Early Ambulation
Conditions
Keywords
Walking, Inpatients, Veterans, Early Ambulation, Quality of Life
Brief summary
Optimizing Function and Independence Through STRIDE aims to implement the STRIDE inpatient hospital mobility program at 8 VAMC sites in a stepped-wedge design and evaluate patient outcomes before and after the program is implemented, as well as the efficacy of a usual vs enhanced implementation design.
Detailed description
Background/Purpose. A key contributor to hospital-associated disability is immobility during hospitalization. While fewer than 5% of patients have physician orders for bed rest, hospitalized older adults spend only 3% of their time standing or walking. The hazards of immobility in the hospital have been recognized for more than two decades, but there are currently no VA-system wide approaches to address this important gap in clinical care. STRIDE is a supervised inpatient walking program developed by an interdisciplinary team of investigators, clinicians and administrators at the Durham VA and funded by the VHA Office of GEC. STRIDE consists of a one-time gait and balance assessment conducted by a physical therapist, followed by daily supervised walks by a recreation therapy assistant for the duration of the hospital stay. Program evaluation has demonstrated high satisfaction among Veteran participants and reduced need for post-acute institutional care. As a result, the Durham VAMC funded STRIDE as a permanent program that currently serves over 650 Veterans annually, and the VHA Office of GEC funded a dissemination grant to launch the program at another medical center. The investigators' initial experience with STRIDE implementation suggests interprofessional relationships and team dynamics are key determinants to the success of a new hospital-based clinical program that requires collaborative processes involving multiple disciplines. As part of the investigators' Optimizing Function and Independence QUERI, the investigators plan to implement the STRIDE clinical program at 8 VAMC sites in a stepped-wedge design with sites randomized to implementation strategy and start date. Objectives. The investigators plan to conduct an evaluation to examine the impact of STRIDE on patient outcomes. Key questions: Do STRIDE participants have fewer discharges to skilled nursing facilities and shorter lengths of stay? Do STRIDE participants have better physical function and higher health-related quality of life at 30 days post-discharge? What is the value of STRIDE from the Veteran's perspective? The investigators also plan to conduct a mixed method evaluation that examines implementation outcomes and provider team experience that will not be reported here. Methodology. The investigators will compare patients discharged from sites before and after the STRIDE program is implemented to assess discharge to skilled nursing facilities and length of stay (approx. n=2000). A subset of patients participating in the STRIDE program and a comparison group will be surveyed 30 days post-hospital discharge to assess outcomes including health status, physical function, and quality of life. A subset of patients will be interviewed one week post-discharge to gain feedback about the STRIDE program and perceived benefits of a hospital inpatient mobility program. In 2023, the following updates were made after results were initially uploaded to clinical trials as follows: primary outcome description and results were modified to reflect discharge to skilled nursing facility versus discharge to home and modifications were made to the sample and discharge to skilled nursing home and length of stay outcomes due to receipt of more complete data sources for use to determine eligibility and to assess the primary outcome.
Interventions
BEHAVIORALSTRIDE
Implementation of STRIDE inpatient hospital mobility program
Sponsors
VA Office of Research and Development
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Stepped Wedge Cluster Randomized Trial - a form of crossover design with unidirectional crossover (from control to experimental) but with randomization of when each cluster undertakes the transition. In the stepped wedge design, there is a staggered roll-out of the intervention, where the time and sequence of clusters that will start the intervention at each period determined by random allocation.
