Cognitive Impairment, Physical Activity, Physical Disability
Conditions
Keywords
aging in place, physical activity, cognitive impairment, dementia, affordable housing, subsidized housing, functional impairment, home health aides, activities of daily living
Brief summary
This pilot study will evaluate the feasibility and preliminary effectiveness of an adapted version of the Function Focused Care intervention, delivered by telephone, for improving aging in place for older adults living in subsidized housing. The study will include participants with and without mild cognitive impairment or mild dementia and will examine whether the study outcomes differ by cognitive status. Findings from this study will provide new information about how to optimize function and physical activity among older adults with and without cognitive impairment living in subsidized housing.
Detailed description
Millions of older adults with low incomes live in federally-subsidized housing and are at disproportionate risk for nursing home admission. Effective approaches are needed to improve aging in place for this vulnerable population. The objective of this study is to pilot test the feasibility and preliminary effectiveness of a telephone-based intervention to improve aging in place for older adults living in subsidized housing. In the first phase of this study, the investigators used methods of implementation science to adapt an existing intervention, Function Focused Care for Assisted Living, to the unique setting of affordable housing. Function Focused Care is a philosophy of care in which assisted living staff members engage residents in functional and physical activity during all care interactions. Prior research supports the effectiveness of Function Focused Care for maintaining function and increasing physical activity among older adults in assisted living settings. In the first phase of this study, the investigators interviewed subsidized housing stakeholders - including residents, staff members, and caregivers - to identify barriers, facilitators, and needed adaptations to Function Focused Care for Assisted Living. The investigators used the findings from these interviews to adapt the intervention. In this 2-month pilot study, the investigators will use a wait-list control design with site randomization to assess the feasibility and preliminary effectiveness of the adapted intervention. The investigators will recruit individuals with and without mild cognitive impairment or mild dementia and will examine whether the study outcomes differ by cognitive status. The findings from this study will provide new information about how to optimize function and physical activity among older adults with and without cognitive impairment living in subsidized housing.
Interventions
BEHAVIORALIndependent Living Program for Affordable Housing.
Two-month program intended to increase physical activity and function, including the following 4 steps: 1. Environmental and Policy Assessments: Nurse facilitator works with the affordable housing staff to identify and recommend feasible interventions to alter the environment, policy, and procedures to optimize resident function and physical activity. 2. Education: Nurse educates residents and study partners in the principles of the Independent Living Program, using established materials and adult learning techniques. 3. Establishing Resident Goals: The nurse completes Capability Assessment Forms and helps resident set goals to increase function and physical activity. 4. The nurse helps to motivate and mentor residents and study partners to achieve and maintain their goals, using evidence-based approaches.
Sponsors
University of California, Berkeley
HumanGood
University of Maryland, Baltimore
Diocesan Housing Services Corporation of the Diocese of Camden, Inc
Fair Share Housing Development
National Institute on Aging (NIA)
University of Pennsylvania
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
This is a pilot study testing the adapted Function Focused Care intervention. The study employs a wait-list control design and site randomization.
