Dissemination and Implementation of Evidence-Based Falls Prevention Programs: Reach and Effectiveness

Abstract Background Using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, we describe the implementation of evidence-based falls prevention programs by Administrative for Community Living grantees during 2014-2019. Methods Forty-four grantees contributed to the national data repository. Data components include workshop information, participant information, attendance records, and organizational data. Data were collected before and after implementation of the evidence-based fall prevention programs. Results Ten different programs were offered in 35 states with the most common settings being senior centers (25.3%), residential facilities (16.8%), health care organizations (12.5%), and faith-based organizations (11.1%). Individuals who participated in the programs (n=85,848) had an age of 75.5±9.7 years, were primarily female (79.7%) and the majority (86.2%) reported at least some fear of falling. At the post-program assessment, 31.8% reported less fear of falling, 21.6% reported fewer falls, and 10.1% reported fewer injurious falls (all p<0.0001). Conclusions Evidence-based fall prevention programs implemented by Administration for Community Living grantees reached over 85,000 older adults. Participation in the evidence-based fall prevention programs resulted in improved confidence, decreased fear of falling, and fewer falls and injurious falls. Future efforts should focus on reaching specific underserved minorities and examining the effectiveness of individual programs.

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Participation in Two Evidence-Based Falls Prevention Programs by Adults Aging With a Long-Term Disability: Case-Control Study of Reach and Effectiveness

Journal of Aging and Health ◽

10.1177/0898264318808918 ◽

2018 ◽

Vol 31 (10_suppl) ◽

pp. 39S-67S ◽

Cited By ~ 1

Author(s):

Thomas J. Eagen ◽

Salom M. Teshale ◽

Angelica P. Herrera-Venson ◽

Anne Ordway ◽

Joe Caldwell

Keyword(s):

Older Adults ◽

Fear Of Falling ◽

Prevention Programs ◽

Preliminary Evidence ◽

Case Control ◽

Falls Prevention ◽

Evidence Based ◽

Activity Restriction ◽

Increased Risk

Objective: Adults aging with a long-term disability (LTD) are at an increased risk for falls. The Older Americans Act Title III-D and Prevention and Public Health Fund (PPHF) support several organizations to deliver falls prevention evidence-based programs designed to reduce risk factors; however, little is understood about the reach and effectiveness of these fall prevention programs for those with LTD compared to those without LTD. This study compared the reach and effectiveness of two evidence-based falls prevention programs between older adults with and without LTD. Method: Using a matched case-control design, 105 LTD older adults enrolled in A Matter of Balance (AMOB) or Stepping On were matched to 315 non-LTD older adults on age, sex, race, and education. Results: On average, LTD older adults attended a higher number of class sessions and were significantly more likely to complete the program compared with the matched-sample of non-LTD older adults. LTD older adults were equally likely as non-LTD older adults to report significant reductions in self-reported fear of falling, falls-related activity restriction, and improvement in falls self-efficacy following completion of the programs. Discussion: These findings provide preliminary evidence for the effectiveness of these evidence-based falls prevention programs for LTD older adults; however, more research is needed to extend these findings.

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PARTICIPATION IN TWO EVIDENCE-BASED FALLS PREVENTION PROGRAMS AMONG OLDER ADULTS WITH AND WITHOUT A DISABILITY

Innovation in Aging ◽

10.1093/geroni/igz038.452 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S123-S124

Author(s):

Thomas J Eagen ◽

Ellen McGough ◽

Tracy Mroz ◽

Deborah Kartin ◽

Anjum Hajat ◽

...

Keyword(s):

Older Adults ◽

Program Effectiveness ◽

Fear Of Falling ◽

Prevention Programs ◽

Falls Prevention ◽

Original Research ◽

Evidence Based ◽

National Council ◽

Activity Restriction ◽

Using Data

Abstract Older adults with a disability are at greater risk for falls and injury due to falling compared to those without a disability. Evidence-based falls prevention programs (EBFPPs) have been developed and disseminated broadly, however individuals with disabilities were excluded from original research on effectiveness. Using data from the National Falls Prevention Database from the National Council on Aging, we compared the reach and effectiveness of two EBFPPs, A Matter of Balance (MOB) or Stepping On, between those with and without a disability. Program reach was measured using attendance percentage. Program effectiveness was measured using change in fear of falling (FOF), fall-related activity restriction (FAR), and falls self-efficacy (FSE) post-program. A total of 12,667 participants were analyzed. Participants were, on average, 76 years old (M = 76.18, SD = 9.86), largely female (75%), well educated (80% some college or higher), and white (90%). Nearly half self-reported a disability (40%). Older adults with a disability were as likely to attend (M = 0.88, SD = 0.14) the program compared to those without a disability (M = 0.88, SD = 0.14, p =.30). Older adults with a disability reported greater FOF and FAR and lower FSE compared to participants without a disability at baseline. Significant improvements were made across effectiveness measures, irrespective of disability status. MOB and Stepping On are effective programs, well attended by older adults with and without disabilities, however older adults with a disability continued to report higher FOF and FAR, and lower FSE compared to those without a disability.