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion/Exclusion listed here apply to subset of patients providing consent for telephone interviews: * Able and willing to provide informed consent (does not lack decision-making capacity) * Discharged from a participating hospital within the preceding 30 days * Age \>= 60 * Index admission for medical illness * Community-dwelling (i.e. not in a nursing home or institutional care) prior to hospital visit * Ability to ambulate safely and independently (does not need help walking across a small room) * Valid telephone number in the medical record * Admitted to a STRIDE ward and discharged from a STRIDE ward * Index hospital stay was in a ward identified to participate in the STRIDE program
Exclusion criteria
* Patient deceased * Index hospital stay was \< 2 business days * Currently hospitalized * Current high-risk suicide flag in medical record * Diagnosis of cognitive impairment or dementia * Difficulty with or unable to communicate on the telephone, or no telephone access * Discharged to another hospital or acute care setting * Transferred into index hospital from another hospital * Bedrest order not lifted for at least 2 days on STRIDE ward
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of Patients Discharged to Skilled Nursing Facility | Assessed at hospital discharge, an average of 7 days | Discharge to skilled nursing facility (versus home) will be assessed via administrative data pulls and chart review (not patient report). |
| Hospital Length of Stay (Days) | Assessed at hospital discharge, an average of 7 days | Hospital length of stay will be assessed via administrative data pulls (not patient report) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient Physical Function | 30 days following hospital discharge, hospital stay an average of 6 days | Analysis of physical function will be measured by the Late Life Function and Disability Instrument (LL-FDI) - Function Component - Basic Lower Extremity Functioning Domain. Raw scores transformed to scaled scores ranging from 0-100, with higher scores reflecting higher functioning. |
| Proportion Highly Satisfied With Care | 30 days following hospital discharge, hospital stay an average of 6 days | Analysis of satisfaction with care will be measured with the Consumer Assessment of Healthcare Providers and Systems (CAHPS)-based item Would you recommend this hospital to other Veterans if they needed care for a condition such as yours? Responses were categorized into two categories: highly satisfied (responses of Definitely Yes) and less satisfied (responses of Probably Yes, Probably No, and Definitely No). |
| Health Utility | 30 days following hospital discharge, hospital stay an average of 6 days | Analysis of health utility, a health-related quality of life measure, will be assessed with the ICEpop CAPability measure for adults (ICECAP-A). Tariff values for an overall state are calculated by summing the values across the individual attributes (Feeling settled and secure; Love, friendship and support; Being independent; Achievement and progress; and Enjoyment and pleasure). Tariff values can range from 0 to 1, with higher values reflecting greater quality of life. |
| Health-related Quality of Life | 30 days following hospital discharge, hospital stay an average of 6 days | Analysis of health-related quality of life will be measured by the Euroqol (EQ-5D). Response profiles are mapped to a score via a crosswalk. Scores range from -0.109 to 1.0, with higher scores reflecting a higher quality of life. |
| Mobility in the Environment | 30 days following hospital discharge, hospital stay an average of 6 days | Analysis of mobility in the environment will be assessed by the Life Space Questionnaire. The composite score incorporates use of equipment, need for personal help, and frequency of movement. Scores range from 0-120 with higher scores reflecting greater mobility. |
| Patient Physical Function - Disability | 30 days following hospital discharge, hospital stay an average of 6 days | Analysis of physical function will be measured by the Late Life Function and Disability Instrument (LL-FDI) - Disability Component. Raw scores transformed to scaled scores ranging from 0-100, with higher scores reflecting higher functioning. |
| Patient Physical Function - Limitations | 30 days following hospital discharge, hospital stay an average of 6 days | Analysis of physical function will be measured by the Late Life Function and Disability Instrument (LL-FDI) - Limitations Component -Instrumental Role Domain. Raw scores transformed to scaled scores ranging from 0-100, with higher scores reflecting higher functioning. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Depression | 30 days following hospital discharge, hospital stay an average of 6 days | Analysis of depression will be assessed with the Center for Epidemiologic Studies Depression Scale (CESD-10). Scores range from 0-30, with higher scores reflecting more depressive symptoms |
