title: Study protocol for a multicenter investigation of reablement in Norway.
abstract: BACKGROUND
  Reablement is a promising new rehabilitation model, which is being implemented in some Western countries to meet current and future needs for home-based services. There is a need for further investigation of the effects of reablement among community-dwelling adults in terms of clinical and economic outcomes. This study will investigate the effectiveness of reablement in home-dwelling adults compared with standard treatment in terms of daily activities, physical functioning, health-related quality of life, coping, mental health, use of health care services, and costs.
  
  
  METHODS
  The study is a multicenter controlled trial. In total, 44 Norwegian municipalities will participate, including eight municipalities as a control group. For three municipalities with two zones, one will be assigned to the control group and the other to the intervention group. The experimental group will be offered reablement and the control group standard treatment. The sample will comprise approximately 750 participants. People will be eligible if they are home-dwelling adults, understand Norwegian, and have functional decline. Participants will be assessed at baseline, and after 10 weeks, 6 months, and 12 months. The primary outcome will be activity and participation measured by the Canadian Occupational Performance Measure. Physical functioning will be measured by the Short Physical Performance Battery and health-related quality of life by the European Quality of Life Scale. Coping will be measured by the Sense of Coherence questionnaire and mental health by the Mental Health Continuum Short Form. Costs will be generated based on registered working hours in different professions. Data analyses will be performed according to intention to treat. Univariate analysis of covariance will be used to investigate differences between the groups at baseline and the end of intervention. The data will be organized into two levels using a multilevel structure, i.e., individuals and municipalities, which will be analyzed using linear mixed-effects models. The working hours data (panel data) will be analyzed with random mixed-effects regression models. The cost-effectiveness of reablement will be evaluated according to the incremental cost-effectiveness ratio and uncertainty will be explored via the bootstrap method.
  
  
  CONCLUSIONS
  The findings will make an important contribution to knowledge of rehabilitation approaches for community-dwelling adults.
  
  
  BACKGROUND
  The trial was registered at ClinicalTrials.gov on October 24, 2014, identifier: NCT02273934 .
authors.forename: Eva
authors.initials: E
authors.lastname: Langeland
authors.affiliation: Centre for Care Research Western Norway, Bergen University College, P.O Box 7030, 5020, Bergen, Norway. eva.langeland@hib.no.|Department of Nursing, Bergen University College, P.O Box 7030, 5020, Bergen, Norway. eva.langeland@hib.no.
authors.forename: Eva
authors.initials: E
authors.lastname: Langland
authors.affiliation: Centre for Care Research Western Norway, Bergen University College, P.O Box 7030, 5020, Bergen, Norway. hanne.kristin.tuntland@hib.no.|Departement of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, P.O Box 7030, 5020, Bergen, Norway. hanne.kristin.tuntland@hib.no.
authors.forename: Hanne
authors.initials: H
authors.lastname: Tuntland
authors.affiliation: Centre for Care Research Western Norway, Bergen University College, P.O Box 7030, 5020, Bergen, Norway. oddvar.forland@hib.no.|Haraldsplass Deaconess University College, Ulriksdal 10, 5009, Bergen, Norway. oddvar.forland@hib.no.
authors.forename: Oddvar
authors.initials: O
authors.lastname: Førland
authors.affiliation: Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, P.O Box 1089, Blindern, 0318, Oslo, Norway. eline.aas@medisin.uio.no.|Department of Health Management and Health Economics, University of Oslo, P.O Box 1089, Blindern, 0318, Oslo, Norway. eline.aas@medisin.uio.no.
authors.forename: Eline
authors.initials: E
authors.lastname: Aas
authors.affiliation: Centre for Care Research Western Norway, Bergen University College, P.O Box 7030, 5020, Bergen, Norway. bjarte.folkestad@uni.no.|Uni Research Rokkan Centre, P.O Box 7810, 5020, Bergen, Norway. bjarte.folkestad@uni.no.
authors.forename: Bjarte
authors.initials: B
authors.lastname: Folkestad
authors.affiliation: Centre for Care Research Western Norway, Bergen University College, P.O Box 7030, 5020, Bergen, Norway. frode.fadnes.jacobsen@hib.no.
authors.forename: Frode F
authors.initials: FF
authors.lastname: Jacobsen
authors.affiliation: Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, P.O Box 1089, Blindern, 0318, Oslo, Norway. ingvild.kjeken@diakonsyk.no.|Diakonhjemmet Hospital, National Advisory Unit on Rehabilitation in Rheumatology, P.O. Box 23, Vinderen, 0319, Oslo, Norway. ingvild.kjeken@diakonsyk.no.|Oslo and Akershus University College of Applied Sciences, Program of Occupational Therapy, Prosthetics and Orthotics, P.O. Box 4, St. Olavs plass, 0130, Oslo, Norway. ingvild.kjeken@diakonsyk.no.
authors.forename: Ingvild
authors.initials: I
authors.lastname: Kjeken
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway / Q000453:epidemiology; D011788:Quality of Life / Q000523:psychology*; D012046:Rehabilitation / Q000379:methods* / Q000523:psychology*; D011795:Surveys and Questionnaires