Eligibility
Sex/Gender
ALL
Age
62 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
, Residents: * Lives in an included subsidized housing setting * 62 years of age or older * Speaks English or Spanish well or very well * Able to provide informed consent OR able to provide assent and has a proxy who provides informed consent on his/her behalf * Has difficulty or needs help in at least 1 ADL and/or IADL OR has mild cognitive impairment or mild dementia based on their Montreal Cognitive Assessment (MoCA) score * Not enrolled in hospice Inclusion Criteria, Study Partners: * Speaks English or Spanish well or very well * Able to provide informed consent * Spends at least an hour per week with the resident Inclusion Criteria, Staff Members: * Speaks English or Spanish well or very well * Able to provide informed consent
Exclusion criteria
, Residents: * Younger than 62 years of age * Does not speak English or Spanish * Lacks decision making capacity and lacks a proxy to consent on his/her behalf * Does not have functional impairment or cognitive impairment * Has moderate to severe dementia based on his/her MoCA score * Is enrolled in hospice
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fidelity to Motivational Interviewing, Measured Using the Motivational Interviewing Treatment Integrity Scale (MITI 4) | 2 months | Assessed by psychologist (4 global scores, scored on a 5-point Likert scale from 1 (low) to 5 (high)) |
| Change in Short Physical Performance Battery Score From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | Baseline, 2 months | Objective measure of lower extremity functioning in older adults (Range, 0-12; higher scores indicate worse lower extremity functioning) The measure will be collected only if in-person contact is possible during the COVID-19 outbreak. |
| Change in Average Step Counts From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | Measured continuously from 0-2 months | Measured using Fitbit |
| Change in Time Spent in Differing Levels of Activity From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | Measured continuously from 0-2 months | Measured using Fitbit (minutes spent in each of 4 levels of activity: sedentary; lightly active; fairly active; very active) |
| Change in Physical Activity Scale for the Elderly (PASE) Score From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | Baseline, 2 months | Self-reported physical activity (Range, 0-793; higher scores indicate greater physical activity) |
| Feasibility of Study Recruitment, Measured as Percentage of Eligible Participants Recruited | 0-4 months | Assessed using participant responses to invitation to participate in the study (enrolled vs. refused) |
| Feasibility of Study Retention, Measured as Percentage of Participants Retained Over Study Follow-up | 0-4 months | Assessed as percentage of participants who remain enrolled in the study |
| Acceptability Assessed Using a Survey Question | 2 months | Self-reported acceptability of the intervention (5-point Likert scale ranging from very unacceptable (1) to very acceptable (5); higher numbers indicate higher acceptability) |
| Number of Participants With High Fidelity to Treatment Protocol, Measured Using Fidelity Checklist | 0-4 months | Number of participants with \>80% fidelity to treatment protocol, measured using fidelity checklist including each study protocol task |
| Change in Precipitating Events Project (PEP) Functional Status Scale From Baseline to 2 Months for Immediate Intervention Sites and Waitlist Control Sites | Baseline, 2 months | Self-reported ability to perform 7 ADLs, 5 IADLs, and 3 mobility tasks (Range, 0-30; higher scores indicate more functional impairment) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Geriatric Depression Scale Short Form (GDS Short Form) Score From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | Baseline, 2 months | Self-reported measure of depressive symptoms (Range, 0-15; score of 5-8 suggests mild depression, 9-11 moderate depression, and 12-15 severe depression) |
| Percentage of Participants With a Hospitalization During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline, 2 months | Self-reported hospitalization |
| Change in Number of Hospitalizations During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline, 2 months | Self-reported number of hospitalizations |
| Percentage of Participants With an Emergency Department Visit During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline, 2 months | Self-reported emergency department visit |
| Change in Number of Emergency Department Visits During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline, 2 months | Self-reported number of emergency department visits |
| Percentage of Participants With a Move to a Higher Level of Care (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline, 2 months | Self-reported or emergency contact-reported move to a higher level of care, defined as a move to assisted living, board and care, or nursing home |
| Percentage of Participants With a Skilled Nursing Facility Stay (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline, 2 months | Self-reported skilled nursing facility stay |
| Change in EuroQol 5 Dimensions (EQ-5D-5L) Scale From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | Baseline, 2 months | Self-reported measure (Range, 11111-55555, converted to a single index utility score ranging from of 0-1; higher scores indicate better quality of life) |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Immediate Intervention Upon enrollment, participants receive the adapted telephone-based intervention, the Independent Living Program for Affordable Housing, for two consecutive months.
Independent Living Program for Affordable Housing.: Two-month program intended to increase physical activity and function, including the following 4 steps:
1. Environmental and Policy Assessments: Nurse facilitator works with the affordable housing staff to identify and recommend feasible interventions to alter the environment, policy, and procedures to optimize resident function and physical activity.