| PROMIS-29 Pain Subscale | 30 days following hospital discharge, hospital stay an average of 6 days | Analysis of pain will be assessed with the pain subscale of the Patient-Reported Outcomes Measurement Information System (PROMIS-29). Raw scores converted to t-scores ranging from 41.6 to 75.6. Higher scores indicate higher (worse) pain interference. |
| Proportion of Participants Self-reporting at Least One Fall | 30 days following hospital discharge, hospital stay an average of 6 days | Veterans self-reporting at least one fall in the 30 days since discharge from an eligible hospitalization, as queried during a telephone survey. |
| Sleep | 30 days following hospital discharge, hospital stay an average of 6 days | Analysis of sleep functioning will be assessed with the sleep subscale of the Patient-Reported Outcomes Measurement Information System (PROMIS-29). Raw scores converted to t-scores ranging from 32.0 to 73.3. Higher scores indicate more sleep disturbance. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Intervention Implementation of STRIDE program
STRIDE: Implementation of STRIDE inpatient hospital mobility program | 7,134 |
| Intervention Implementation of STRIDE program
STRIDE: Implementation of STRIDE inpatient hospital mobility program | 9,070 |
| Usual Care Pre-implementation before STRIDE program | 6,723 |
| Usual Care Pre-implementation before STRIDE program | 8,167 |
| Total | 31,094 |
Baseline characteristics
| Characteristic | Intervention | Total | Usual Care |
|---|---|---|---|
| Age, Continuous | 73.0 years STANDARD_DEVIATION 8.6 | 72.9 years STANDARD_DEVIATION 8.7 | 72.8 years STANDARD_DEVIATION 8.8 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 157 patient hospitalizations | 592 patient hospitalizations | 435 patient hospitalizations |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 8751 patient hospitalizations | 16377 patient hospitalizations | 7626 patient hospitalizations |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 162 patient hospitalizations | 268 patient hospitalizations | 106 patient hospitalizations |
| Race (NIH/OMB) American Indian or Alaska Native | 56 patient hospitalizations | 102 patient hospitalizations | 46 patient hospitalizations |
| Race (NIH/OMB) Asian | 10 patient hospitalizations | 17 patient hospitalizations | 7 patient hospitalizations |
| Race (NIH/OMB) Black or African American | 2468 patient hospitalizations | 4886 patient hospitalizations | 2418 patient hospitalizations |
| Race (NIH/OMB) More than one race | 70 patient hospitalizations | 161 patient hospitalizations | 91 patient hospitalizations |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 43 patient hospitalizations | 96 patient hospitalizations | 53 patient hospitalizations |
| Race (NIH/OMB) Unknown or Not Reported | 217 patient hospitalizations | 352 patient hospitalizations | 135 patient hospitalizations |
| Race (NIH/OMB) White | 6206 patient hospitalizations | 11623 patient hospitalizations | 5417 patient hospitalizations |
| Region of Enrollment United States | 9070 patient hospitalizations | 17237 patient hospitalizations | 8167 patient hospitalizations |
| Sex: Female, Male Female | 308 patient hospitalizations | 521 patient hospitalizations | 213 patient hospitalizations |
| Sex: Female, Male Male | 8762 patient hospitalizations | 16716 patient hospitalizations | 7954 patient hospitalizations |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 7,134 | 0 / 6,723 |
| other Total, other adverse events | 0 / 7,134 | 0 / 6,723 |
| serious Total, serious adverse events | 0 / 7,134 | 0 / 6,723 |
Outcome results
Primary
Hospital Length of Stay (Days)
Hospital length of stay will be assessed via administrative data pulls (not patient report)
Time frame: Assessed at hospital discharge, an average of 7 days
Population: Length of stay was analyzed for the first hospitalization for each patient during the study period. Patients can be in both intervention and usual care groups if hospitalized during the respective intervention and usual care time periods; however, for this outcome patients will be analyzed in only one group, based upon the earliest of their hospitalizations if had more than one.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Hospital Length of Stay (Days) | 6.92 Days | Standard Error 0.21 |
| Usual Care | Hospital Length of Stay (Days) | 6.58 Days | Standard Error 0.2 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the 7 post-baseline time points), a site-level random effect and random effects for each of the time periods. Model was not adjusted for patient characteristics. Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.2595% CI: [0.97, 1.15]generalized linear model
Primary
Proportion of Patients Discharged to Skilled Nursing Facility
Discharge to skilled nursing facility (versus home) will be assessed via administrative data pulls and chart review (not patient report).
