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Feasibility and Effects of Preventive Home Visits for Older Adults

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00985283
Recruitment Status : Completed
First Posted : September 28, 2009
Last Update Posted : September 16, 2011
Information provided by (Responsible Party):
University of North Carolina, Chapel Hill

Brief Summary:
The goals of this project are to implement an innovative intervention for older adults and assess both its feasibility and effects on health and well-being. The investigators hypothesize that the intervention group will show a significantly better slope for a range of outcomes during and after the intervention.

Condition or disease Intervention/treatment Phase
Frailty Behavioral: Preventive home visit Behavioral: minimal intervention Not Applicable

Detailed Description:
Aging in place is now recognized as a goal of most older adults. While medically driven interventions such as home health care assist older adults to age in place, these occur not as true preventive measures but as reactions to losses in function or health. The search for preventive methods to mitigate decline and unwanted moves from home and community is important. One such method, Preventive Home Visits (PHVs), has been utilized in parts of Europe for approximately two decades. The PHV model is based on infrequent but regular visits to an older adult's home by a trained practitioner (typically an occupational therapist or nurse). The visit is designed to assess the older person's situation and provide information and advice to optimize function and well-being. Evidence about PHV efficacy is mixed but generally supportive, and there is a distinct need to create and examine a preventive non-medical intervention model in the USA. A successfully developed and implemented approach could enhance lives and save costs. We plan to implement an intervention informed by a framework based on a synthesis of the World Health Organization function and disability model and the Occupational Therapy Practice Framework. We aim to implement and evaluate this PHV intervention in Orange County, North Carolina to assess the feasibility and effects of preventive home visits with older adults. We will use an experimental, repeated measures design in which approximately 120 older (75+ years) community-dwelling adults who are at-risk for functional decline are randomly assigned to experimental and comparison groups. The experimental group will receive the PHV intervention four times across a 12 month period. The comparison group will receive a minimal intervention of two informational phone calls and printed materials about local services during the same period. An occupational therapist with the requisite training and experience in home-based evaluation and intervention will conduct the experimental intervention. We will independently administer a set of standardized scales to both groups immediately pre-intervention, and again at regular intervals after each intervention. These outcome measures will cover the primary dimensions on which we hypothesize PHVs will have a positive influence: functional ability, participation, self-efficacy, life satisfaction, and self-reported health. Secondary outcomes include hospitalization and institutionalization. Analyses will compare the differences in outcomes for the two groups as well as assess several dimensions of intervention feasibility. These data will be the basis for a subsequent, enhanced intervention and study.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 110 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Prevention
Official Title: Feasibility and Effects of Preventive Home Visits for Older Adults
Study Start Date : January 2008
Actual Primary Completion Date : May 2010
Actual Study Completion Date : May 2010

Arm Intervention/treatment
Experimental: Preventive home visit
receives preventive home visit intervention 4 times over 1 year
Behavioral: Preventive home visit
in-home visit by a trained occupational therapist to assess older adult's living context and occupational performance and to provide recommendations for changes or continuation of behavior or context

Active Comparator: comparison group
receives information packets on local services for older adults and health promotion material twice during 1 year
Behavioral: minimal intervention
provision of information related to services and health promotion for older adults as a low-cost minimal alternative to the intervention

Primary Outcome Measures :
  1. functional ability [ Time Frame: 5 times across approx. 15 months ]

Secondary Outcome Measures :
  1. life satisfaction [ Time Frame: 5 times across approx. 15 months ]

Information from the National Library of Medicine

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Ages Eligible for Study:   75 Years and older   (Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • 75 years or older
  • lives in community (not in nursing home or assisted living)
  • not currently receiving home health services
  • vulnerable elders survey score of 3 or higher

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00985283

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United States, North Carolina
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States, 27516
Sponsors and Collaborators
University of North Carolina, Chapel Hill
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Principal Investigator: Malcolm P. Cutchin, PhD University of North Carolina, Chapel Hill
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: University of North Carolina, Chapel Hill Identifier: NCT00985283    
Other Study ID Numbers: R21-AG29502-2
First Posted: September 28, 2009    Key Record Dates
Last Update Posted: September 16, 2011
Last Verified: September 2011
Keywords provided by University of North Carolina, Chapel Hill:
older adults
life satisfaction
self-rated health
Additional relevant MeSH terms:
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Pathologic Processes