title: Effect of preventive home visits for ambulatory housebound elders in Japan: a pilot study.
abstract: OBJECTIVE
  Programs of preventive home visits for ambulatory housebound elders have not yet become established in Japan. The aim of this randomized pilot study was to investigate effects of such visits by public health nurses in Japan.
  
  
  METHODS
  A randomized controlled study with 18-month follow-up was conducted in a small Japanese agricultural town. Participants (n=119) were ambulatory housebound elders aged 65 and over, who were able to walk but who went outdoors less than three times a week at baseline survey. They were randomly assigned to intervention (n=59) or control group (n=60). Intervention group subjects received preventive home visits by public health nurses over 18 months (mean home visits=4.3). Control group subjects received usual primary and community care. Activities of daily living (ADLs), functional capacity, self-efficacy for daily activities, self-efficacy for health promotion, depression, and social support were collected via questionnaire at baseline and at the 18-month follow-up point.
  
  
  RESULTS
  At follow-up, 81.4% of intervention group subjects were still living at home vs 73.3% of control group subjects (NS). Simple group comparisons following repeated measures (ANCOVA) showed that the intervention group had higher ADL scores than the control group at follow-up (p=0.044).
  
  
  CONCLUSIONS
  These pilot results suggest that home visits by public health nurses may be effective in helping to reduce ADL decline among ambulatory housebound elders.
authors.affiliation: Sepulveda VA GRECC, School of Medicine, UCLA, Los Angeles, 91343, USA. ayukono-tky@umin.ac.jp
authors.forename: Ayumi
authors.initials: A
authors.lastname: Kono
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kai
authors.forename: Chiyoko
authors.initials: C
authors.lastname: Sakato
authors.forename: Judith O
authors.initials: JO
authors.lastname: Harker
authors.forename: Laurence Z
authors.initials: LZ
authors.lastname: Rubenstein
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D018577:Homebound Persons; D006792:House Calls / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male; D010865:Pilot Projects; D011315:Preventive Medicine / Q000379:methods*; D011795:Surveys and Questionnaires