Time frame: Assessed at hospital discharge, an average of 7 days
Population: Discharge to skilled nursing facility was analyzed for the first hospitalization for each patient during the study period. Patients can be in both intervention and usual care groups if hospitalized during the respective intervention and usual care time periods; however, for this outcome patients will be analyzed in only one group, based upon the earliest of their hospitalizations if had more than one.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Proportion of Patients Discharged to Skilled Nursing Facility | 0.16 proportion of patients | Standard Error 0.02 |
| Usual Care | Proportion of Patients Discharged to Skilled Nursing Facility | 0.20 proportion of patients | Standard Error 0.03 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the 7 post-baseline timepoints), and a site-level random effect. Model was not adjusted for patient characteristics. Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.0195% CI: [0.64, 0.93]generalized linear model
Secondary
Health-related Quality of Life
Analysis of health-related quality of life will be measured by the Euroqol (EQ-5D). Response profiles are mapped to a score via a crosswalk. Scores range from -0.109 to 1.0, with higher scores reflecting a higher quality of life.
Time frame: 30 days following hospital discharge, hospital stay an average of 6 days
Population: Veterans completing a telephone survey 30 days after discharge from an eligible hospitalization. While Veterans may have multiple eligible hospitalizations, in the study framework Veterans can only be surveyed once.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Health-related Quality of Life | 0.76 score on a scale | Standard Error 0.02 |
| Usual Care | Health-related Quality of Life | 0.73 score on a scale | Standard Error 0.02 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the time periods) and a site-level random effect. Model was not adjusted for patient characteristics.~Missing data due to item nonresponse in usual care: 7 out of 227 Missing data due to item nonresponse in intervention: 23 out of 399~Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.1895% CI: [-0.01, 0.07]Mixed Models Analysis
Secondary
Health Utility
Analysis of health utility, a health-related quality of life measure, will be assessed with the ICEpop CAPability measure for adults (ICECAP-A). Tariff values for an overall state are calculated by summing the values across the individual attributes (Feeling settled and secure; Love, friendship and support; Being independent; Achievement and progress; and Enjoyment and pleasure). Tariff values can range from 0 to 1, with higher values reflecting greater quality of life.
Time frame: 30 days following hospital discharge, hospital stay an average of 6 days
Population: Patients completing a telephone survey 30 days post discharge
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Health Utility | 0.82 score on a scale | Standard Error 0.02 |
| Usual Care | Health Utility | 0.80 score on a scale | Standard Error 0.01 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the time periods) and a site-level random effect. Model was not adjusted for patient characteristics.~Missing data due to item nonresponse in usual care: 14 out of 227 Missing data due to item nonresponse in intervention: 33 out of 399~Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.495% CI: [-0.03, 0.06]Mixed Models Analysis
Secondary
Mobility in the Environment
Analysis of mobility in the environment will be assessed by the Life Space Questionnaire. The composite score incorporates use of equipment, need for personal help, and frequency of movement. Scores range from 0-120 with higher scores reflecting greater mobility.
Time frame: 30 days following hospital discharge, hospital stay an average of 6 days
Population: Veterans completing a telephone survey 30 days after discharge from an eligible hospitalization. While Veterans may have multiple eligible hospitalizations, in the study framework Veterans can only be surveyed once.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Mobility in the Environment | 58.81 score on a scale | Standard Error 3.26 |
| Usual Care | Mobility in the Environment | 58.01 score on a scale | Standard Error 3.02 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the time periods) and a site-level random effect. Model was not adjusted for patient characteristics.~Missing data due to item nonresponse in usual care: 1 out of 227 Missing data due to item nonresponse in intervention: 4 out of 399~Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.8395% CI: [-6.38, 7.98]Mixed Models Analysis
Secondary
Patient Physical Function
Analysis of physical function will be measured by the Late Life Function and Disability Instrument (LL-FDI) - Function Component - Basic Lower Extremity Functioning Domain. Raw scores transformed to scaled scores ranging from 0-100, with higher scores reflecting higher functioning.