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24-Months Cluster-Randomized Intervention Trial of a Targeted Fall Prevention Program in a Primary Care Setting

Journal of General Internal Medicine ◽

10.1007/s11606-021-06944-w ◽

2021 ◽

Author(s):

Christian Hentschke ◽

Martin Halle ◽

Barbara Geilhof ◽

Peter Landendoerfer ◽

Wolfgang Blank ◽

...

Keyword(s):

Primary Care ◽

High Risk ◽

Fall Prevention ◽

Care Setting ◽

Primary Care Setting ◽

Fear Of Falling ◽

Community Dwelling ◽

Risk Of Falling ◽

Injurious Falls ◽

Cluster Randomized

Abstract Background Falls and fall-related injuries are common in community-dwelling older persons. Longitudinal data on effective fall prevention programs are rare. Objective Therefore, we evaluated a 4-months multi-component exercise fall prevention program in a primary care setting on long-term effects over 24 months on falls and concomitant injuries in older community-dwelling persons with high risk of falling. Design and Setting In the Prevention of Falls (PreFalls) study, forty general practitioners in Germany were cluster-randomized (1:1) into an intervention group (IG) or control group (CG). Three hundred seventy-eight independently living people with high risk of falling (78.1 ± 5.9 years, 75% women) were assigned to IG (n = 222) or CG (n = 156). Intervention and Measurements Patients in IG took part in a 4-months multi-component exercise program comprising strength and balance exercises (28 sessions); patients in CG received no intervention. Primary outcome measure was number of falls over 24 months, analyzed by a patient-level, linear mixed Poisson model. Secondary endpoints were number of fall-related injuries, changes in physical function, fear of falling, and mortality. Results After 24 months, the IG demonstrated significantly fewer falls (IRR = 0.63, p = 0.021), injurious falls (IRR = 0.69, p = 0.034), and less fear of falling (p = 0.005). The mortality rate was 5.0% in IG and 10.3% in CG (HR = 0.51, 95% CI: 0.24 to 1.12; p = 0.094). Conclusions In older community-dwelling persons with high risk of falling, a short-term multi-component exercise intervention reduced falls and injurious falls, as well as fear of falling over 24 months.

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Home care providers’ experience of translating evidence-based fall prevention programs into practice

Home Health Care Services Quarterly ◽

10.1080/01621424.2019.1604460 ◽

2019 ◽

Vol 38 (3) ◽

pp. 182-193

Author(s):

Kyeongra Yang ◽

Kimberly M. Colorito ◽

Kathryn H. Bowles ◽

Gail R. Woomer ◽

Christopher M. Murtaugh

Keyword(s):

Home Care ◽

Fall Prevention ◽

Prevention Programs ◽

Evidence Based ◽

Care Providers ◽

Home Care Providers

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EXPERIENCES AND FACILITATORS OF FALLS PREVENTION AMONG ETHNICALLY DIVERSE OLDER ADULTS: A QUALITATIVE STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.3142 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S854-S854

Author(s):

Ladda Thiamwong ◽

Norma E Conner

Keyword(s):

Older Adults ◽

Fall Prevention ◽

Fall Risk ◽

Fear Of Falling ◽

Ethnically Diverse ◽

Role Identity ◽

Community Dwelling ◽

Falls Prevention ◽

Facilitators And Barriers ◽

And Behaviors

Abstract Background: Falls increase as people age and decrease the quality of life. Even though fall interventions have received great attention, fall incidence rates have still arisen. In order for older adults to reap the benefits of evidence-based fall interventions, a challenge of implementation in the real world and right context must be met. Understanding experiences, facilitators, and barriers of fall prevention among four major ethnic groups in the Unites States could be extremely valuable. Objective: The aim of this study was to describe experiences and highlight facilitators and barriers on fall and fear of falling interventions among ethnically diverse community-dwelling older adults. Methods: Four ethnically specified (African American, Asian, Hispanic and Non-Hispanic White) focus groups were conducted. A total of 28 older adults and four family caregivers were interviewed. Interviews covered experiences on falls and fear of falling, attitudes, factors, consequences, risk assessment, and interventions. Data were organized and analyzed with the NViVo software. Results: Falls related experiences and behaviors were multifaceted and varied. Three themes related to falls experiences and behaviors were identified, 1) falls prevention versus fear of falling amplification; 2) role identity, culture and family considerations; and 3) take care of you, take care of me. Facilitators of fall prevention were integration of individual learning within a group meeting, providing appropriate assistive devices and promoting environmental safety. Barriers were inconsistent fall risk assessments, low fall risk awareness and acknowledgment, and balance and visual impairment.

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