Pragmatic Randomized Control Trial of a Coordinated Community Response: Increasing Access to Services for At-Risk Older Adults.

Abstract

Elder abuse, neglect, and financial exploitation (EANF) impacts over five million community-dwelling older adults. Yet, no evidence-based intervention models exist that prevent EANF. In this article, we describe the assessment of process outcomes for a Community Complex Care Response Team (C3RT) model developed, via a practitioner-researcher partnership, to reduce instances of EANF victimization among higher risk community-dwelling older adults by identifying and coordinating their service needs. Specifically, we evaluated whether this C3RT approach produced more service coordination among providers (measured as documented interagency communications), more referrals for services, and more enrollment in services. A pragmatic randomized control trial using a 1:1 randomization scheme allocated participants to either the C3RT intervention (N = 74) or standard practice (N = 72) group offered by a local Area Agency on Aging. Outcome data were extracted from the participants' administrative service records. The participants assigned to C3RT had significantly more interagency communications and services provided (p < 0.05) than those in standard practice. Communications and services increased across a broad range of multidisciplinary services, which attend to the social determinants of health. This study is the first to use objective outcome measures to evaluate the processes of a coordinated community response approach systematically.