Home hazard removal for older adults (HARP)
The Home Hazard Removal Program (HARP) is an intervention designed to reduce falls by removing hazards from the homes of older adults. We are conducting a randomized controlled trial and implementation study of 300 older adults at risk of a fall to test the program.
We recruited participants through the St. Louis Area Agency on Aging’s annual assessment of participants’ health. Interventionists use a manualized protocol to deliver the intervention, and we follow participants monthly using a highly successful calendar-journal technique. We will disseminate the program, manuals and training programs using our advisory network.
See the HARP resource page for more information on the intervention.
The first aim of the study is to determine the acceptability and feasibility of delivering the program in partnership with St. Louis Area Agency on Aging. To examine the effects of the adapted program, we are conducting a hybrid effectiveness/implementation trial of 300 older adults at high risk for a fall.
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 other participant-reported outcomes that may be affected by the intervention.
Funding: Department and Housing and Urban Development, MOHHU0024
Community participation transition after stroke (COMPASS II)
Community Participation Transition after Stroke (COMPASS II) is an occupational therapy intervention to support individuals returning home from hospital/rehabilitation following a stroke. The study is a phase IIb, single-blind, parallel-group, randomized controlled trial among patients undergoing inpatient rehabilitation for ischemic stroke. Participants are randomized to receive either COMPASS II or attentional control.
See the COMPASS resource page for more information on the intervention.
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 II uses two complementary evidence-based interventions: home modifications and strategy training delivered in the home.
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 (DRRP)
This project consists of four distinct but interrelated research projects to promote participation for people aging with long-term physical disabilities:
- Develop a community-based research network—a formal network of researchers and community-based organizations serving older adults and people with disabilities—to serve as a platform and testbed for research studies.
- Conduct a longitudinal cohort study to examine changes in community participation in ~400 people aging with long-term physical disabilities over time, identifying potential intervention points to sustain participation.
- Culturally and pragmatically adapt an existing, effective, evidence-based intervention (from gerontology and rehabilitation) and evaluate its efficacy for people aging with long-term physical disability in community settings.
- Conduct a a pilot randomized controlled trial to examine the feasibility of implementing the adapted program through the community-based research network established under Project 1.
To improve community participation for people aging with a long-term physical disability, 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 one inaugural cohort research study in the CBRN on the barriers to and facilitators of community participation, and (3) build research capacity and facilitate the translation of evidence for CILs and AAAs.
Funding: NIDILRR Rehabilitation Research Projects Community Living & Participation, 90DPCP0001-01-00
Removing home hazards for older adults living in affordable housing (HARP II)
The goal of this project is to conduct a hybrid effectiveness/implementation trial to simultaneously establish the effectiveness of the Home Hazard Removal Program for fall prevention in affordable housing (HARP II) and conduct a process of evaluation of how the intervention works in the context of low-income senior apartments.
The long-term goal of this study is to increase the supply of healthy housing in the U.S. 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.
Funding: Department and Housing and Urban Development, MOHHU0040
Retaining participants in longitudinal studies of Alzheimer disease (NACC)
The purpose of this project is to study barriers and facilitators to retention of participants in longitudinal Alzheimer disease research and to develop guidelines for improving participant retention. We are conducting a mixed methods study, employing identical procedures across three centers: Washington University (Knight ADRC), the University of Pittsburgh (Pitt-ADRC) and the University of Wisconsin (Wisconsin ADRC). We are recruiting 330 community-dwelling older adults with decisional capacity for survey participation. We are also recruiting 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.
The specific 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 implementing these guidelines to improve retention in longitudinal Alzheimer disease studies.
Funding: National Alzheimer’s Coordinating Center Collaborative Project, 2017-01
Falls: A marker of preclinical Alzheimer disease (Falls & AD)
The purpose of this project is to examine the relationship between falls, functional mobility and preclinical Alzheimer disease. We are recruiting 350 individuals who are currently enrolled in longitudinal studies at the Knight Alzheimer Disease Research Center. We conduct one home visit annually for 4 years to administer a battery of assessments with items related to fall risk factors, including sensation, strength, balance, gait and home hazards. Participants complete monthly fall monitoring using a calendar-journal technique for the duration of the study.
The first aim of this study is to examine the relationship between falls and functional mobility in the preclinical stages of Alzheimer 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 preclinical stages of Alzheimer disease.
Funding: National Institute on Aging, 1 R01 AG057680-01A1