Introduction / Rationale
Falls are often associated with older adults; emerging data reveal even higher fall rates among people with disabilities (PwD). Nearly two-thirds of PwD fall within a year, with even higher rates of injury and fear of falling. Occupational therapists (OTs) are uniquely qualified to address these challenges by delivering home modifications to reduce fall risk.
Objectives
We aimed to adapt the Home Hazard Removal Program (HARP), an evidence-based fall prevention program designed for frail older adults, to meet the needs of middle-aged PwD and assess its feasibility, acceptability, and preliminary impact on fall risk reduction.
Methods / Approach
OTs partnered with community-based organizations to adapt HARP for PwD and establish the feasibility of the adapted program (single-group pre-post design). Adapted HARP was delivered to 14 PwD aged 45–65 and who reported a recent fall or fear of falling over 3–4 sessions. Participants were followed for 30 days. Adaptations were characterized and feasibility was evaluated.
Results / Practice Implications
HARP for PwD participants had more hazards (average of 25.4), a greater need to address architectural barriers and more specialized medical equipment. The adapted intervention was acceptable, with an 86% adherence rate and 89% of participants rating the program as useful. Fall prevention for people with disabilities is an important area of OT practice. The intervention is focused on environmental barriers compared to fall prevention for older people and is aligned with OT practice.
Conclusion / Significance to the Occupational Therapy Profession
By tailoring evidence-based fall prevention to address PwD’s diverse needs, OT can play a critical role in reducing falls to support safe, independent living.