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BMC Geriatrics
Published in: BMC Geriatrics 1/2018

Open Access 01-12-2018 | Study protocol

Effects, costs and feasibility of the ‘Stay Active at Home’ Reablement training programme for home care professionals: study protocol of a cluster randomised controlled trial

Authors: Silke F. Metzelthin, Teuni H. Rooijackers, Gertrud A. R. Zijlstra, Erik van Rossum, Marja Y. Veenstra, Annemarie Koster, Silvia M. A. A. Evers, Gerard J. P. van Breukelen, Gertrudis I. J. M. Kempen

Published in: BMC Geriatrics | Issue 1/2018

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Abstract

Background

According to the principles of Reablement, home care services are meant to be goal-oriented, holistic and person-centred taking into account the capabilities and opportunities of older adults. However, home care services traditionally focus on doing things for older adults rather than with them. To implement Reablement in practice, the ‘Stay Active at Home’ programme was developed. It is assumed that the programme leads to a reduction in sedentary behaviour in older adults and consequently more cost-effective outcomes in terms of their health and wellbeing. However, this has yet to be proven.

Methods/ design

A two-group cluster randomised controlled trial with 12 months follow-up will be conducted. Ten nursing teams will be selected, pre-stratified on working area and randomised into an intervention group (‘Stay Active at Home’) or control group (no training). All nurses of the participating teams are eligible to participate in the study. Older adults and, if applicable, their domestic support workers (DSWs) will be allocated to the intervention or control group as well, based on the allocation of the nursing team. Older adults are eligible to participate, if they: 1) receive homecare services by the selected teams; and 2) are 65 years or older. Older adults will be excluded if they: 1) are terminally ill or bedbound; 2) have serious cognitive or psychological problems; or 3) are unable to communicate in Dutch. DSWs are eligible to participate if they provide services to clients who fulfil the eligibility criteria for older adults. The study consists of an effect evaluation (primary outcome: sedentary behaviour in older adults), an economic evaluation and a process evaluation. Data for the effect and economic evaluation will be collected at baseline and 6 and/or 12 months after baseline using performance-based and self-reported measures. In addition, data from client records will be extracted. A mixed-methods design will be applied for the process evaluation, collecting data of older adults and professionals throughout the study period.

Discussion

This study will result in evidence about the effectiveness, cost-effectiveness and feasibility of the ‘Stay Active at Home’ programme.

