Effectiveness of a reablement training program for homecare staff on older adults' sedentary behavior: A cluster randomized controlled trial

T.H. Rooijackers*, G.I.J.M. Kempen, G.A.R. Zijlstra, E. van Rossum, A. Koster, V.L. Passos, S.F. Metzelthin

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Web of Science)

Abstract

Background/Objectives Homecare staff often take over activities instead of "doing activities with" clients, thereby hampering clients from remaining active in daily life. Training and supporting staff to integrate reablement into their working practices may reduce clients' sedentary behavior and improve their independence. This study evaluated the effectiveness of the "Stay Active at Home" (SAaH) reablement training program for homecare staff on older homecare clients' sedentary behavior.Design Cluster randomized controlled trial (c-RCT).Setting Dutch homecare (10 nursing teams comprising a total of 313 staff members).Participants 264 clients (aged >= 65 years).Intervention SAaH seeks to equip staff with knowledge, attitude, and skills on reablement, and to provide social and organizational support to implement reablement in homecare practice. SAaH consists of program meetings, practical assignments, and weekly newsletters over a 9-month period. The control group received no additional training and delivered care as usual.Measurements Sedentary behavior (primary outcome) was measured using tri-axial wrist-worn accelerometers. Secondary outcomes included daily functioning (GARS), physical functioning (SPPB), psychological functioning (PHQ-9), and falls. Data were collected at baseline and at 12 months; data on falls were also collected at 6 months. Intention-to-treat analyses using mixed-effects linear and logistic regression were performed.Results We found no statistically significant differences between the study groups for sedentary time expressed as daily minutes (adjusted mean difference: beta 18.5 (95% confidence interval [CI] -22.4, 59.3), p = 0.374) and as proportion of wake/wear time (beta 0.6 [95% CI -1.5, 2.6], p = 0.589) or for most secondary outcomes.Conclusion Our c-RCT showed no evidence for the effectiveness of SAaH for all client outcomes. Refining SAaH, by adding components that intervene directly on homecare clients, may optimize the program and require further research. Additional research should explore the effectiveness of SAaH on behavioral determinants of clients and staff and cost-effectiveness.
Original languageEnglish
Pages (from-to)2566-2578
Number of pages13
JournalJournal of the American Geriatrics Society
Volume69
Issue number9
Early online date2021
DOIs
Publication statusPublished - Sep 2021

Keywords

  • accelerometry
  • home and community-based care services
  • independence
  • reablement training program
  • sedentary behavior
  • PHYSICAL-ACTIVITY LEVELS
  • CARE
  • INTERVENTIONS
  • INDEPENDENCE
  • PEOPLE
  • REHABILITATION
  • SUPPORT
  • TEAM
  • TIME

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