Effect, cost-effectiveness, and usefulness of the ’Everyday Life Rehabilitation’ (ELR) intervention: a pragmatic RCT of integrated, personcentred rehabilitation within sheltered housing facilities

People with severe psychiatric disability and impaired autonomy, living in sheltered housing facilities, generally lead sedentary, solitary lives and have significantly poorer health than others in the population, while additionally, they do not have access to equal and cost-effective health care, despite being highest priority group.

Engagement in everyday activities, is important for the recovery towards a meaningful and active life.

The recovery-, activity-based, and personcentred interventionmodel Everyday Life Rehabilitation (ELR), integrated in sheltered housing facilities, has shown significant outcomes in feasibility studies, and thus an RCT is required, for the purpose of establishing the effectiveness of ELR, along with cost-effectiveness and usefulness.

All municipalities within 270 kilometres from Umeå University, will be invited. Housing-units will be stratified based on autism, psychosis, or blended. Residents who meet the inclusioncriteria, will be invited to participate.

Housing-units, with associated residents giving consent, will then be block-randomized to either receive intervention with ELR plus treatment as usual (TAU), or TAU alone for control-group. These will, after control-period, be offered ELR.

Professionals involved in the ELR interventiongroup; that is occupational therapists and housing staff, will receive an educational package.The outcomes are self-perceived recovery, quality of life, everyday functioning, symptoms, and goal-attainment at 6 months, assesed using the ReQoL, RAS-DS, ADL-taxonomy, SCL-90, and GAS.

ReQoL will be transformed into QALY´s, calculating cost-effectivness.The study has an adaptive design, including an internal pilot, in order to determine required sample sizes before continuing with the full scale RCT.In parallell, qualitative studies and process evaluations will be conducted. Mixed methods will be applied to synthesize knowledge on usefulness.