Time frame: 30 days following hospital discharge, hospital stay an average of 6 days
Population: Patient telephone survey 30 days post discharge
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Patient Physical Function | 67.88 score on a scale | Standard Error 1.64 |
| Usual Care | Patient Physical Function | 68.40 score on a scale | Standard Error 1.5 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the time periods) and a site-level random effect.. Model was not adjusted for patient characteristics.~Missing data due to item nonresponse in usual care group: 5 out of 227 Missing data due to item nonresponse in intervention group: 14 out of 399~Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.8195% CI: [-4.74, 3.7]Mixed Models Analysis
Secondary
Patient Physical Function - Disability
Analysis of physical function will be measured by the Late Life Function and Disability Instrument (LL-FDI) - Disability Component. Raw scores transformed to scaled scores ranging from 0-100, with higher scores reflecting higher functioning.
Time frame: 30 days following hospital discharge, hospital stay an average of 6 days
Population: Veterans completing a telephone survey 30 days after discharge from an eligible hospitalization. While Veterans may have multiple eligible hospitalizations, in the study framework Veterans can only be surveyed once.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Patient Physical Function - Disability | 67.31 score on a scale | Standard Error 1.55 |
| Usual Care | Patient Physical Function - Disability | 65.99 score on a scale | Standard Error 1.39 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the time periods) and a site-level random effect. Model was not adjusted for patient characteristics.~Missing data due to item nonresponse in usual care group: 5 out of 227 Missing data due to item nonresponse in intervention group: 18 out of 399~Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.5295% CI: [-2.7, 5.33]Mixed Models Analysis
Secondary
Patient Physical Function - Limitations
Analysis of physical function will be measured by the Late Life Function and Disability Instrument (LL-FDI) - Limitations Component -Instrumental Role Domain. Raw scores transformed to scaled scores ranging from 0-100, with higher scores reflecting higher functioning.
Time frame: 30 days following hospital discharge, hospital stay an average of 6 days
Population: Veterans completing a telephone survey 30 days after discharge from an eligible hospitalization. While Veterans may have multiple eligible hospitalizations, in the study framework Veterans can only be surveyed once.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Patient Physical Function - Limitations | 65.67 score on a scale | Standard Error 1.84 |
| Usual Care | Patient Physical Function - Limitations | 64.12 score on a scale | Standard Error 1.66 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the time periods) and a site-level random effect. Model was not adjusted for patient characteristics.~Missing data due to item nonresponse in usual care group: 5 out of 227 Missing data due to item nonresponse in intervention group: 18 out of 399~Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.6695% CI: [-3.14, 6.25]Mixed Models Analysis
Secondary
Proportion Highly Satisfied With Care
Analysis of satisfaction with care will be measured with the Consumer Assessment of Healthcare Providers and Systems (CAHPS)-based item Would you recommend this hospital to other Veterans if they needed care for a condition such as yours? Responses were categorized into two categories: highly satisfied (responses of Definitely Yes) and less satisfied (responses of Probably Yes, Probably No, and Definitely No).
