A research-based strategy for managing housing adaptations: study protocol for a quasi-experimental trial

Abstract

BackgroundThe primary aim of this paper is to describe the design of a project evaluating the effects of using a research-based strategy for managing housing adaptations (HAs). The evaluation targets clients’ perspectives in terms of activity, participation, usability, fear of falling, fall incidence, use of mobility devices, and health-related quality of life, and determines the societal effects of HAs in terms of costs. Additional aims of the project are to explore and describe this strategy in relation to experiences and expectations (a) among clients and cohabitants and (b) occupational therapists in ordinary practice.Methods/designThis study is a quasi-experimental trial applying a multiphase design, combining quantitative and qualitative data. At the experimental sites, the occupational therapists (OTs) apply the intervention, i.e. a standardized research-based strategy for HA case management. At the control site, the occupational therapists are following their regular routine in relation to HA. Three municipalities in south Sweden will be included based on their population, their geographical dispersion, and their similar organizational structures for HA administration. Identical data on outcomes is being collected at all the sites at the same four time points: before the HA and then 3, 6, and 12 months after the HA. The data-collection methods are semi-structured qualitative interviews, observations, clinical assessments, and certificates related to each client’s HA.Primary outcomes are the usability of the home and the client’s independence in daily activities (ADL). Cross-sectional and longitudinal data analyses will be conducted as well as statistical analyses, health-economic analyses, and qualitative analyses. Qualitative and quantitative data will be sequentially analyzed, and case studies will be developed.DiscussionThe intervention in this study has been developed and tested through many years of research and in collaboration with practitioners. This process includes methodological development and testing research aimed at identifying the most important outcomes and research targeting current HA case-management procedures in Swedish municipalities. When the study is completed, the results will be used for further optimization of the practice strategy for HA, in close collaboration with the data-collecting OTs.Trial registrationNo: NCT01960582.

Heterogeneity of Characteristics among Housing Adaptation Clients in Sweden—Relationship to Participation and Self-Rated Health

“…This study has a cross-sectional design and draws on baseline data from a larger longitudinal study of housing adaptation clients in three municipalities in southern Sweden [ 4 ].…”

“…The full costs of housing adaptions are borne by municipalities based on a need certification by a health professional. Accordingly, people applying for the grants have certified difficulties with independent living due to physical barriers in their homes [ 4 , 5 ]. They are at risk for declining activity, participation and health due to barriers in the physical environment and may need careful monitoring to avoid further decline.…”

Participation in Everyday Life Before and After a Housing Adaptation

“…In this specific study, the participants were sampled purposefully, to ensure diversity (Creswell, 2014) in terms of gender, age, living arrangements, type of housing, type of HA applied for, and use of mobility devices. Seventeen participants were enrolled in the study when they had applied for an HA, and participated in an interview before the HA.…”

Health-Related Quality of Life among People Applying for Housing Adaptations: Associated Factors

“…People applying for HA are a heterogeneous group, in terms of e.g., age, independence in activities of daily living, participation in social activities and living conditions [ 19 , 20 ]. Most of them are 70 years or older [ 18 ] with declining physical and cognitive capacity due to normal ageing, or diseases such as stroke and dementia.…”