2. Education: Nurse educates residents and study partners in the principles of the Independent Living Program, using established materials and adult learning techniques.
3. Establishing Resident Goals: The nurse completes Capability Assessment Forms and helps resident set goals to increase function and physical activity.
4. The nurse helps to motivate and mentor residents and study partners to achieve and maintain their goals, using evidence-based approaches. | 47 |
| Wait-list Control Two months after study enrollment, participants receive the adapted telephone-based intervention, the Independent Living Program for Affordable Housing, for two consecutive months.
Independent Living Program for Affordable Housing.: Two-month program intended to increase physical activity and function, including the following 4 steps:
1. Environmental and Policy Assessments: Nurse facilitator works with the affordable housing staff to identify and recommend feasible interventions to alter the environment, policy, and procedures to optimize resident function and physical activity.
2. Education: Nurse educates residents and study partners in the principles of the Independent Living Program, using established materials and adult learning techniques.
3. Establishing Resident Goals: The nurse completes Capability Assessment Forms and helps resident set goals to increase function and physical activity.
4. The nurse helps to motivate and mentor residents and study partners to achieve and maintain their goals, using evidence-based approaches. | 28 |
| Total | 75 |
Baseline characteristics
| Characteristic | Immediate Intervention | Wait-list Control | Total |
|---|---|---|---|
| Age, Continuous | 72.5 years STANDARD_DEVIATION 7.9 | 72.3 years STANDARD_DEVIATION 7 | 72.4 years STANDARD_DEVIATION 7.5 |
| Race/Ethnicity, Customized Black, non-Hispanic | 13 Participants | 11 Participants | 24 Participants |
| Race/Ethnicity, Customized Hispanic/Latino | 4 Participants | 13 Participants | 17 Participants |
| Race/Ethnicity, Customized Other (individuals who self-identified as American Indian or Alaska Native, Asian, or other race) | 0 Participants | 2 Participants | 2 Participants |
| Race/Ethnicity, Customized White, non-Hispanic | 30 Participants | 2 Participants | 32 Participants |
| Region of Enrollment United States | 47 Participants | 28 Participants | 75 Participants |
| Sex: Female, Male Female | 42 Participants | 18 Participants | 60 Participants |
| Sex: Female, Male Male | 5 Participants | 10 Participants | 15 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 47 | 0 / 28 |
| other Total, other adverse events | 0 / 47 | 0 / 28 |
| serious Total, serious adverse events | 0 / 47 | 0 / 28 |
Outcome results
Primary
Acceptability Assessed Using a Survey Question
Self-reported acceptability of the intervention (5-point Likert scale ranging from very unacceptable (1) to very acceptable (5); higher numbers indicate higher acceptability)
Time frame: 2 months
Population: Please note that due to loss to follow-up for self-reported outcome measures, the overall number of participants analyzed is not consistent with numbers provided in the rows in the participant flow module.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Immediate Intervention | Acceptability Assessed Using a Survey Question | 4.0 score on a scale |
| Wait-list Control | Acceptability Assessed Using a Survey Question | 5.0 score on a scale |
Primary
Change in Average Step Counts From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites
Measured using Fitbit
Time frame: Measured continuously from 0-2 months
Population: Please note that due to loss to follow-up for self-reported outcome measures, the overall number of participants analyzed is not consistent with numbers provided in the rows in the participant flow module.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Immediate Intervention | Change in Average Step Counts From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | 9,706 steps |
| Wait-list Control | Change in Average Step Counts From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | 3,880 steps |
Primary
Change in Physical Activity Scale for the Elderly (PASE) Score From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites
Self-reported physical activity (Range, 0-793; higher scores indicate greater physical activity)
Time frame: Baseline, 2 months
Population: Please note that due to loss to follow-up for self-reported outcome measures, the overall number of participants analyzed is not consistent with numbers provided in the rows in the participant flow module.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Immediate Intervention | Change in Physical Activity Scale for the Elderly (PASE) Score From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | 4.52 score on a scale | Standard Deviation 38.95 |
