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Social Work Intervention Focused on Transitions (SWIFT)

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ClinicalTrials.gov Identifier: NCT02232126
Recruitment Status : Completed
First Posted : September 5, 2014
Results First Posted : February 10, 2017
Last Update Posted : February 10, 2017
Sponsor:
Collaborators:
Huntington Hospital
National Institute on Aging (NIA)
Information provided by (Responsible Party):
Susan Enguidanos, University of Southern California

Study Type: Interventional
Study Design: Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: Triple (Participant, Investigator, Outcomes Assessor);   Primary Purpose: Health Services Research
Conditions: Study Focus: 30-day Rehospitalizations Among At-risk Older Adults Randomized to a Social Work-driven Care Transitions Intervention
Heart Disease
Diabetes
Hypertension
Cancer
Depression
Asthma
Chronic Heart Failure
Chronic Obstructive Pulmonary Disease
Stroke
Intervention: Other: SWIFT home intervention

  Participant Flow

Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
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Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
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Reporting Groups
  Description
Usual Care No text entered.
Intervention SWIFT home intervention: 1 in-home assessment performed by study social worker, another in-home visit performed if needed. Up to 4 telephone contacts performed by study social worker. A maximum of 6 contacts

Participant Flow:   Overall Study
    Usual Care   Intervention
STARTED   91   90 
COMPLETED   91   90 
NOT COMPLETED   0   0 



  Baseline Characteristics

Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
No text entered.

Reporting Groups
  Description
Usual Care Usual care consisted of the usual course of care provided to older adults transitioning home from a hospital stay at Huntington Memorial Hospital
Intervention SWIFT home intervention: 1 in-home assessment performed by study social worker, another in-home visit performed if needed. Up to 4 telephone contacts performed by study social worker. A maximum of 6 contacts
Total Total of all reporting groups

Baseline Measures
   Usual Care   Intervention   Total 
Overall Participants Analyzed 
[Units: Participants]
 91   90   181 
Age 
[Units: Participants]
Count of Participants
     
<=18 years      0   0.0%      0   0.0%      0   0.0% 
Between 18 and 65 years      0   0.0%      0   0.0%      0   0.0% 
>=65 years      91 100.0%      90 100.0%      181 100.0% 
Age 
[Units: Years]
Mean (Standard Deviation)
 79.2  (8.8)   78.4  (7.8)   78.8  (8.3) 
Gender 
[Units: Participants]
Count of Participants
     
Female      49  53.8%      39  43.3%      88  48.6% 
Male      42  46.2%      51  56.7%      93  51.4% 
Race/Ethnicity, Customized 
[Units: Participants]
     
African American   23   14   37 
Caucasian   52   57   109 
Latino   7   9   16 
Native American   1   1   2 
Asian/Pacific Islander   4   2   6 
Other   3   6   9 
Declined to provide response   1   1   2 
Region of Enrollment 
[Units: Participants]
     
United States   91   90   181 
Marital status 
[Units: Participants]
     
Married   35   45   80 
Single   11   16   27 
Divorced   10   7   17 
Widowed   35   19   54 
Declined to provide response   0   3   3 
Current living situation 
[Units: Participants]
     
Own house/apartment   82   78   160 
Living in family member's home   7   6   13 
Other   2   3   5 
Declined to provide response   0   3   3 
Who do you live with? 
[Units: Participants]
     
Alone   35   20   55 
Spouse/partner   31   43   74 
Child   14   13   27 
Paid caregiver   2   1   3 
Other   9   8   17 
Declined to provide response   0   5   5 
Who is your primary caregiver? 
[Units: Participants]
     
No one/self   43   33   76 
Spouse   19   24   43 
Significant other   0   4   4 
Child   11   11   22 
Paid caregiver   9   6   15 
Other   9   8   17 
Declined to provide response   0   4   4 
Current annual income 
[Units: Participants]
     
Under $10,000   15   9   24 
$10,000-$19,000   9   10   19 
$20,000-$29,000   9   5   14 
$30,000-$39,000   3   1   4 
$40,000-$49,000   0   1   1 
$50,000 or more   11   11   22 
Refused to respond   44   53   97 
Highest grade completed in school 
[Units: Participants]
     
8th grade or less   1   5   6 
9th-11th grade   4   5   9 
High school graduate   17   13   30 
Some college   27   20   47 
College graduate   17   19   36 
Graduate degree   10   14   24 
Doctoral degree   7   4   11 
Declined to provide response   8   10   18 
Chronic condition inventory [1] 
[Units: Participants]
     