Time frame: 30 days following hospital discharge, hospital stay an average of 6 days
Population: Veterans completing a telephone survey 30 days after discharge from an eligible hospitalization. While Veterans may have multiple eligible hospitalizations, in the study framework Veterans can only be surveyed once.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Proportion Highly Satisfied With Care | 0.85 proportion of patients | Standard Error 0.04 |
| Usual Care | Proportion Highly Satisfied With Care | 0.84 proportion of patients | Standard Error 0.04 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the time periods) and a site-level random effect. Model was not adjusted for patient characteristics.~Missing data due to item nonresponse in usual care: 0 out of 227 Missing data due to item nonresponse in intervention: 5 out of 399~Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.7495% CI: [0.55, 2.32]generalized linear model
Other Pre-specified
Depression
Analysis of depression will be assessed with the Center for Epidemiologic Studies Depression Scale (CESD-10). Scores range from 0-30, with higher scores reflecting more depressive symptoms
Time frame: 30 days following hospital discharge, hospital stay an average of 6 days
Population: Veterans completing a telephone survey 30 days after discharge from an eligible hospitalization. While Veterans may have multiple eligible hospitalizations, in the study framework Veterans can only be surveyed once.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Depression | 9.04 score on a scale | Standard Error 0.57 |
| Usual Care | Depression | 9.11 score on a scale | Standard Error 0.53 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the time periods) and a site-level random effect. Model was not adjusted for patient characteristics.~Missing data due to item nonresponse in usual care: 2 out of 227 Missing data due to item nonresponse in intervention group: 7 out of 399~Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.9495% CI: [-1.76, 1.62]Mixed Models Analysis
Other Pre-specified
PROMIS-29 Pain Subscale
Analysis of pain will be assessed with the pain subscale of the Patient-Reported Outcomes Measurement Information System (PROMIS-29). Raw scores converted to t-scores ranging from 41.6 to 75.6. Higher scores indicate higher (worse) pain interference.
Time frame: 30 days following hospital discharge, hospital stay an average of 6 days
Population: Veterans completing a telephone survey 30 days after discharge from an eligible hospitalization. While Veterans may have multiple eligible hospitalizations, in the study framework Veterans can only be surveyed once.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | PROMIS-29 Pain Subscale | 56.46 score on a scale | Standard Error 0.96 |
| Usual Care | PROMIS-29 Pain Subscale | 55.47 score on a scale | Standard Error 0.91 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the time periods) and a site-level random effect. Model was not adjusted for patient characteristics.~Missing data due to item nonresponse in usual care: 11 out of 227 Missing data due to item nonresponse in intervention: 20 out of 399~Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.4795% CI: [-1.71, 3.69]Mixed Models Analysis
Other Pre-specified
Proportion of Participants Self-reporting at Least One Fall
Veterans self-reporting at least one fall in the 30 days since discharge from an eligible hospitalization, as queried during a telephone survey.
Time frame: 30 days following hospital discharge, hospital stay an average of 6 days
Population: Veterans completing a telephone survey 30 days after discharge from an eligible hospitalization. While Veterans may have multiple eligible hospitalizations, in the study framework Veterans can only be surveyed once.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Proportion of Participants Self-reporting at Least One Fall | 0.18 proportion of patients | Standard Error 0.02 |
| Usual Care | Proportion of Participants Self-reporting at Least One Fall | 0.16 proportion of patients | Standard Error 0.03 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the time periods) and a site-level random effect. Model was not adjusted for patient characteristics.~Missing data due to item nonresponse in usual care: 1 out of 227 Missing data due to item nonresponse in intervention: 3 out of 399~Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.5995% CI: [0.68, 1.99]generalized linear model
Other Pre-specified
Sleep
Analysis of sleep functioning will be assessed with the sleep subscale of the Patient-Reported Outcomes Measurement Information System (PROMIS-29). Raw scores converted to t-scores ranging from 32.0 to 73.3. Higher scores indicate more sleep disturbance.
Time frame: 30 days following hospital discharge, hospital stay an average of 6 days
Population: Veterans completing a telephone survey 30 days after discharge from an eligible hospitalization. While Veterans may have multiple eligible hospitalizations, in the study framework Veterans can only be surveyed once.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Sleep | 51.79 score on a scale | Standard Error 0.98 |
| Usual Care | Sleep | 50.33 score on a scale | Standard Error 0.9 |
Comparison: Model included a time-varying indicator for when STRIDE program launched, fixed effects for time (indicator variables for each of the time periods) and a site-level random effect. Model was not adjusted for patient characteristics.~Missing data due to item nonresponse in usual care: 2 out of 227 Missing data due to item nonresponse in intervention: 6 out of 399~Estimated means and standard errors are provided in Outcome Measure Data table.p-value: 0.2595% CI: [-1.05, 3.96]Mixed Models Analysis