This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
The number of Americans who are ages 65 and older is increasing steadily. Although much research has looked at how to care for older adults who are frail, questions remain about how to help healthy older adults stay healthy and continue to live on their own.
In this study, the research team is comparing two ways to help older adults living in low-income housing maintain their health and independence. In the first way, nurses deliver a healthcare program in older adults’ apartments. In the second way, trained teachers lead health and wellness classes in older adults’ apartment buildings.
Who can this research help?
Results may help health systems, policy makers, and directors of housing services when considering ways to promote health and well-being in diverse community settings.
What is the research team doing?
This study is taking place in 18 low-income apartment buildings for older adults in Los Angeles County, California. The research team is inviting tenants who are ages 60 and older and who can perform basic activities of daily living, such as walking and dressing, to take part in the study. The team is assigning buildings by chance to offer one of two programs for helping older adults continue to live on their own. Both programs take place in the buildings.
In the first program, a nurse meets with a tenant in their apartment. The nurse assesses the tenant’s physical health and emotional well-being and notes any health risks. Then the nurse works with the tenant to tailor a plan to help the tenant modify their behavior to maintain or improve their health and independence. Plans may address home safety, how to manage medicines, or exercise or food choices that are in line with the tenant’s own health goals. Every three months, the nurse returns to answer questions and help tenants follow or update their plan. Nurses also help tenants find and use healthcare services.
In the second program, trained teachers offer tenants weekly exercise, social and emotional health, and wellness classes that take place in the tenant’s building. Exercise classes focus on movement, preventing falls, and improving symptoms of arthritis. Mental health classes include activities to help prevent depression and improve memory. Wellness classes cover various topics that the tenants choose, such as managing medicines and building computer skills. Teachers hold five classes each week.
The research team is surveying tenants at the start of the study and again 9 and 18 months later. Surveys ask about overall health, physical health, and mental health. The team is also looking at outcomes such as use of health care for injury and illness, self-care behaviors, and which classes tenants prefer.
Tenants who live in buildings in the study are meeting with the research team to provide input on the study. Doctors, housing services, and hospital administrators are also advising the team on this study.
Research methods at a glance
|Design||Randomized controlled trial|
|Population||640 adults ages 60 and older who can perform basic activities of daily living and who live in 1 of 18 older adult low-income independent living apartment buildings in Los Angeles County, California|
Primary: global health, physical functioning (Physical Functioning Subscale of the Patient-Reported Outcomes Measurement Information System [PROMIS®] 10-item Global Health Scale), mental functioning
Secondary: physical functioning (PROMIS Physical Functioning Short Form 10b); general self-efficacy; self-efficacy for managing daily activities with a chronic condition; self-efficacy for managing social interactions; loneliness and social isolation; self-report of number of injury falls, emergency department visits, hospital admissions, and skilled nursing facility/nursing home/rehabilitation admissions in the past 9 and 18 months; primary and preventive care visits; participants’ engagement in preventive health behaviors; attendance at health education classes; participant preferences for offered services
|Timeframe||18-month follow-up for primary outcomes|
- Cardiovascular Diseases
- Congestive Heart Failure
- Cardiovascular Diseases
- Mental/Behavioral Health
- Muscular and Skeletal Disorders
- Nutritional and Metabolic Disorders
- Respiratory Diseases
- Chronic Obstructive Pulmonary Disease
- Multiple/Comorbid Chronic Conditions