PROGRAMS, POLICIES, AND SERVICES TO FACILITATE AGING IN PLACE

Abstract

Abstract Rooted in the person-environment-fit theory, home modification has been tested as an intervention to support older adults to age safely at home by improving functioning and reducing fall risks. Home modification is often a complex process, involving multiple steps and various stakeholders. As such, proper implementation is important to its effectiveness. However, limited research has focused on how to implement home modification from a comprehensive perspective. To advance the implementation science of home modification for older adults and achieve a better understanding of promising practices, we conducted a scoping analysis of review articles, referred to as umbrella review, to identify strategies that have been found effective in implementing home modification. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P), after performing a thorough literature search from six electronic databases, including MEDLINE, PubMed, Embase, CINAHL, Web of Science, and Cochrane Review, we identified 16 highly relevant review articles from 1,310 articles retrieved. From these, we derived a set of practical strategies for service delivery professionals and developed an implementation matrix with the strategies clustered under two dimensions: (1) types of home modification based on demands of effort and level of evidence, including evidence-based practices, best practices, emerging practices; and (2) the critical stages of home modification, including preparation, home assessment, installation, follow-up visit. Our findings highlight the importance of maintaining cohesion between different stages of home modification and sustaining consensus among service delivery professionals and residents when implementing home modification for older adults.