3 research outputs found
Effectiveness of a reablement training program for homecare staff on older adults' sedentary behavior: A c luster randomized controlled trial
BACKGROUND/OBJECTIVES: Homecare staff often take over activities instead of âdoing activities withâ 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 âStay Active at Homeâ (SAaH) reablement training program for homecare staff on older homecare clients' sedentary behavior. DESIGN: Cluster randomized controlled trial (câRCT). SETTING: Dutch homecare (10 nursing teams comprising a total of 313 staff members). PARTICIPANTS: 264 clients (aged â„65âyears). 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 9âmonth period. The control group received no additional training and delivered care as usual. MEASUREMENTS: Sedentary behavior (primary outcome) was measured using triâaxial wristâworn accelerometers. Secondary outcomes included daily functioning (GARS), physical functioning (SPPB), psychological functioning (PHQâ9), and falls. Data were collected at baseline and at 12âmonths; data on falls were also collected at 6âmonths. Intentionâtoâtreat analyses using mixedâeffects 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: ÎČ 18.5 (95% confidence interval [CI] â22.4, 59.3), p = 0.374) and as proportion of wake/wear time (ÎČ 0.6 [95% CI â1.5, 2.6], p = 0.589) or for most secondary outcomes. CONCLUSION: Our câRCT 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 costâeffectiveness