A Process Evaluation of a Fall Prevention Intervention Using the RE-AIM Framework

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Background: Home hazard removal programs are effective in reducing falls among older adults, but delivery in the United States is limited. Objectives: We completed a process evaluation of the Home Hazard Removal Program (HARP), an intervention delivered by occupational therapists. Methods: Using the RE-AIM framework (reach, effectiveness, adoption, implementation, maintenance), we examined outcomes using descriptive statistics and frequency distribution. We examined differences between covariates using Pearson correlation coefficients and two-sample t tests. Results: 79.1% of eligible older adults participated (reach); they experienced a 38% reduction in fall rates (effectiveness). Ninety percent of recommended strategies were completed (adoption), 99% of intervention elements were delivered (implementation), and 91% of strategies were still used at 12 months (maintenance). Participants received an average of 258.6 minutes of occupational therapy. An average of US$765.83 was spent per participant to deliver the intervention. Conclusions: HARP has good reach, effectiveness, adherence, implementation, and maintenance and is a low-cost intervention.

Original languageEnglish
Pages (from-to)278-286
Number of pages9
JournalOTJR Occupation, Participation and Health
Issue number2
StatePublished - Apr 2024


  • environment
  • evidence-based practice
  • intervention
  • occupational therapy
  • older adults


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