Implementing CAPABLE in PSH

NCT04076319 | Completed Results

• 1 other identifier: UP-19-00361
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This pilot project seeks to implement an intervention known as CAPABLE (Community Aging in Place-Advancing Better Living for Elders) for formerly homeless adults living in permanent supportive housing. This home-based intervention that consists of time-limited services (no more than 6-months) from an occupational therapist, a nurse, and a handyman is intended to improve functioning and decrease falls among this population that prematurely ages and is at increased fall risk.

Conditions

Accidental Fall; Frailty; Depression; Activities of Daily Living; Housing Problems

Outcome Measures

Primary Outcomes (6)

• Activities of Daily Living Limitations Score

  The modified Katz Activities of Daily Living (ADL) Index is an 8-item questionnaire that was completed by participants to rate their ability to perform daily activities, such as bathing, toileting, eating, and dressing, across a 5-point Likert scale (1 = no difficulty, 2 = a little difficulty, 3 = moderate difficulty, 4 = a lot of difficulty, 5 = unable to do). Items are summed to obtain a score with minimum and maximum values of 8 to 40, respectively, whereby higher scores represent greater difficulty performing ADLs.

  Change of ability to perform activities of daily living from baseline to 6-month follow up (post-intervention).

• Instrumental Activities of Daily Living Score

  The Brief Instrumental Functioning Scale will be used to assess ability to perform in six functions: bathing, dressing, going to toilet, transferring, continence, and feeding. Each area is assessed on a five point scale; participants rated their ability to perform daily tasks on a 5-point scale (1 = no difficulty, 2 = a little difficulty, 3 = moderate difficulty, 4 = a lot of difficulty, 5 = unable to do). Items are summed to obtain a score with minimum and maximum values of 8 to 40, respectively, whereby higher scores represent greater difficulty performing ADLs.

  Change of ability to perform IADLs from baseline to 6-month follow up (post-intervention).

• Depression

  Eight of the nine items in the Patient Health Questionnaire-9 were used to measure depression, rated on a 4-point scale of how frequently participants were bothered by the eight problems during a 2-week period (0 = not at all, 1 = several days, 2 = more than half the days, and 3 = nearly every day). Items are summed to obtain a score with minimum and maximum values of 0 to 24, respectively, whereby higher scores represent greater depressive symptoms.

  Change in depression symptoms from baseline to 6-month follow up (post-intervention).

• Falls Efficacy

  Participants rated their confidence they could do each of 10 activities without falling on a 10-point scale, with total scores ranging from 10 (not very confident) to 100 (very confident) using the Tinetti Falls Efficacy Scale. Thus, higher scores indicate greater efficacy related to falls.

  Change of falls efficacy from baseline to 6-month follow up (post-intervention).

• Pain Interference With Usual Activities

  Pain interference with usual activities was assessed using an item from the 3-item PEG to assess average pain intensity (P), interference with enjoyment of life (E), and interference with general activity (G) on a 10-point Likert scale from 0 (does not interfere) to 10 (completely interferes).

  Change in the degree that pain interferes with usual activities from baseline to 6-month follow up (post-intervention).

• Number of Falls in the Past Year or 6 Months

  Mean number of falls to the ground during the past year.

  Number of falls in the past year reported at 6-month follow up.

Secondary Outcomes (2)

• Self-rated Health

  Change in self-rated health from baseline to 6-month follow up (post-intervention).

• Overall Quality of Life

  Change in quality of life from baseline to 6-month follow up (post-intervention).

Other Outcomes (4)

• Proportion of Participants With Emergency Room Visits in Past 6 Months

  Proportion of participants with ER visits in past 6 months reported at 6-month follow up.

• Number of Emergency Room Visits in Past 6 Months

  Number of ER visits in past 6 months reported at follow up.

• Proportion of Participants With Hospitalizations in Past 6 Months

  Proportion of participants with hospitalizations in past 6 months reported at 6-month follow-up

Study Arms (1)

CAPABLE

OTHER

CAPABLE Intervention

Behavioral: CAPABLE: Community Aging in Place-Advancing Better Living for Elders

Interventions

CAPABLE: Community Aging in Place-Advancing Better Living for Elders BEHAVIORAL

CAPABLE is a client-directed home-based intervention that consists of time-limited services from an occupational therapist, a nurse, and a handyman working collaboratively with the older adult client. In most cases, the OT makes 6 visits, the RN makes 4 visits, and a handyman makes 1 to 2 visits to make any modifications to a person's home during a 6-month period. The first visits for the OT and RN are usually 90 minutes each and the later ones are usually an hour each. Visits are spaced to enable older adults to practice new strategies learned in the previous visit. There should be a clear "conclusion/graduation," with the older adult understanding how to use their new skills and apply them to future situations.

CAPABLE

Eligibility Criteria

• Age: 50 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Older than 50 years in age
• cognitively intact or have only mild cognitive impairment
• have some or a lot of difficulty performing ADLs
• tenant of Skid Row Housing Trust

You may not qualify if:

• see above

Sponsors & Collaborators

• University of Southern California: lead

Study Sites (1)

Skid Row Housing Trust

Los Angeles, California, 90021, United States

Location

MeSH Terms

Conditions

Frailty; Depression

Interventions

elderberry extract

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Behavioral Symptoms; Behavior

Limitations and Caveats

Pilot study resulting in a small number of individuals assigned to each study arm and potentially limiting the ability to detect significant differences. Further, because assessments were based solely on self-report, objective measurements on outcomes such as hospitalization and health care utilization require additional investigation. This would allow for the development of a comprehensive picture of the intervention's potential to positively affect health and behavior outcomes.

Results Point of Contact

• Title: Dr. Benjamin Henwood
• Organization: USC Suzanne Dworak-Peck School of Social Work

bhenwood@usc.edu

+1 (213) 821-0496

Study Officials

• Benjamin F Henwood, PhD

  University of Southern California

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Waitlist control design

Study Record Dates

• First Submitted: August 27, 2019
• First Posted: September 3, 2019
• Study Start: December 17, 2020
• Primary Completion: July 25, 2022
• Study Completion: July 30, 2022
• Last Updated: June 15, 2025
• Results First Posted: June 15, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)