A HAPA-based Multicomponent Fall Intervention on Older Adults With Declines in Intrinsic Capacity in Nursing Homes

NCT ID: NCT05891782

Last Updated: 2025-03-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-12-01

Study Completion Date

2024-12-30

Brief Summary

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Falls are a common geriatric syndrome that impedes healthy aging and are the primary cause of accidental death in older adults. Globally, more than 50% of older adults experience falls in nursing homes each year. Intrinsic capacity (IC) is a quantifiable measure of healthy aging, and consists of five dimensions: cognitive, locomotor, vitality, sensory (vision and hearing), and psychological capacity. Decline in IC is an independent factor in the occurrence of falls in older adults. A related theoretical framework indicates that healthy behaviors are the key to enhance IC. The health action process approach (HAPA) has been shown to have positive effects on health behavior promotion. Therefore, the aim of this study is to examine the effect of multidimensional fall management based on HAPA on fall risk, fall efficacy, and healthy aging among older adults with declines in IC in Chinese nursing homes.

Detailed Description

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Method: First, a randomly selected nursing home in Huzhou, will be selected for the study using the WHO Intrinsic Ability Screening Scale for older adults with declines in IC. A baseline assessment will be conducted followed by clustered randomization to divide into an intervention group (n=50) and a control group (n=50). All subjects will be intervened, after signing the informed consent. The subjects will be assessed by blinded evaluators for primary and secondary outcomes at at study baseline (T0), 4 weeks for the intention intervention (T1), 12 weeks for the action intervention (T2), and 8 weeks for the follow-up (T3). Finally, data collection and statistical processing will be carried out.

Expected results:

Reduce falls risk among the nursing home residents of the intervention group. Improvement of IG among the intervention group. Improvement of healthy aging among the intervention group.

Conditions

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Fall Risk

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The study was planned as a randomized controlled clinical trial; by clustered randomization method, cases will be divided into two groups. There are 100 older adults in the nursing home to be studied. Study was planned as group 1 and group 2. The subjects will be assessed by blinded evaluators for primary and secondary outcomes at study baseline (T0), 4 weeks for the intention intervention (T1), 12 weeks for the action intervention (T2), and 8 weeks for the follow-up (T3).
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Intervention group

A HAPA-based multicomponent fall intervention will use group education, individualized plans and face-to-face interviews to develop health behaviors, such as fall emergency management, IC enhancement (exercise management, diet management, cognitive improvement, psychological regulation, vision protection), medication and disease management, environmental improvement, and fall self-efficacy enhancement.

Group Type EXPERIMENTAL

HAPA-based Multidomain Fall Risk Management

Intervention Type BEHAVIORAL

According to the HAPA and the conceptual model of IC, this intervention consists of 3 stages.

Stage 1: The main format will be group lectures and scenario simulation, each intervention will have a duration of 30 to 45 minutes. Intervention content will utilize BCT \[5.1, 5.3, 5.5, 5.6, 9.3, 15.1\] .

Stage 2: This stage will utilize mostly group lectures or one-to-one interviews, to provide an action and coping plan to participants for fall risk management. This will apply BCT \[1.1-1.4, 4.1\] at week 4.Firstly, individualized targets will be established. Secondly, professionals and participants will collaborate to develop an implementation plan.

Stage 3:Recovery self-efficacy will be implemented as group discussions, with each intervention lasting 15-30 minutes. Maintenance will be implemented in one-to-one interviews, with each intervention lasting 15-30 minutes.Finally, the consolidation and outlook will provide the foundation for the habit formation of healthy behaviors.

Control Group

The control group will receive the same overall duration and frequency of interventions as the intervention group.

Group Type EXPERIMENTAL

Regular health education lectures

Intervention Type BEHAVIORAL

Weeks 1-4 will be provided with fall-related regular health education lectures. Weeks 5-16 will have regular activities according to the daily arrangement of the nursing home. Meanwhile, telephone, WeChat, or face-to-face interviews will be conducted fortnightly, to understand the needs of the participants. During the process, staff will provide usual care such as vital signs monitoring, disease treatment, medication prescription, and health record maintenance.

Interventions

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HAPA-based Multidomain Fall Risk Management

According to the HAPA and the conceptual model of IC, this intervention consists of 3 stages.

Stage 1: The main format will be group lectures and scenario simulation, each intervention will have a duration of 30 to 45 minutes. Intervention content will utilize BCT \[5.1, 5.3, 5.5, 5.6, 9.3, 15.1\] .

Stage 2: This stage will utilize mostly group lectures or one-to-one interviews, to provide an action and coping plan to participants for fall risk management. This will apply BCT \[1.1-1.4, 4.1\] at week 4.Firstly, individualized targets will be established. Secondly, professionals and participants will collaborate to develop an implementation plan.

Stage 3:Recovery self-efficacy will be implemented as group discussions, with each intervention lasting 15-30 minutes. Maintenance will be implemented in one-to-one interviews, with each intervention lasting 15-30 minutes.Finally, the consolidation and outlook will provide the foundation for the habit formation of healthy behaviors.

