Aging With Long Term Physical Disabilities

NCT04589988 | Completed Results

• 1 other identifier: 201710186
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine the feasibility and efficacy of an adapted evidence-based program (REBIL) to reduce barriers to community participation and remove fall hazards at home for adults aging with physical disabilities.

Conditions

Physical Disability

Keywords

community participation; environmental modifications; home modifications; fall prevention

Outcome Measures

Primary Outcomes (6)

• In-Home Occupational Performance Evaluation (I-HOPE) Activity Score

  The In-Home Occupational Performance Evaluation (I-HOPE) activity score measures current activity patterns of participants across 44 activities. The score ranges from 0 to 1.0, with a higher score indicating fewer problematic activities for the participant.

  Baseline and 6-month follow up

• In-Home Occupational Performance Evaluation (I-HOPE) Performance Score

  The In-Home Occupational Performance Evaluation (I-HOPE) performance score is a mean rating across up to 10 participant-prioritized activities on a scale of 1 (unable to perform the activity at all) to 5 (able to perform the activity without difficulty).

  Baseline and 6-month follow up

• In-Home Occupational Performance Evaluation (I-HOPE) Satisfaction Score

  The In-Home Occupational Performance Evaluation (I-HOPE) satisfaction score is a mean rating across up to 10 participant-prioritized activities on a scale of 1 (not satisfied at all with the performance of the activity) to 5 (very satisfied with their performance of the activity).

  Baseline and 6-month follow up

• In-Home Occupational Performance Evaluation (I-HOPE) Barrier Severity Score

  The In-Home Occupational Performance Evaluation (I-HOPE) barrier severity score is a total sum of barrier ratings (0=independent with/without a device, 1=stand-by assistance needed, 2=minimum assistance needed, 3=moderate assistance needed, 4=maximum assistance needed, 5=no activity) for all identified barriers across up to 10 prioritized activities. Multiple barriers could be identified for each prioritized activity. Higher scores indicate greater barrier severity. There is no maximum score.

  Baseline and 6-month follow up

• Reintegration to Normal Living Index (RNLI)

  The Reintegration to Normal Living Index is a disability-related quality-of life-instrument that will be used to measure participants' satisfaction with their home and community participation and has been validated on a population of community-dwelling individuals with chronic conditions. It uses an 11-item, 10 point visual analog scale with higher scores indicating greater reintegration to normal living. The sum score is divided by 110 and then multiplied by 100 to obtain an adjusted score. Adjusted scores range from 0 to 100, with higher scores indicating greater reintegration to normal living.

  Baseline and 6-month follow-up

• Westmead Home Safety Assessment (WeHSA) Short Form

  The Westmead Home Safety Assessment (WeHSA) short form is a performance-based assessment of fall hazards in different spaces of the home (e.g., kitchen, bathroom, hallway, bedroom etc.). WeSHA scores indicate the total number of environmental fall hazards in the home.

  Baseline and 6-month follow up

Secondary Outcomes (3)

• Fall Prevention Strategy Survey (FPSS)

  Baseline and 6-month follow-up

• Participation Scale

  Baseline and 6-month follow-up

• Fall Rate

  6 months

Study Arms (2)

REBIL- Intervention arm

EXPERIMENTAL

Participants in this arm will receive the Removing Environmental Barriers to Independent Living (REBIL) intervention.

Behavioral: Removing Environmental Barriers to Independent Living (REBIL)

Waitlist Attentional control

OTHER

Participants in this arm will receive life interview visits provided by a trained occupational therapist (OT) or OT student remotely for an equivalent amount of time to the treatment group. The waitlist control group will be offered the REBIL intervention after the 6-month follow-up is completed.

Behavioral: Waitlist Attentional Control

Interventions

Removing Environmental Barriers to Independent Living (REBIL) BEHAVIORAL

REBIL is a complex intervention with two essential components: (1) removing environmental barriers and home hazards in the home tailored to the participant's unique abilities and limitations and (2) strategy training with the participant to help participant to be able to identify barriers in the home and community and identify potential resources and strategies to remove the barriers. Treatment includes one assessment session and four 75-minute visits in the home with an occupational therapist over 8 weeks, followed by a 6 -month assessment session by a blinded rater.

REBIL- Intervention arm

Waitlist Attentional Control BEHAVIORAL

The waitlist attentional control group will receive an initial assessment session then four 75 minute interview visits from an occupational therapy graduate assistant, followed by a 6-month assessment session by a blinded rater. After the 6-month follow-up is completed this group will receive the REBIL intervention.

Waitlist Attentional control

Eligibility Criteria

• Age: 45 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 45-65 years
• Self-report of difficulty with at least 2 daily activities using the Older Adult Retirement Survey Activities of Daily Living (OARS ADL) scale
• onset of a physical disability 5 years prior to participation (e.g., spinal cord injury (SCI), cerebral palsy, post-polio syndrome, stroke, amputation).
• live within 60 miles of the research lab

You may not qualify if:

• Currently institutionalized.

Sponsors & Collaborators

• Washington University School of Medicine: lead
• National Institute on Disability, Independent Living, and Rehabilitation Research: collaborator

Study Sites (1)

Washington University School of Medicine

St Louis, Missouri, 63108, United States

Location

Related Publications (1)

• Chen SW, Somerville E, Devine M, Stark S. A protocol for Removing Environmental Barriers to Independent Living (REBIL): An adapted evidence-based occupational therapy intervention to increase community participation for individuals aging with long-term physical disabilities. Br J Occup Ther. 2022;86(5):349-58. doi: 10.1177/03080226221126901.

  PMID: 38529197 BACKGROUND

Results Point of Contact

• Title: Dr. Susy Stark
• Organization: Washington University in St. Louis

sstark@wustl.edu

3142734114

Study Officials

• Susan Stark, PhD

  Washington University School of Medicine

  PRINCIPAL INVESTIGATOR

Publication Agreements

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

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The outcomes assessor will be masked.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Parallel-group, randomized control, participants in the waitlist control group will receive the intervention after 6-month follow up is completed

Study Record Dates

• First Submitted: September 8, 2020
• First Posted: October 19, 2020
• Study Start: November 4, 2020
• Primary Completion: June 21, 2023
• Study Completion: June 21, 2023
• Last Updated: August 27, 2025
• Results First Posted: November 18, 2024

Record last verified: 2025-08

Locations

US (1)