Trial registration

ClinicalTrials.gov: NCT03293303, registered on 20 September 2017.
Literature
1.
Tappenden P, Campbell F, Rawdin A, Wong R, Kalita N. The clinical effectiveness and cost-effectiveness of home-based nurse-led health promotion for older people: a systematic review. Health Technol Assess. 2012;16(20):1–72.CrossRef
2.
De Klerk M. Zorg in de laatste jaren. Gezondheid en hulpgebruik in verzorgings- en verpleeghuizen 2000-2008. The Hague, The Netherlands: Sociaal en Cultureel Planbureau; 2011.
3.
Liebel DV, Friedman B, Watson NM, Powers BA. Review of nurse home visiting interventions for community-dwelling older persons with existing disability. Med Care Res Rev. 2009;66(2):119–46.CrossRef
4.
Shah RC, Buchman AS, Leurgans S, Boyle PA, Bennett DA. Association of total daily physical activity with disability in community-dwelling older persons: a prospective cohort study. BMC Geriatr. 2012;22(63):1–8.
5.
Paterson DH, Warburton DE. Physical activity and functional limitations in older adults: a systematic review related to Canada’s physical activity guidelines. Int J Behav Nutr Phys Act. 2010;7(38):1–22.
6.
Motl RW, McAuley E. Physical activity, disability, and quality of life in older adults. Phys Med Rehabil Clin N Am. 2010;21(2):299–308.CrossRef
7.
De Vries NM, van Ravensberg CD, Hobbelen JS, Olde Rikkert MG, Staal JB, Nijhuis-van der Sanden MW. Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Res Rev. 2012;11(1):136–49.CrossRef
8.
Chad KE, Reeder BA, Harrison EL, Ashworth NL, Sheppard SM, Schultz SL, et al. Profile of physical activity levels in communitydwelling older adults. Med Sci Sports Exerc. 2005;37(10):1774–84.CrossRef
9.
Davis MG, Fox KR, Hillsdon M, Sharp DJ, Coulson JC, Thompson JL. Objectively measured physical activity in a diverse sample of older urban UK adults. Med Sci Sports Exerc. 2001;43:647–54.CrossRef
10.
Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, et al. Amount of time spent in sedentary behaviors in the United States. Am J Epidemiol. 2008;167:875–81.CrossRef
11.
Resnick B. Functional performance and exercise of older adults in long- term care settings. J Gerontol Nurs. 2000;26(3):7–16.CrossRef
12.
13.
Resnick B, Boltz M, Galik E, Pretzer-Aboff I. Restorative care nursing for older adults: a guide for all care settings 2nd ed. New York: Springer Publishing Company; 2012.
14.
V&VN. V&V 2020 Beroepsprofiel verpleegkundige 2012.
15.
Resnick B, Galik E, Boltz M. Function focused care approaches: literature review of progress and future possibilities. J Am Med Dir Assoc. 2013;14(5):313–8.CrossRef
16.
Aspinal F, Glasby J, Rostgaard T, Tuntland H, Westendorp RG. New horizons: reablement - supporting older people towards independence. Age Ageing. 2016;45(5):574–8.CrossRef
17.
Whitehead PJ, Worthington EJ, Parry RH, Walker MF, Drummond AE. Interventions to reduce dependency in personal activities of daily living in community dwelling adults who use homecare services: a systematic review. Clin Rehabil. 2015;29(11):1064–76.CrossRef
18.
Metzelthin SF, Zijlstra GAR, de Man-van Ginkel JM, van Rossum E, Resnick B, Lewin G, et al. ‘Doing with…’ rather than ‘doing for…’ older adults: rationale and content of the ‘Stay Active at Home’ programme. Clin Rehabil. 2017;31(11):1419–30.CrossRef
19.
Legg L, Gladman J, Drummond A, Davidson A. A systematic review of the evidence on home care reablement services. Clin Rehabil. 2015;30(8):741–9.CrossRef
20.
Tessier A, Beaulieu MD, Mcginn CA, Latulippe R. Effectiveness of reablement: a systematic review. Healthc Policy. 2016;11(4):49–59.PubMedPubMedCentral
21.
Cochrane A, Furlong M, McGilloway S, Molloy DW, Stevenson M, Donnelly M. Time-limited home-care reablement services for maintaining and improving the functional independence of older adults. Cochrane Database Syst Rev. 2016;10:CD010825.PubMed
22.
Burton E, Lewin G, Boldy D. Physical activity levels of older adults receiving a home care service. J Aging Phys Act. 2013;21(2):140–54.CrossRef
23.
Lewin G, De San MK, Knuiman M, Alan J, Boldy D, Hendrie D, et al. A randomised controlled trial of the home Independence program, an Australian restorative home-care programme for older adults. Health Soc Care Community. 2013;21(1):69–78.CrossRef
24.
Winkel A, Langberg H, Wæhrens EE. Reablement in a community setting. Disabil Rehabil. 2015;37(15):1347–52.CrossRef
25.
Lewin G, Vandermeulen S. A non-randomised controlled trial of the home Independence program (HIP): an Australian restorative programme for older home-care clients. Health Soc Care Community. 2010;18(1):91–9.PubMed
26.
