The Home Hazard Removal Program (HARP) is a fully manualized, evidence-based fall prevention intervention designed to reduce falls for community-dwelling older adults. HARP includes:

  • A comprehensive assessment of abilities, awareness of fall risk behaviors (Falls Behavioral Scale) and hazards in the home (Westmead Home Safety Assessment)
  • A tailored home modification prescription developed collaboratively
  • Assistance in removing the home hazards
  • Education on fall risks and strategies to address fall risks

An in home assessment of environmental hazards

As a part of the intervention, older adults  receive a total of 1-3 visits over one month with an occupational therapist. The occupational therapist uses a home hazard removal kit of low cost items to address fall hazards. More complex modifications are addressed at future visits and may include a contractor for installation. In our experience, on average, the modifications cost less than $200. If needed, assistance to obtain home modifications vary across the US and include local lending closets, Rebuilding Together,  Veterans Affairs, or other non-profit organizations. Therapists may work with these programs to provide additional home modifications as needed.

HARP personal abilities assessment and hazard resolution using a home hazard removal kit (double-sided carpet tape, contrasting floor tape, non-skid treads, automatic night-lights, extension cords, and long phone cord)

The HARP manual includes fall and home hazard background information, assessment of personal and environmental factors to determine fall risk, and the essential elements and active ingredients necessary to provide the intervention. Key activities, example scripts, clinical decisional analysis algorithms, overviews of treatment sessions, and visit by visit grids are provided to ensure fidelity to the intervention and guide integration of the active and essential components within HARP.


We have provided in-person HARP training to both research and occupational therapists in community practice. Currently, we are adapting the in-person training for the full HARP program to be made available for purchase online. In conjunction with the online training, the manual will also be made available for purchase. We are taking pre-orders for the training and manual. If you are interested, please contact us at peplab@wustl.edu for more information.

Training on the home assessment (Westmead Home Safety Assessment) portion of HARP is available for purchase through the Fall Prevention Online Workshop  at http://fallspreventiononlineworkshops.com.au.


The development of the HARP manuals and training programs was supported by the Department of Housing and Urban Development grant MOHHU0024.