Removing home hazards for older adults (HARP)
The first aim of this study is to determine the acceptability and feasibility of delivering the program in an Area Agency on Aging. To examine the effect of the adapted program, we will conduct a hybrid effectiveness/ implementation trial of 300 older adults at high risk for a fall who will be randomized to the adapted program or usual agency care and then followed for 12 months.
The second aim of this study is to determine whether the adapted program is effective in reducing the rate and risk of falls and improving the outcome of other participant-reported outcomes that can be affected by the intervention.
We will conduct a randomized controlled trial and implementation study of 300 older adults at risk for a fall who will be randomized to a home-hazard removal program or usual care and then followed for 12 months.
We will recruit participants through the SLAAA’s annual assessment of participants’ health, interventionists will use a manualized protocol to deliver the intervention. We will follow participants monthly using a highly successful calendar journal technique, and we will disseminate the program, manuals, and training programs using our advisory network.
Funding: Department and Housing and Urban Development, MOHHU0024
COMPASS II (Community Participation Transition after Stroke)
The aim of this study is to investigate the efficacy and safety of a novel enhanced rehabilitation-transition program to reduce environmental barriers and improve daily performance and community participation. COMPASS uses two complimentary evidence-based interventions: home modifications and strategy training delivered in the home.
A phase IIb, single-blind, parallel-group, randomized controlled trial among patients undergoing inpatient rehabilitation for ischemic stroke. Participants will be randomized to receive either COMPASS or attentional control.
Funding: National Institute for Child Health and Human Development, 1R01HD092398-01
Building capacity to improve community participation for people aging with long-term disability through evidence-based strategies
To improve community participation for people aging with a long-term physical disability (PAwLTPD), our aims are to 1) establish a regional community-based research network (CBRN) consisting of a mix of Centers for Independent Living (CILs) and Area Agencies on Aging (AAAs) that represent urban and rural communities and serve a diverse population, 2) conduct 1 inaugural cohort research study in the CBRN of the barriers to and facilitators of community participation, and 3) build research capacity and facilitate the translation of evidence for CILs and AAAs.
We will conduct four distinct but interrelated research projects. 1) We will develop a formal CBRN including Long Term Supportive Service (LTSS) providers to serve as a platform and testbed for research studies. 2) We will conduct a cohort study to examine changes in community participation in 400 PAwLTPD over time, identifying potential intervention points to sustain participation. 3) We will culturally and pragmatically adapt an existing effective EB intervention (from gerontology and rehabilitation) and evaluate its efficacy for PAwLTPD in community LTSS settings. 4) We will conduct a pilot randomized controlled trial to examine the feasibility of implementing the adapted program in the CBRN established under Project 1.
Funding: NIDILRR Rehabilitation Research Projects Community Living & Participation, 90DPCP0001-01-00
Removing home hazards for older adults living in affordable housing
The long-term goal of this study is to increase the supply of healthy housing in the US in order to improve older adults’ ability to maintain their independence and safety. We will translate fall prevention research into an effective program delivered in affordable senior housing facilities. The specific aims of this study are to 1) determine the acceptability and feasibility of delivering the program in low-income senior apartments, and 2) determine whether the program is effective and cost-effective in reducing the rate of falls.
We will conduct a hybrid effectiveness/implementation trial to simultaneously establish the effectiveness of home hazard removal in affordable housing and conduct a process of evaluation of how the intervention works in the context of low-income senior apartments.
Funding: Department and Housing and Urban Development, MOHHU0040
Retaining participants in longitudinal studies of Alzheimer’s disease
The aims of this study are to 1) identify participants’ perceived facilitators and barriers to remaining enrolled in longitudinal studies of Alzheimer disease, 2) identify study partners’ perceived facilitators and barriers to the participant remaining enrolled in longitudinal studies of Alzheimer disease, and 3) develop guidelines and examine the feasibility of implementation of these guidelines to improve retention in longitudinal Alzheimer disease studies.
We will conduct a mixed method study, employing identical procedures across three centers [Washington University (Knight ADRC), University of Pittsburgh(Pitt-ADRC) and University of Wisconsin (Wisconsin ADRC)]. We will recruit 330 community-dwelling older adults with decisional capacity for survey participation. We will also recruit 180 study partners to participate in the survey across the three centers. Focus groups will be conducted with participants and study partners to elicit opinions about the guidelines.
Funding: National Alzheimer’s Coordinating Center Collaborative Project, 2017-01
Falls & AD
The first aim of this study is to examine the relationship between falls and functional mobility in pre-clinical stages of Alzheimer’s disease.
The second aim of this study is to examine a hypothesized model of central and peripheral mechanism(s) underlying falls and functional mobility in pre-clinical stages of AD.
We will recruit 350 individuals who are currently enrolled in longitudinal studies at the Knight Alzheimer’s Disease Research Center. We will conduct assessments related to fall risks and functional mobility in participant’s homes annually for four years. Participant’s will then use a calendar journal technique to report and falls each month for the duration of the study.
Funding: National Institute on Aging, 1 R01 AG057680-01A1