Tuntland H, Aaslund MK, Espehaug B, Førland O, Kjeken I. Reablement in community-dwelling older adults: a randomised controlled trial. BMC Geriatr. 2015;15(145):1–11.
27.
King AII, Parsons M, Robinson E, Joergensen D. Assessing the impact of a restorative home care service in New Zealand: a cluster randomised controlled trial. Health Soc Care Community. 2012;20(4):365–74.CrossRef
28.
Glendinning C, Jones K, Baxter K, Rabbie P, Curtis LA, Wilde A, Glendinning C, Jones K, Baxter K, Rabbie P, Curtis LA, Wilde A, Arksey H, Forder JE, et al. Home care Re-ablement services: investigating the longer-term impacts (prospective longitudinal study). York/Canterburry: Social Policy Research Unit (SPRU)/Personal Social Service Research Unit (PSSRU); 2010. http://​www.​york.​ac.​uk/​inst/​spru/​research/​pdf/​Reablement.​pdf
29.
Lewin G, Allan J, Patterson C, Knuiman M, Boldy D, Hendrie D. A comparison of the home-care and healthcare service use and costs of older Australians randomised to receive a restorative or a conventional home-care service. Health Soc Care Community. 2014;22(3):328–36.CrossRef
30.
Parsons M, Senior HEJ, Kerse N, Chen M, Jacobs S, Vanderhoorn S, et al. The assessment of services promoting Independence and recovery in elders trial (ASPIRE): a pre-planned meta-analysis of three independent randomised controlled trial evaluations of ageing in place initiatives in New Zealand. Age Ageing. 2012;41:722–8.CrossRef
31.
Lewin GF, Alfonso HS, Alan JJ. Evidence for the long term cost effectiveness of home care reablement programs. Clin Interv Aging. 2013;8:1273–81.CrossRef
32.
Zwakhalen SMG, Hamers JHP, Metzelthin SF, Ettema R, Heinen M, de Man-van Ginkel JM, et al. Essential nursing care: most provided, least evidence. Time to change: the Basic Care Revisited research program. J Clin Nurs. 2018;27(11–12):2496–505.CrossRef
33.
Chan A-W, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.CrossRef
34.
Chan A-W, Tetzlaff JM, Gøtzsche PC, Altman DG, Mann H, Berlin JA, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:–e7586.CrossRef
35.
Prochaska JO, DiClemente CC. Stages and processes of self-change in smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51(3):390–5.CrossRef
36.
Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12:38–48.CrossRef
37.
Bandura A. Social foundations of thought and action: a social-cognitive theory: Englewood cliffs. Prentice Hall: NJ; 1986.
38.
Bandura A. Self-efficacy: the exercise of control. New York, NY: W.H. Freeman and Company; 1997.
39.
Santos-Lozano A, Marín PJ, Torres-Luque G, Ruiz JR, Lucía A, Garatachea N. Technical variability of the GT3X accelerometer. Med Eng Phys. 2012;34(6):187–90.CrossRef
40.
Copeland JL, Esliger DW. Accelerometer assessment of physical activity in active, healthy older adults. J Aging Phys Act. 2009;17(1):17–30.CrossRef
41.
Pruitt LA, Glynn NW, King AC, Guralnik JM, Aiken EK, Miller G, et al. Use of accelerometry to measure physical activity in older adults at risk for mobility disability. J Aging Phys Act. 2008;16(4):416–34.CrossRef
42.
Sasaki JE, John D, Freedson PS. Validation and comparison of ActiGraph activity monitors. J Sci Med Sport. 2011;14(5):411–6.CrossRef
43.
Schrack JA, Cooper R, Koster A, Shiroma EJ, Murabito JM, Rejeski WJ, et al. Assessing daily physical activity in older adults: unraveling the complexity of monitors, measures, and methods. J Gerontol A Biol Sci Med Sci. 2016;71(8):1039–48.CrossRef
44.
45.
Koster A, Shiroma EJ, Caserotti P, Matthews CE, Chen KY, Glynn NW, et al. Comparison of sedentary estimates between activPAL and hip and wrist-worn ActiGraph. Med Sci Sports Excers. 2016;48(8):1514–22.CrossRef
46.
Visser M, Koster A. Development of a questionnaire to assess sedentary time in older persons – a comparative study using accelerometry. BMC Geriatr. 2013;13(80):1–8.
47.
Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol A Biol Sci Med Sci. 1994;49(2):M85–94.CrossRef
48.
Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55(4):M221–31.CrossRef
49.
Ostir GV, Volpato S, Fried LP, Chaves P, Guralnik JM, Women’s Health and Aging Study. WsHaA. Reliability and sensitivity to change assessed for a summary measure of lower body function: results from the Women’s health and aging study. J Clin Epidemiol. 2002;55(9):916–21.CrossRef
50.
Kempen GIJM, Miedema I, Ormel J, Molenaar W. The assessment of disability with the Groningen activity restriction scale. Conceptual framework and psychometric properties. Soc Sci Med. 1996;43(11):1601–10.CrossRef
51.
Lamers F, Jonkers CC, Bosma H, Penninx BW, Knottnerus JA, van Eijk JT. Summed score of the patient health Questionnaire-9 was a reliable and valid method for depression screening in chronically ill elderly patients. J Clin Epidemiol. 2008;61(7):679–87.CrossRef