Cancer   24   20   44 
Cardiac disease   58   55   113 
Dementia/Alzheimer's disease   3   4   7 
Depression   14   32   46 
Diabetes   18   23   41 
Hypertension   57   54   111 
Respiratory disease   30   29   59 
Stroke   7   10   17 
[1] Measure NOT mutually exclusive. Inventory of conditions
Patient Health Questionnaire 9-item (PHQ-9) [1] 
[Units: Units on a scale]
Mean (Standard Deviation)
 4.33  (3.9)   6.15  (5.1)   5.24  (4.5) 
[1]

The Patient Health Questionnaire, 9-item uses nine questions to asses for depression and has been widely and successfully used in health care research since the early 1990's, particularly in investigations among older adults aged 65 years or more.

A total score is reported at the end of the questionnaire and scores can range from 0-27 with a higher value indicating more severe or worse depression. Total scores correspond to the following: 0 no depression, 1-4 minimal depression, 5-9 mild depression, 10-14 moderate depression, 15-19 moderate severe depression, and 20-27 severe depression.

Pain (Number Rating Scale) [1] 
[Units: Units on a scale]
Mean (Standard Deviation)
 3.54  (3.4)   9.18  (1.1)   6.36  (2.25) 
[1] The Number Rating Scale is a self-reported measure for pain level that is widely used in US hospitals. Patients are asked to rate their level of pain felt over the last 24-hours on a scale ranging from 0-10, where zero indicates no pain, and 10 is the worst pain imaginable.
Physical Functioning Index (abbreviated Short Form-12) [1] 
[Units: Units on a scale]
Mean (Standard Deviation)
 7.67  (5.12)   7.18  (5.08)   7.43  (5.1) 
[1] The Short-Form, 12-item is a survey tool to measure physical health and functional level and an abbreviated version of this tool was used in the present study which constituted eight of the 12-items that focused on physical functioning. Response options ranged from 'not limited at all,' to 'limited a lot' and after assigning numerical values to response options, total scores ranged from 0-16 with a higher score corresponding to greater physical limitations.
Cognition (SPMSQ score) [1] 
[Units: Units on a scale]
Mean (Standard Deviation)
 9.08  (1.2)   9.18  (1.1)   9.13  (1.15) 
[1] The Short Portable Mental Health Questionnaire (SPMSQ) is widely used tool to screen for cognitive impairment. This questionnaire consists of 10 questions and a total score is derived at the end. Scores can range from 0-10 where a low score indicates high cognitive impairment and a high score indicates higher cognitive functioning. The scale has an established cut-off score of 5 where those scoring 5 or higher are cognitively intact to participate in research, understand the study and associated activities, and provide consent. Those scoring below 5 are deemed ineligible.
Number of health conditions 
[Units: Health conditions]
Mean (Standard Deviation)
 6.35  (4.1)   5.88  (2.9)   6.17  (3.5) 
Number of daily medications 
[Units: Medications]
Mean (Standard Deviation)
 7.61  (3.8)   8.00  (3.8)   7.81  (3.8) 
Discharged home under self-care 
[Units: Participants]
     
Yes   61   67   128 
No   30   23   53 
Had inpatient stay or emergency department visit in previous 6 months 
[Units: Participants]
     
Yes   35   32   67 
No   56   58   114 
Has Advance Directive 
[Units: Participants]
     
Yes   50   46   96 
No   41   44   85 


  Outcome Measures

1.  Primary:   30-day Hospital Readmission   [ Time Frame: 30-days post hospitalization ]

2.  Secondary:   30-day Readmission Among Intervention Participants   [ Time Frame: 30-days ]


  Serious Adverse Events


  Other Adverse Events


  Limitations and Caveats

Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
No text entered.


  More Information

Certain Agreements:  
Principal Investigators are NOT employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.


Results Point of Contact:  
Name/Title: Dr. Susan Enguidanos
Organization: University of Southern California
phone: 213-740-9822
e-mail: enguidan@usc.edu



Responsible Party: Susan Enguidanos, University of Southern California
ClinicalTrials.gov Identifier: NCT02232126     History of Changes
Other Study ID Numbers: UP-10-00372
5R21AG034557-02 ( U.S. NIH Grant/Contract )
First Submitted: August 25, 2014
First Posted: September 5, 2014
Results First Submitted: December 4, 2014
Results First Posted: February 10, 2017
Last Update Posted: February 10, 2017