| Wait-list Control | Change in Physical Activity Scale for the Elderly (PASE) Score From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | 16.25 score on a scale | Standard Deviation 46 |
Primary
Change in Precipitating Events Project (PEP) Functional Status Scale From Baseline to 2 Months for Immediate Intervention Sites and Waitlist Control Sites
Self-reported ability to perform 7 ADLs, 5 IADLs, and 3 mobility tasks (Range, 0-30; higher scores indicate more functional impairment)
Time frame: Baseline, 2 months
Population: Please note that due to loss to follow-up for self-reported outcome measures, the overall number of participants analyzed is not consistent with numbers provided in the rows in the participant flow module.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Immediate Intervention | Change in Precipitating Events Project (PEP) Functional Status Scale From Baseline to 2 Months for Immediate Intervention Sites and Waitlist Control Sites | -1.3 score on a scale | Standard Deviation 1.7 |
| Wait-list Control | Change in Precipitating Events Project (PEP) Functional Status Scale From Baseline to 2 Months for Immediate Intervention Sites and Waitlist Control Sites | 0.6 score on a scale | Standard Deviation 2.6 |
Primary
Change in Short Physical Performance Battery Score From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites
Objective measure of lower extremity functioning in older adults (Range, 0-12; higher scores indicate worse lower extremity functioning) The measure will be collected only if in-person contact is possible during the COVID-19 outbreak.
Time frame: Baseline, 2 months
Population: Unable to collect data due to visitation restrictions in the setting of the COVID pandemic
Primary
Change in Time Spent in Differing Levels of Activity From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites
Measured using Fitbit (minutes spent in each of 4 levels of activity: sedentary; lightly active; fairly active; very active)
Time frame: Measured continuously from 0-2 months
Population: Please note that all data are missing due to a lack of synced Fitbit data.
Primary
Feasibility of Study Recruitment, Measured as Percentage of Eligible Participants Recruited
Assessed using participant responses to invitation to participate in the study (enrolled vs. refused)
Time frame: 0-4 months
Population: The count exceeds the number analyzed because this is a measure of eligible participants recruited by aim. In the immediate intervention arm, 54 eligible individuals were invited to participate of whom 7 declined and 47 were enrolled; for the waitlist control arm, 33 eligible individuals were invited to participate of whom 5 declined and 28 were enrolled.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Immediate Intervention | Feasibility of Study Recruitment, Measured as Percentage of Eligible Participants Recruited | 47 Participants |
| Wait-list Control | Feasibility of Study Recruitment, Measured as Percentage of Eligible Participants Recruited | 28 Participants |
Primary
Feasibility of Study Retention, Measured as Percentage of Participants Retained Over Study Follow-up
Assessed as percentage of participants who remain enrolled in the study
Time frame: 0-4 months
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Immediate Intervention | Feasibility of Study Retention, Measured as Percentage of Participants Retained Over Study Follow-up | 42 Participants |
| Wait-list Control | Feasibility of Study Retention, Measured as Percentage of Participants Retained Over Study Follow-up | 23 Participants |
Primary
Fidelity to Motivational Interviewing, Measured Using the Motivational Interviewing Treatment Integrity Scale (MITI 4)
Assessed by psychologist (4 global scores, scored on a 5-point Likert scale from 1 (low) to 5 (high))
Time frame: 2 months
Population: Please note that MITI scores were calculated at the level of the nurse providing motivational interviewing rather than at the level of the resident. Thus, only a single score is available for each group.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Immediate Intervention | Fidelity to Motivational Interviewing, Measured Using the Motivational Interviewing Treatment Integrity Scale (MITI 4) | Cultivating change | 4.0 4 scores for subdomains |
| Immediate Intervention | Fidelity to Motivational Interviewing, Measured Using the Motivational Interviewing Treatment Integrity Scale (MITI 4) | Softening sustain | 3.8 4 scores for subdomains |
| Immediate Intervention | Fidelity to Motivational Interviewing, Measured Using the Motivational Interviewing Treatment Integrity Scale (MITI 4) | Partnership | 4.3 4 scores for subdomains |
| Immediate Intervention | Fidelity to Motivational Interviewing, Measured Using the Motivational Interviewing Treatment Integrity Scale (MITI 4) | Empathy | 4.3 4 scores for subdomains |