52.
Zijlstra GAR. Managing concerns about falls. Fear of falling and avoidance of activity in older people. [PhD thesis]. Maastricht: Maastricht University; 2008.
53.
Resnick B, Galik E, Gruber-Baldini AL, Zimmerman S. Falls and fall-related injuries associated with function-focused care. Clin Nurs Res. 2012;21(1):43–63.CrossRef
54.
Knies S, Dragt NM, Enzing JJ, LAH H, SMC V. Richtlijn voor het uitvoeren van economische evaluaties in de gezondheidszorg. Diemen: Zorginstituut Nederland; 2015.
55.
Hakkaart-van Roijen L, Van der Linden N, Bouwmans C, Kanters T, Swan TS. Bijlagen Kostenhandleiding. Methodologie van kostenonderzoek en referentieprijzen voor economische evaluaties in de gezondheidszorg. Rotterdam: Zorginstituut Nederland; 2015.
56.
The EuroQol Group. EuroQol* - a new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199–208.CrossRef
57.
Brooks R. EuroQol: the current state of play. Health Policy. 1996;37(1):53–72.CrossRef
58.
Herdman M, Gudex C, Lloyd A, Janssen MF, Kind P, Parkin D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20(10):1727–36.CrossRef
59.
Van Reenen M, Janssen B. EQ-5D-5L user guide basic information on how to use the EQ-5D-5L instrument. Rotterdam: EuroQol Research Foundation; 2015.
60.
Versteegh MM, Vermeulen KM, Evers SMAA, Wit A, Prenger R, Stolk EA. Dutch tariff for the five-level version of EQ-5D. Value Health. 2016;19(4):343–52.CrossRef
61.
Bouwmans C, Hakkaart-van Roijen L, Koopmanschap M, Krol M, Severens H, Brouwer W. Handleiding iMTA medical cost questionnaire (iMCQ). Rotterdam: Zorginstituut Nederland; 2013.
62.
Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ. 2015;350:h1258.CrossRef
63.
64.
Van Breukelen GJ, Candel MJ. Calculating sample sizes for cluster randomized trials: we can keep it simple and efficient! J Clin Epidemiol. 2012;65(11):1212–8.CrossRef
65.
Béland S, Pichette F, Jolani S. Impact on Cronbach’s α of simple treatmen tmethods for missing data. Quan Meth Psyc. 2016;12(1):57–73.CrossRef
66.
Drummond MF, Sculpher MJ, Thorrance GW, O’Brien BJ, Stoddard GL. Methods for the economic evaluation of health care programmes. 3rd edition ed. New York: Oxford University Press; 2005.
67.
Card JJ, Solomon J, Cunningham SD. How to adapt effective programs for use in new contexts. Health Promot Pract. 2011;12(1):25–35.CrossRef
68.
Davies S, BNolan M. Editorial nurturing research partnerships with older people and their carers: learning from experience. Qual Ageing. 2003;4(4):2–5.CrossRef
69.
Vossen C, Slager M. Wilbrink N. Utrecht: Handboek participatie voor ouderen in zorg- en welzijnsprojecten; 2010.
70.
Verbeek H, Zwakhalen SM, Schols JM, Hamers JHP. Keys to successfully embedding scientific research in nursing homes: a win-win perspective. J Am Med Dir Assoc. 2013;14(12):855–7.CrossRef
71.
Arnstein S. A ladder of citizen participation. J Am Inst Plann. 1969;35:214–22.
72.
Bandura A. Health promotion from the perspective of social cognitive theory. Psychol Health. 1998;13(4):623–49.CrossRef
73.
Bandura A, Ross D, Ross SA. Vicarious reinforcement and imitative learning. J Abnorm Psychol. 1963;67:601–7.PubMed
74.
Spritzer RL. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA. 1999;282(18):1737–44.CrossRef
75.
Resnick B, Galik E, Pretzer-Aboff I, Rogers V, Gruber-Baldini AL. Testing the reliability and validity of self-efficacy and outcome expectations of restorative care performed by nursing assistants. J Nurs Care Qual. 2008;23(2):162–9.CrossRef
76.
Resnick B, Simpson M, Bercovitz A, Galik E, Gruber-Baldini AL, Zimmerman S, et al. Testing of the res-care pilot intervention: impact on nursing assistants. Geriatr Nurs. 2004;25(5):292–7.CrossRef
77.
Resnick B, Simpson M. Restorative care nursing activities: pilot testing self-efficay and outcome expectation measure. Geriatr Nurs. 2003;24(2):82–9.CrossRef
78.
Resnick B. Reliability and validity testing of the self-efficacy for functional activity scale. J Nurs Meas. 1999;7:5–20.CrossRef
Metadata
Title
Effects, costs and feasibility of the ‘Stay Active at Home’ Reablement training programme for home care professionals: study protocol of a cluster randomised controlled trial
Authors
Silke F. Metzelthin
Teuni H. Rooijackers
Gertrud A. R. Zijlstra
Erik van Rossum
Marja Y. Veenstra
Annemarie Koster
Silvia M. A. A. Evers
Gerard J. P. van Breukelen
Gertrudis I. J. M. Kempen
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2018
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-018-0968-z

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