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Adapting, Implementing and Evaluating the Effectiveness of HARP for People With Disabilities

Adapting, Implementing and Evaluating the Effectiveness of the Home Hazard Removal Program for People With Disabilities

Who can join

Ages 45 to 64 · All sexes

Inclusion Criteria:

* age 45-64 years
* self-report of difficulty with ≥2 daily activities
* have had a physical disability for ≥5 years (e.g., spinal cord injury, cerebral palsy, post-polio syndrome, stroke, amputation)
* live in the City of St. Louis
* had a fall in the past year, or are worried about falling, or feel unsteady when standing or walking

Exclusion Criteria:

• individuals who are institutionalized

About the study

The Home Hazard Removal Program (HARP) is an effective fall prevention intervention program which targets home hazard identification/removal. In this study the investigators will examine the effectiveness and implementation potential of HARP, adapted for PwD. Investigators will conduct a pilot randomized control trial (RCT) to test the implementation, cost, and preliminary efficacy of an adapted version of HARP for community-dwelling PwD. The single-blinded feasibility RCT will randomize 40 participants to treatment (adapted HARP) and 40 to a waitlist control group. Data on specific types of fall hazards and resulting home modifications as well as falls and fall-related injuries (collected monthly over 12 months) and fear of falling (collected at baseline and 12 months) will inform the preliminary efficacy of adapted HARP among PwD. To ensure usefulness, relevance, and broad dissemination of findings, the investigators will adopt a "designing for implementation and dissemination" approach. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework will guide intervention adaptation, trial design, and future implementation. The Practical Robust Implementation and Sustainability Model (PRISM) guides study development by identifying multi-level contextual factors hypothesized to affect the RE-AIM outcomes.

What is being tested

• Adapted HARP (behavioral)

Sponsor: Washington University School of Medicine · Participants: 80 · Started: Aug 20, 2025

Contact the study team

• Susan L Stark, PhD · Phone: (314)935-2551
• Rebecca M Bollinger, OTD · Phone: (314)935-2503

Official record on ClinicalTrials.gov — NCT07033897

Locations in the U.S.

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.