Multimodal Intervention for Older Adults After an Earthquake

NCT ID: NCT07273253

Last Updated: 2025-12-09

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-09-15
• Study Completion Date: 2025-07-15

Brief Summary

This randomized controlled study was conducted among older adults (≥65 years) living in temporary container housing in Kahramanmaraş after the February 2023 earthquakes. A total of 60 participants meeting inclusion criteria were recruited and randomized into two groups: an intervention group (n=30) and a control group (n=30). Randomization was performed using a sealed envelope method following minimization based on frailty scores (Edmonton Frailty Scale ≥4).

The intervention group received a 12-week health management program designed with a holistic approach, addressing physical, mental, and nutritional health needs. Individualized exercise prescriptions (balance, strength, range of motion, posture correction), lifestyle counseling, nutrition education, and medication use training were provided under professional supervision. The control group received no active intervention and only underwent assessments at baseline and at the end of the study.

Measurements were performed at baseline and after 12 weeks. Primary assessments included frailty status (Edmonton Frailty Scale), balance and mobility (Berg Balance Scale, Timed Up and Go Test, Functional Reach Test, Gyko postural sway analysis), physical activity level (PASE questionnaire), physical performance (Short Physical Performance Battery), muscle strength (hand dynamometer, pinch meter, digital force measurement), posture (PostureScreen app), and nutritional status (Mini Nutritional Assessment, anthropometric measures). Cognitive and mental health were evaluated using the Mini-Mental State Examination (MMSE) and the Geriatric Anxiety Scale. Quality of life was assessed with the Nottingham Health Profile.

The study aims to determine whether a structured, holistic health management plan can improve balance, physical activity, and overall health outcomes compared with control in older adults living in post-disaster temporary housing. Findings are expected to inform rehabilitation and preventive health strategies for vulnerable elderly populations in disaster settings.

Detailed Description

This randomized controlled trial was designed to address the health priorities of older adults (≥65 years) living in temporary container housing following the devastating Kahramanmaraş earthquakes in February 2023. Recognizing the unique vulnerabilities of elderly individuals in post-disaster environments - such as frailty, physical inactivity, limited access to care, and psychosocial distress - the study implemented a multidisciplinary, holistic intervention targeting their comprehensive health needs.

Participants were allocated into two groups (intervention and control) based on frailty stratification using the Edmonton Frailty Scale and randomized using a sealed-envelope method. The intervention group received a 12-week individualized health management program, tailored to physical, mental, and nutritional domains. The program was developed and delivered by a multidisciplinary team including physiotherapists, geriatric nurses, nutritionists, and mental health professionals.

The intervention included:

Physical health sessions: individualized exercise plans for posture correction, mobility, strength, and balance.

Nutritional counseling: personalized dietary education based on individual risk factors and nutritional deficiencies.

Mental health support: education on coping mechanisms, peer group interaction, and anxiety-reducing strategies.

Medication education: safe drug use training, including awareness of polypharmacy and drug-food interactions.

All sessions were conducted in person within the container housing area, considering participants' mobility limitations. Adherence was monitored throughout the study. The control group underwent only baseline and 12-week follow-up assessments and received no active intervention during the trial period.

This trial aims to demonstrate the feasibility and effectiveness of a holistic health model in disaster-stricken elderly populations. The approach moves beyond disease management, incorporating lifestyle reorganization and psychosocial support. The findings are intended to contribute to the creation of post-disaster rehabilitation guidelines and policies for geriatric populations in similar emergency settings.

Conditions

Frailty at Older Adults; Post-Traumatic Stress Disorder in Old Age; Depression in Adults; Malnutrition Elderly; Falls (Accidents) in Old Age

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Study Group

Individuals over the age of 65 who experienced the earthquake

Group Type: EXPERIMENTAL

Multimodal intervention

Intervention Type: OTHER

Pre-earthquake and post-earthquake health problems were identified, and general health status was assessed using a holistic approach. A health management plan was developed to address changing health priorities, and this plan was implemented by the participants under the supervision and consultancy of the researchers. A three-month health management plan and observation were conducted to determine the impact of the health management plan and recommendations on quality of life. Participants' general health status was reassessed at the end of the study.

Control Group

Individuals over the age of 65 who experienced the earthquake

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Multimodal intervention

Pre-earthquake and post-earthquake health problems were identified, and general health status was assessed using a holistic approach. A health management plan was developed to address changing health priorities, and this plan was implemented by the participants under the supervision and consultancy of the researchers. A three-month health management plan and observation were conducted to determine the impact of the health management plan and recommendations on quality of life. Participants' general health status was reassessed at the end of the study.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Living in a container city,
• Scoring 4 or below on the vulnerability scale,
• Being an earthquake victim,
• Being able to understand verbal commands and being over 65 years of age,
• Being able to speak and understand Turkish,
• Volunteering to participate in the research.

Exclusion Criteria

• Not being an earthquake victim,
• Not living in a container,
• Being under 65 years of age,
• Not knowing or understanding Turkish,
• Not wanting to participate in the study,
• Not being able to understand verbal commands,
• Having received any psychological diagnosis,
• Having undergone any surgery within the last 6 months,
• Scoring 5 or above on the frailty scale.

• Minimum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Kahramanmaras Sutcu Imam University

OTHER

Sponsor Role: lead

Responsible Party

Yusuf Şinasi Kirmaci

Assistant Professor, PhD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Yusuf Şinasi KIRMACI, Assist.Prof

Role: PRINCIPAL_INVESTIGATOR

Kahramanmaras Sutcü Imam University

Locations

Kahramanmaras Sutcu İmam University

Kahramanmaraş, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

EARTHQUAKE_GERIARTRIC_1

Identifier Type: -

Identifier Source: org_study_id