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Effects of applying a standardized assessment and evaluation protocol in housing adaptation implementation - Results from a quasi-experimental study

Malmgren Fänge, A. LU ; Carlsson, G. LU ; Axmon, A. LU ; Thordardottir, B. LU ; Chiatti, C. LU ; Nilsson, M. H. LU and Ekstam, L. LU (2019) In BMC Public Health 19(1).
Abstract

Background: Standardized, research-based strategies to guide the implementation and evaluate the effects of housing adaptations (HA) on client outcomes are rare. We hypothesized that, compared to ordinary practice, a standardized assessment and evaluation protocol for HA implementation would better maintain or improve client outcomes over 1 year. Method: Using a cluster design, South Swedish municipalities were recruited to an intervention or control group. Data on activities of daily living, usability of the home, health related quality of life, and participation frequency and satisfaction were collected at home visits 1 month before the HA (baseline; T1), and at 3 (T2), 6 (T3) and 12 (T4) months after. In the intervention group (n =... (More)

Background: Standardized, research-based strategies to guide the implementation and evaluate the effects of housing adaptations (HA) on client outcomes are rare. We hypothesized that, compared to ordinary practice, a standardized assessment and evaluation protocol for HA implementation would better maintain or improve client outcomes over 1 year. Method: Using a cluster design, South Swedish municipalities were recruited to an intervention or control group. Data on activities of daily living, usability of the home, health related quality of life, and participation frequency and satisfaction were collected at home visits 1 month before the HA (baseline; T1), and at 3 (T2), 6 (T3) and 12 (T4) months after. In the intervention group (n = 112) data were collected according to a standardized protocol while in the control group (n = 129) ordinary routines were applied. Changes from baseline to subsequent time points were categorized as no deterioration (i.e. improvement or no change) or deterioration, for each outcome item separately. Differences in "no deterioration" between the groups were assessed using logistic regression. Results: Little effect of using the standardized protocol was detected. For activities of daily living, statistically significant differences between the groups were found for toileting (T1-T4; OR 3.14), dressing (T1-T4; OR2.89) and cooking (T1-T3 and T1-T4; OR 3.14). For usability of the home differences were found in personal hygiene (T1-T2; OR 2.32) using a wheelchair (T1-T2 and T1-T3; OR 9.50), picking up the mail (T1-T3; OR 4.06), and in participation, helping others (T1-T3 and T1-T4; OR 2.33 and 3.36). Conclusion: The applied standardized protocol for HA implementation did not show any convincing effect, possibly due to the complexity of the intervention itself, and the implementation process. A process evaluation might generate in-depth knowledge about the reasons behind the findings. Trial registration: ClinicalTrials.gov. NCT01960582.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Activities of daily living, Complex intervention, Disability, Evaluation, Health related quality of life, Home modification, Occupational therapy, Participation, Usability
in
BMC Public Health
volume
19
issue
1
article number
1446
publisher
BioMed Central
external identifiers
  • scopus:85074545275
  • pmid:31684916
ISSN
1471-2458
DOI
10.1186/s12889-019-7815-9
language
English
LU publication?
yes
id
9593070c-cd58-4698-abc1-3bfd9dce9710
date added to LUP
2019-11-18 13:38:45
date last changed
2020-01-13 02:31:58
@article{9593070c-cd58-4698-abc1-3bfd9dce9710,
  abstract     = {<p>Background: Standardized, research-based strategies to guide the implementation and evaluate the effects of housing adaptations (HA) on client outcomes are rare. We hypothesized that, compared to ordinary practice, a standardized assessment and evaluation protocol for HA implementation would better maintain or improve client outcomes over 1 year. Method: Using a cluster design, South Swedish municipalities were recruited to an intervention or control group. Data on activities of daily living, usability of the home, health related quality of life, and participation frequency and satisfaction were collected at home visits 1 month before the HA (baseline; T1), and at 3 (T2), 6 (T3) and 12 (T4) months after. In the intervention group (n = 112) data were collected according to a standardized protocol while in the control group (n = 129) ordinary routines were applied. Changes from baseline to subsequent time points were categorized as no deterioration (i.e. improvement or no change) or deterioration, for each outcome item separately. Differences in "no deterioration" between the groups were assessed using logistic regression. Results: Little effect of using the standardized protocol was detected. For activities of daily living, statistically significant differences between the groups were found for toileting (T1-T4; OR 3.14), dressing (T1-T4; OR2.89) and cooking (T1-T3 and T1-T4; OR 3.14). For usability of the home differences were found in personal hygiene (T1-T2; OR 2.32) using a wheelchair (T1-T2 and T1-T3; OR 9.50), picking up the mail (T1-T3; OR 4.06), and in participation, helping others (T1-T3 and T1-T4; OR 2.33 and 3.36). Conclusion: The applied standardized protocol for HA implementation did not show any convincing effect, possibly due to the complexity of the intervention itself, and the implementation process. A process evaluation might generate in-depth knowledge about the reasons behind the findings. Trial registration: ClinicalTrials.gov. NCT01960582.</p>},
  author       = {Malmgren Fänge, A. and Carlsson, G. and Axmon, A. and Thordardottir, B. and Chiatti, C. and Nilsson, M. H. and Ekstam, L.},
  issn         = {1471-2458},
  language     = {eng},
  month        = {11},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Public Health},
  title        = {Effects of applying a standardized assessment and evaluation protocol in housing adaptation implementation - Results from a quasi-experimental study},
  url          = {http://dx.doi.org/10.1186/s12889-019-7815-9},
  doi          = {10.1186/s12889-019-7815-9},
  volume       = {19},
  year         = {2019},
}