Intervention Type BEHAVIORAL

Regular health education lectures

Weeks 1-4 will be provided with fall-related regular health education lectures. Weeks 5-16 will have regular activities according to the daily arrangement of the nursing home. Meanwhile, telephone, WeChat, or face-to-face interviews will be conducted fortnightly, to understand the needs of the participants. During the process, staff will provide usual care such as vital signs monitoring, disease treatment, medication prescription, and health record maintenance.

Intervention Type BEHAVIORAL

Other Intervention Names

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HAPA-MFRM Usual care

Eligibility Criteria

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Inclusion Criteria

1. Age ≥ 60 years.
2. Living in the nursing home for ≥ 3 months.
3. WHO screening tool identifies at least one dimension of decline in IC.
4. Ability to move independently (non-disabled) with a score of ≥ 4 on the SPPB.

(4) Voluntary involvement in the trial and informed consent provided by the participant.

Exclusion Criteria

1. Have severe visual or hearing deprivation.
2. Have severe mental impairment or severe cognitive deficits (i.e., severe depression, schizophrenia).
3. Have severe and terminal heart, liver, brain, and kidney disease (i.e., tumors, brain trauma).
4. Other trials received within 6 months prior to the study.
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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ZHANG Qing-hua

OTHER

Sponsor Role lead

Responsible Party

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ZHANG Qing-hua

PhD, associate professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Qinghua Zhang, PhD

Role: PRINCIPAL_INVESTIGATOR

School of Medicine & Nursing Sciences, Huzhou University

Locations

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Huzhou Social Welfare Center

Huzhou, Zhejiang, China

Site Status

Countries

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China

References

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Beard JR, Officer AM, Cassels AK. The World Report on Ageing and Health. Gerontologist. 2016 Apr;56 Suppl 2:S163-6. doi: 10.1093/geront/gnw037. No abstract available.

Reference Type BACKGROUND
PMID: 26994257 (View on PubMed)

Zhou Y, Ma L. Intrinsic Capacity in Older Adults: Recent Advances. Aging Dis. 2022 Apr 1;13(2):353-359. doi: 10.14336/AD.2021.0818. eCollection 2022 Apr.

Reference Type BACKGROUND
PMID: 35371613 (View on PubMed)

Chhetri JK, Xue QL, Ma L, Chan P, Varadhan R. Intrinsic Capacity as a Determinant of Physical Resilience in Older Adults. J Nutr Health Aging. 2021;25(8):1006-1011. doi: 10.1007/s12603-021-1629-z.

Reference Type BACKGROUND
PMID: 34545921 (View on PubMed)

Schwarzer R, Lippke S, Luszczynska A. Mechanisms of health behavior change in persons with chronic illness or disability: the Health Action Process Approach (HAPA). Rehabil Psychol. 2011 Aug;56(3):161-70. doi: 10.1037/a0024509.

Reference Type BACKGROUND
PMID: 21767036 (View on PubMed)

Treacy D, Hassett L. The Short Physical Performance Battery. J Physiother. 2018 Jan;64(1):61. doi: 10.1016/j.jphys.2017.04.002. Epub 2017 Jun 20. No abstract available.

Reference Type BACKGROUND
PMID: 28645532 (View on PubMed)

Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, Albarede JL. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999 Feb;15(2):116-22. doi: 10.1016/s0899-9007(98)00171-3.

Reference Type BACKGROUND
PMID: 9990575 (View on PubMed)

Xia NG, Lin JH, Ding SQ, Dong FR, Shen JZ, Du YR, Wang XS, Chen YY, Zhu ZG, Zheng RY, Xu HQ. Reliability and validity of the Chinese version of the Patient Health Questionnaire 9 (C-PHQ-9) in patients with epilepsy. Epilepsy Behav. 2019 Jun;95:65-69. doi: 10.1016/j.yebeh.2019.03.049. Epub 2019 Apr 24.

Reference Type BACKGROUND
PMID: 31026785 (View on PubMed)

Lach HW, Ball LJ, Birge SJ. The Nursing Home Falls Self-Efficacy Scale: development and testing. Clin Nurs Res. 2012 Feb;21(1):79-91. doi: 10.1177/1054773811426927. Epub 2011 Oct 31.

Reference Type BACKGROUND
PMID: 22042908 (View on PubMed)

Thanakwang K, Soonthorndhada K. Mechanisms by which social support networks influence healthy aging among Thai community-dwelling elderly. J Aging Health. 2011 Dec;23(8):1352-78. doi: 10.1177/0898264311418503. Epub 2011 Aug 23.

Reference Type BACKGROUND
PMID: 21862701 (View on PubMed)

Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. doi: 10.1111/j.1532-5415.1986.tb05480.x. No abstract available.

Reference Type BACKGROUND
PMID: 3944402 (View on PubMed)

Shang S, Cheng S, Qi L, Liu T, Yang Y, Yao X, Lu D, Cheng X, Yang J, Cheng M, Zhang Q. Effectiveness of HAPA-based multidomain fall risk management for older adults with declining intrinsic capacity in nursing homes: protocol of a randomised controlled trial. BMJ Open. 2025 Apr 30;15(4):e082702. doi: 10.1136/bmjopen-2023-082702.

Reference Type DERIVED
PMID: 40306996 (View on PubMed)

Other Identifiers

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HuzhouU

Identifier Type: -

Identifier Source: org_study_id

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