COMPASS III
Funding: National Institute of Child Health and Human Development, R01HD092398-06
Brief Description
The Community Participation Transition after Stroke (COMPASS) intervention, delivered at home during the transition from inpatient rehabilitation, addresses barriers to independence through home modifications and self-management. This hybrid type I randomized effectiveness-implementation trial will evaluate the clinical efficacy, cost-effectiveness, and real-world implementation potential of COMPASS.
Aims
The primary objective of this study is to evaluate the impact of COMPASS on the incidence of skilled nursing facility admissions compared to enhanced usual care (EUC) at 12 months after inpatient rehabilitation discharge.
Other objectives are to:
- Compare the cumulative incidence of mortality between the COMPASS and EUC groups at 12 months following inpatient rehabilitation discharge
- Compare the cumulative incidence of rehospitalization from 30 days post-discharge to 12 months post-discharge between the COMPASS and EUC groups
- Compare the rate of falls between both groups at 12 months post-discharge
The economic objective is to evaluate the quality, cost and efficacy of COMPASS compared to EUC, and the implementation evaluation objective is to examine the real-world implementation and sustainability potential of COMPASS.
HARP III
Funding: Department of Housing and Urban Development, MOHHU008-24
Brief Description
The Home Hazard Removal Program (HARP) is an effective fall prevention intervention that targets home hazard identification/removal. In this pilot randomized controlled trial, we are testing the implementation, cost, and preliminary efficacy of an adapted version of HARP for 80 community-dwelling people with disabilities (PwD). Participants are recruited through the St. Louis Area Agency on Aging and other MADRN organizations. Participants are randomized to receive HARP or waitlist control. Participants complete monthly fall monitoring using a calendar-journal for 12 months.
Aims
Objective 1: Estimate the magnitude of efficacy of the adapted fall prevention program to address primary outcomes of reduction in fall rates, injurious fall rates, and fear of falling compared to the waitlist control condition.
Objective 2: Identify the most common locations of fall hazards in the home to inform housing recommendations for PwD to reduce the likelihood of falls.
Objective 3: Conduct a mixed methods study informed by the Practical Robust Implementation and Sustainability Model (PRISM) and Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to evaluate the acceptability, feasibility and implementation potential of the home hazard removal program among community-dwelling PwD.