Dissemination Research on Fall Prevention: "Stepping On" in A Wisconsin Community

描述（由申请人提供）：“踩踏”是一种有效的跌倒预防干预措施，已在澳大利亚进行了测试。 然而，关于在美国使用这种干预措施的数据缺乏。 这项研究将审查有关传播的几个问题，包括在农村和城市环境中的可行性， 不同的社区组织，如教区护士，高级住房，或高级中心的吸收，7周课程后家访与电话的可行性和有效性，以及由没有健康学位的专业人士提供时的模式的有效性。 坚持和结果可能会因不同的实施环境、领导者和服务人群而异。 我们建议为美国的环境开发“踩踏”，保持与原始程序的忠实性。 我们的过程将开始与焦点小组评估现有的材料和建议的修订。 此外，我们将寻求谁曾在几个威斯康星州试点“踩”的领导者和学习者的输入。 内容专家将协助完善材料，所有材料和评价工具将再次由焦点小组进行测试。 我们将在第一个环境中试点实施 然后修改材料。 然后，我们将在威斯康星州的三个社区环境中实施和评估“踩”。 在所有情况下，我们将评估实施的可行性，服务的人口，对原始模型的忠诚度，参与者出勤率，参与者遵守锻炼日志和建议，以及参与者的结果。 在第一个设置中，一个老年公寓社区，“踩”将由一个健康学位的专业领导人，然后由一个非健康学位的专业领导人实施。 第二个和第三个地点将由一名教区护士和一个老年中心测试实施情况，一个地点是城市，一个地点是农村。 每个设置中的第一组将在7次会议后接受家访，第二组将接受电话访问而不是家访。 根据这些评估的结果，我们将制作一套最后的“踩踏”，在全国范围内广泛传播和使用。 这项建议建立在我们以前与克莱姆森博士在威斯康星州实施“踩”的合作基础上。 此外，我们为这项提案带来了学术界与社区在福尔斯预防方面的合作伙伴关系，这导致了高质量，富有成效的研究。 最后，我们通过威斯康星州密尔沃基的伤害研究中心，在伤害预防的传播研究方面取得了既定的记录。

DESCRIPTION (provided by applicant): "Stepping On" is an effective fall prevention intervention that has been tested in Australia. However, data regarding the use of this intervention in the United States are lacking. This study will examine several questions regarding dissemination including feasibility in rural versus urban settings, feasibility of uptake by different community organizations such as parish nurse, senior housing, or senior center, feasibility and effectiveness of home visit versus phone call following the 7-week class sessions, and effectiveness of the model when delivered by a professional without a health degree. Adherence and outcomes may vary according to different implementation settings, leaders, and populations served. We propose to develop "Stepping On" for a United States setting, maintaining fidelity with the original program. Our process will begin with focus groups to evaluate existing materials and advise on revisions. In addition, we will seek input from leaders and learners who have piloted "Stepping On" previously in several Wisconsin sites. Content experts will assist with refinement of materials, and all materials and evaluation tools will again be tested with the focus group. We will pilot implementation in our first setting then revise materials. We will then implement and evaluate "Stepping On" in three community settings in Wisconsin. In all settings, we will evaluate feasibility of implementation, population served, fidelity to the original model, participant attendance, participant adherence with exercise logs and recommendations, and participant outcomes. In the first setting, a senior apartment community, "Stepping On" will be implemented by a health-degree professional leader and then by a non-health-degree professional leader. The second and third sites will test implementation by a parish nurse and by a senior center, with one location being urban, and one rural. The first group in each setting will receive a home visit following their 7 sessions, and the second a phone call instead of the home visit. Based on our findings from these evaluations, we will produce a final package of "Stepping On" for broad dissemination and use nationwide. This proposal builds on our previous collaboration with Dr. Clemson in implementing "Stepping On" in Wisconsin. In addition, we bring to this proposal a strong history of academic-community partnerships in falls prevention, which has resulted in high quality, fruitful research. Lastly, we bring an established track record in dissemination research in injury prevention through the Injury Research Center in Milwaukee, Wisconsin.