Testing and Adapting the Home Hazard Removal Program to Prevent Falls in Adults with Physical Disabilities Aged 45 to 64

What this Trial Is About

Researchers are evaluating the Home Hazard Removal Program HARP, adapted for people with disabilities PwD, to prevent falls by identifying and removing hazards in the home. This pilot randomized controlled trial RCT will test how well the adapted HARP works and how it can be implemented for community-dwelling PwD. The study uses frameworks like RE-AIM and PRISM to guide adaptation, design, and evaluation, aiming for broad usefulness and dissemination of findings. Participants will be randomized into two groups one receiving the adapted HARP intervention and the other placed on a waitlist control receiving virtual social visits. The adapted HARP involves two to three in-home visits by an occupational therapist over about five weeks to identify fall hazards and collaboratively create solutions. Additional visits and a contractor, if needed, help implement home modifications, all provided at no cost. Booster visits occur 3 to 6 months later to check and support ongoing home safety. Participants will be followed for 12 months, with monthly tracking of falls, fall-related injuries, and home modifications. Fear of falling is assessed at the start and end of the study. Researchers will collect quantitative and qualitative data, including interviews and focus groups, to evaluate hazard types, costs, adherence to modifications, and barriers to adoption. The total study duration includes the intervention and follow-up to monitor safety and effectiveness in everyday home settings.

Adapting, Implementing and Evaluating the Effectiveness of HARP for People With Disabilities