Cited by 138Aging, Health, and DisabilityOccupational Therapy Practice and ResearchFrailty in Older Adults

CAPABLE trial: A randomized controlled trial of nurse, occupational therapist and handyman to reduce disability among older adults: Rationale and design

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Szanton, Sarah L., Wolff, J.W., Leff, B., Thorpe, R.J., Tanner, E.K., Boyd, C., Xue, Q., Guralnik, J. +2 more·2014·Contemporary Clinical Trials

Abstract

BACKGROUND: As the population ages, it is increasingly important to test new models of care that improve life quality and decrease health costs. This paper presents the rationale and design for a randomized clinical trial of a novel interdisciplinary program to reduce disability among low income older adults based on a previous pilot trial of the same design showing strong effect. METHODS: The CAPABLE (Community Aging in Place, Advancing Better Living for Elders) trial is a randomized controlled trial in which low income older adults with self-care disability are assigned to one of two groups: an interdisciplinary team of a nurse, occupational therapist, and handyman to address both personal and environmental risk factors for disability based on participants' functional goals, or an attention control of sedentary activities of choice. Both groups receive up to 10 home visits over 4 months. OUTCOMES: The primary outcome is decreased disability in self-care (ADL). Secondary outcomes are sustained decrease in self care disability as well as improvement in instrumental ADLS, strength, balance, walking speed, and health care utilization. Careful cost tracking and analysis using intervention data and claims data will enable direct measurement of the cost impact of the CAPABLE approach. CAPABLE has the potential to leverage current health care spending in Medicaid waivers, Accountable Care Organizations and other capitated systems to save the health care system costs as well as improving low income older adults' ability to age at home with improved life quality.

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  1. [44]Tanner EK Martinez I Xu J Roth DL Is family support for community-living older adults with chronic illnesses adequate? use of a family support satisfaction scale. Journal of Gerontology B. under review
  2. [45]Tanner EK Feldman RH Social support and appointment keeping among a black chronically ill population. The Negro Educational Review 1989 40 2 15 20

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Authors
Szanton, S. L., Wolff, J. W., Leff, B., Thorpe, R. J., Tanner, E. K., Boyd, C., Xue, Q., Guralnik, J., Bishai, D., & Gitlin, L. N.
Affiliations
Johns Hopkins University (US)
Corresponding author
Szanton, Sarah L.
Venue
Contemporary Clinical Trials
Publisher
Elsevier BV
Published
2014-05
Volume
38
Issue
1
Pages
102-112
ISSN
1551-7144 (ISSN-L)
OpenAlex
W1983685374
Cited by
138
References
62
Citations by year
2026: 7 · 2025: 6 · 2024: 10 · 2023: 10 · 2022: 9 · 2021: 44 · 2020: 11 · 2019: 16 · 2018: 5 · 2017: 7 · 2016: 10 · 2015: 3
FWCI
6.63
Type
journal article
Language
en
Open access
Locations
  • Contemporary Clinical Trials (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Aging (R01-AG040100)
  • Robert Wood Johnson Nurse Faculty Scholars Program (69351)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
  • Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Keywords
self-care disability, older adults, low income, interdisciplinary care teams, nurses, occupational therapists, home visits, aging in place, activities of daily living, instrumental activities of daily living, environmental risk factors, health care costs, Medicaid waivers, accountable care organizations, capitation
MeSH terms
Activities of Daily Living, Aged, Postural Balance, Female, Persons with Disabilities, Disabled Persons, House Calls, Humans, Male, Nurses, Occupational Therapy, Patient Acceptance of Health Care, Poverty, Quality of Life, Research Design, Risk Factors, Socioeconomic Factors, United States, Muscle Strength, Independent Living

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