| Wait-list Control | Fidelity to Motivational Interviewing, Measured Using the Motivational Interviewing Treatment Integrity Scale (MITI 4) | Empathy | 4.3 4 scores for subdomains |
| Wait-list Control | Fidelity to Motivational Interviewing, Measured Using the Motivational Interviewing Treatment Integrity Scale (MITI 4) | Cultivating change | 4.0 4 scores for subdomains |
| Wait-list Control | Fidelity to Motivational Interviewing, Measured Using the Motivational Interviewing Treatment Integrity Scale (MITI 4) | Partnership | 4.3 4 scores for subdomains |
| Wait-list Control | Fidelity to Motivational Interviewing, Measured Using the Motivational Interviewing Treatment Integrity Scale (MITI 4) | Softening sustain | 3.8 4 scores for subdomains |
Primary
Number of Participants With High Fidelity to Treatment Protocol, Measured Using Fidelity Checklist
Number of participants with \>80% fidelity to treatment protocol, measured using fidelity checklist including each study protocol task
Time frame: 0-4 months
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Immediate Intervention | Number of Participants With High Fidelity to Treatment Protocol, Measured Using Fidelity Checklist | 37 Participants |
| Wait-list Control | Number of Participants With High Fidelity to Treatment Protocol, Measured Using Fidelity Checklist | 21 Participants |
Secondary
Change in EuroQol 5 Dimensions (EQ-5D-5L) Scale From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites
Self-reported measure (Range, 11111-55555, converted to a single index utility score ranging from of 0-1; higher scores indicate better quality of life)
Time frame: Baseline, 2 months
Population: Please note that due to loss to follow-up for self-reported outcome measures, the overall number of participants analyzed is not consistent with numbers provided in the rows in the participant flow module.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Immediate Intervention | Change in EuroQol 5 Dimensions (EQ-5D-5L) Scale From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | 0.09 units on a scale | Standard Deviation 0.27 |
| Wait-list Control | Change in EuroQol 5 Dimensions (EQ-5D-5L) Scale From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | -0.05 units on a scale | Standard Deviation 0.34 |
Secondary
Change in Geriatric Depression Scale Short Form (GDS Short Form) Score From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites
Self-reported measure of depressive symptoms (Range, 0-15; score of 5-8 suggests mild depression, 9-11 moderate depression, and 12-15 severe depression)
Time frame: Baseline, 2 months
Population: Please note that due to loss to follow-up for self-reported outcome measures, the overall number of participants analyzed is not consistent with numbers provided in the rows in the participant flow module.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Immediate Intervention | Change in Geriatric Depression Scale Short Form (GDS Short Form) Score From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | -1.26 score on a scale | Standard Deviation 2.23 |
| Wait-list Control | Change in Geriatric Depression Scale Short Form (GDS Short Form) Score From Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites | 0.42 score on a scale | Standard Deviation 2.02 |
Secondary
Change in Number of Emergency Department Visits During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites)
Self-reported number of emergency department visits
Time frame: Baseline, 2 months
Population: Please note that due to loss to follow-up for self-reported outcome measures, the overall number of participants analyzed is not consistent with numbers provided in the rows in the participant flow module.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Immediate Intervention | Change in Number of Emergency Department Visits During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | 0.11 number of visits | Standard Deviation 0.74 |
| Wait-list Control | Change in Number of Emergency Department Visits During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | -0.38 number of visits | Standard Deviation 0.65 |
Secondary
Change in Number of Hospitalizations During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites)
Self-reported number of hospitalizations
Time frame: Baseline, 2 months
Population: Please note that due to loss to follow-up for self-reported outcome measures, the overall number of participants analyzed is not consistent with numbers provided in the rows in the participant flow module.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Immediate Intervention | Change in Number of Hospitalizations During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | -0.18 number of hospitalizations | Standard Deviation 0.61 |
