of Allied Health Sciences, Division of Occupational Science and Occupational Therapy
  • Coppola, Susan
    • Affiliation: School of Medicine, Department of Allied Health Sciences, Division of Occupational Science and Occupational Therapy
  • Svihula, Judie
    • Affiliation: School of Medicine, Center for Aging and Health
  • Cutchin, Malcolm
    • Affiliation: School of Medicine, Department of Allied Health Sciences, Division of Occupational Science and Occupational Therapy
Abstract
  • Abstract Background The search for preventive methods to mitigate functional decline and unwanted relocation by older adults living in the community is important. Preventive home visit (PHV) models use infrequent but regular visits to older adults by trained practitioners with the goal of maintaining function and quality of life. Evidence about PHV efficacy is mixed but generally supportive. Yet interventions have rarely combined a comprehensive (biopsychosocial) occupational therapy intervention protocol with a home visit to older adults. There is a particular need in the USA to create and examine such a protocol. Methods/Design The study is a single-blind randomized controlled pilot trial designed to assess the feasibility, and to obtain preliminary efficacy estimates, of an intervention consisting of preventive home visits to community-dwelling older adults. An occupational therapy-based preventive home visit (PHV) intervention was developed and is being implemented and evaluated using a repeated measures design. We recruited a sample of 110 from a population of older adults (75+) who were screened and found to be at-risk for functional decline. Participants are currently living in the community (not in assisted living or a skilled nursing facility) in one of three central North Carolina counties. After consent, participants were randomly assigned into experimental and comparison groups. The experimental group receives the intervention 4 times over a 12 month follow-up period while the comparison group receives a minimal intervention of mailed printed materials. Pre- and post-intervention measures are being gathered by questionnaires administered face-to-face by a treatment-blinded research associate. Key outcome measures include functional ability, participation, life satisfaction, self-rated health, and depression. Additional information is collected from participants in the experimental group during the intervention to assess the feasibility of the intervention and potential modifiers. Fidelity is being addressed and measured across several domains. Discussion Feasibility indications to date are positive. Although the protocol has some limitations, we expect to learn enough about the intervention, delivery and effects to support a larger trial with a more stringent design and enhanced statistical power. Trial Registration ClinicalTrials.gov ID NCT00985283
Date of publication
Identifier
  • doi:10.1186/1471-2318-9-54
  • 19958547
Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Malcolm P Cutchin et al.; licensee BioMed Central Ltd.
License
Journal title
  • BMC Geriatrics
Journal volume
  • 9
Journal issue
  • 1
Page start
  • 54
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1471-2318
Bibliographic citation
  • BMC Geriatrics. 2009 Dec 03;9(1):54
Access
  • Open Access
Publisher
  • BioMed Central Ltd
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