{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Krauss MJ"],"funding":["National Center for Advancing Translational Sciences","U.S. Department of Housing and Urban Development","NCATS NIH HHS","ACL HHS"],"pagination":["670-681"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC10947940"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["72(3)"],"pubmed_abstract":["<h4>Background</h4>Falls are the leading cause of injury, disability, premature institutionalization, and injury-related mortality among older adults. Home hazard removal can effectively reduce falls in this population but is not implemented as standard practice. This study translated an evidence-based home hazard removal program (HARP) for delivery in low-income senior apartments to test whether the intervention would work in the \"real world.\"<h4>Methods</h4>From May 1, 2019 to December 31, 2020, a stepped-wedge cluster-randomized trial was used to implement the evidence-based HARP among residents with high fall risk in 11 low-income senior apartment buildings. Five clusters of buildings were randomly assigned an intervention allocation sequence. Three-level negative-binomial models (repeated measures nested within individuals, individuals nested within buildings) were used to compare fall rates between treatment and control conditions (excluding a crossover period), controlling for demographic characteristics, fall risk, and time period.<h4>Results</h4>Among 656 residents, 548 agreed to screening, 435 were eligible (high fall risk), and 291 agreed to participate and received HARP. Participants were, on average, 72 years, 67% female, and 76% Black. Approximately 95.4% of fall prevention strategies and modifications implemented were still used 3 months later. The fall rate (per 1000 participant-days) was 4.87 during the control period and 4.31 during the posttreatment period. After adjusting for covariates and secular trend, there was no significant difference in fall rate (incidence rate ratio [IRR] 0.97, 95% CI 0.66-1.42). After excluding data collected during a hiatus in the intervention due to COVID-19, the reduction in fall rate was not significant (IRR 0.93, 95% CI 0.62-1.40).<h4>Conclusions</h4>Although HARP did not significantly reduce the rate of falls, this pragmatic study showed that the program was feasible to deliver in low-income senior housing and was acceptable among residents. There was effective collaboration between researchers and community agency staff."],"journal":["Journal of the American Geriatrics Society"],"pubmed_title":["Removing home hazards for older adults living in affordable housing: A stepped-wedge cluster-randomized trial."],"pmcid":["PMC10947940"],"funding_grant_id":["MMOHHU0040‐17","90DPCP0001","UL1 TR002345","UL1 TR000448"],"pubmed_authors":["Kehrer-Dunlap AL","Stark SL","Somerville E","Bollinger RM","Haxton M","Yan Y","Krauss MJ","Chen SW"],"additional_accession":[]},"is_claimable":false,"name":"Removing home hazards for older adults living in affordable housing: A stepped-wedge cluster-randomized trial.","description":"<h4>Background</h4>Falls are the leading cause of injury, disability, premature institutionalization, and injury-related mortality among older adults. Home hazard removal can effectively reduce falls in this population but is not implemented as standard practice. This study translated an evidence-based home hazard removal program (HARP) for delivery in low-income senior apartments to test whether the intervention would work in the \"real world.\"<h4>Methods</h4>From May 1, 2019 to December 31, 2020, a stepped-wedge cluster-randomized trial was used to implement the evidence-based HARP among residents with high fall risk in 11 low-income senior apartment buildings. Five clusters of buildings were randomly assigned an intervention allocation sequence. Three-level negative-binomial models (repeated measures nested within individuals, individuals nested within buildings) were used to compare fall rates between treatment and control conditions (excluding a crossover period), controlling for demographic characteristics, fall risk, and time period.<h4>Results</h4>Among 656 residents, 548 agreed to screening, 435 were eligible (high fall risk), and 291 agreed to participate and received HARP. Participants were, on average, 72 years, 67% female, and 76% Black. Approximately 95.4% of fall prevention strategies and modifications implemented were still used 3 months later. The fall rate (per 1000 participant-days) was 4.87 during the control period and 4.31 during the posttreatment period. After adjusting for covariates and secular trend, there was no significant difference in fall rate (incidence rate ratio [IRR] 0.97, 95% CI 0.66-1.42). After excluding data collected during a hiatus in the intervention due to COVID-19, the reduction in fall rate was not significant (IRR 0.93, 95% CI 0.62-1.40).<h4>Conclusions</h4>Although HARP did not significantly reduce the rate of falls, this pragmatic study showed that the program was feasible to deliver in low-income senior housing and was acceptable among residents. There was effective collaboration between researchers and community agency staff.","dates":{"release":"2024-01-01T00:00:00Z","publication":"2024 Mar","modification":"2026-06-01T23:13:59.661Z","creation":"2025-04-04T02:11:22.503Z"},"accession":"S-EPMC10947940","cross_references":{"pubmed":["38103187"],"doi":["10.1111/jgs.18706"]}}