| Wait-list Control | Change in Number of Hospitalizations During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | -0.08 number of hospitalizations | Standard Deviation 0.28 |
Secondary
Percentage of Participants With a Hospitalization During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites)
Self-reported hospitalization
Time frame: Baseline, 2 months
Population: Please note that due to loss to follow-up for self-reported outcome measures, the overall number of participants analyzed is not consistent with numbers provided in the rows in the participant flow module.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Immediate Intervention | Percentage of Participants With a Hospitalization During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline | 4 Participants |
| Immediate Intervention | Percentage of Participants With a Hospitalization During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Follow-up | 1 Participants |
| Wait-list Control | Percentage of Participants With a Hospitalization During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline | 2 Participants |
| Wait-list Control | Percentage of Participants With a Hospitalization During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Follow-up | 1 Participants |
Secondary
Percentage of Participants With a Move to a Higher Level of Care (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites)
Self-reported or emergency contact-reported move to a higher level of care, defined as a move to assisted living, board and care, or nursing home
Time frame: Baseline, 2 months
Population: Please note that due to loss to follow-up for self-reported outcome measures, the overall number of participants analyzed is not consistent with numbers provided in the rows in the participant flow module.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Immediate Intervention | Percentage of Participants With a Move to a Higher Level of Care (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline | 0 Participants |
| Immediate Intervention | Percentage of Participants With a Move to a Higher Level of Care (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Follow-up | 0 Participants |
| Wait-list Control | Percentage of Participants With a Move to a Higher Level of Care (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Follow-up | 0 Participants |
| Wait-list Control | Percentage of Participants With a Move to a Higher Level of Care (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline | 0 Participants |
Secondary
Percentage of Participants With an Emergency Department Visit During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites)
Self-reported emergency department visit
Time frame: Baseline, 2 months
Population: Please note that due to loss to follow-up for self-reported outcome measures, the overall number of participants analyzed is not consistent with numbers provided in the rows in the participant flow module.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Immediate Intervention | Percentage of Participants With an Emergency Department Visit During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline | 5 Participants |
| Immediate Intervention | Percentage of Participants With an Emergency Department Visit During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Follow-up | 7 Participants |
| Wait-list Control | Percentage of Participants With an Emergency Department Visit During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline | 6 Participants |
| Wait-list Control | Percentage of Participants With an Emergency Department Visit During the Study Period (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Follow-up | 3 Participants |
Secondary
Percentage of Participants With a Skilled Nursing Facility Stay (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites)
Self-reported skilled nursing facility stay
Time frame: Baseline, 2 months
Population: Please note that due to loss to follow-up for self-reported outcome measures, the overall number of participants analyzed is not consistent with numbers provided in the rows in the participant flow module.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Immediate Intervention | Percentage of Participants With a Skilled Nursing Facility Stay (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline | 1 Participants |
| Immediate Intervention | Percentage of Participants With a Skilled Nursing Facility Stay (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Follow-up | 0 Participants |
| Wait-list Control | Percentage of Participants With a Skilled Nursing Facility Stay (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Baseline | 0 Participants |
| Wait-list Control | Percentage of Participants With a Skilled Nursing Facility Stay (Baseline to 2 Months for Immediate Intervention and Waitlist Control Sites) | Follow-up | 0 Participants |