Translating an Effective Fall Prevention Program into a Community-Based Practice

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DESCRIPTION (provided by applicant): Scientifically controlled trials have shown that Tai Chi, a balance-promoting exercise, prevents falls in the elderly, a serious health risk for this population. As an evidence-based exercise program, Tai Chi has now been recommended by public health and geriatric authorities to improve balance and prevent falls in older adults (AGSBGS, 2011; AoA, 2011; CDC, 2008). To facilitate broad translation of this evidence into everyday community practice for effective fall prevention, our long-term goal is to develop an implementable, low-cost, material-supported national Tai Chi fall prevention program for local community centers. On the basis of our promising pilot work, we propose a large-scale dissemination project to assess the potential public health impact of delivering Tai Chi: Moving for Better Balance, a proven fall prevention program, through local community dissemination partners (e.g., senior service providers), in the state of Oregon. To this end, we will implement a twice weekly (60 minutes per session), 12-month single-group Tai Chi intervention, with a 6- month post-intervention follow-up. Our primary aim is to conduct a process and outcome evaluation of our intervention program using the RE-AIM framework of Reach (participation rate of older adults), Effectiveness (reductions in fall incidence, improvement in functional ability and quality of life), Adoption (participation rates of senior service providers), Implementation (degree to which intervention components are delivered as intended), and Maintenance (sustainability of the program among providers who deliver the intervention and among participants who receive the intervention). We will also address dissemination-related issues such as program facilitators/barriers, costs, and availability of materials to the public. It is expected that outcomes from the proposed study will increase the impetus for and impact of community-based diffusion of an evidence- based Tai Chi fall prevention program, with the ultimate objective of making this program easily implementable and sustainable in communities across the country to meet Healthy People 2020 goals for preventing and reducing injuries and enhancing life independence among older adults. PUBLIC HEALTH RELEVANCE: In the U.S.A, more than one of every three adults aged 65 and older fall each year. Fall-related injuries cause significant pre-mature mortality, disability, loss of independence, and early admission to nursing homes. This study will determine whether an evidence-based Tai Chi fall prevention program can be disseminated through a broad spectrum of community-based senior service provides who often cater to low income, under-served community-dwelling older adults at risk of falling. If shown to be both implementable and sustainable, the proposed fall prevention program will provide an effective, low-cost, easy-to-implement intervention that could be used by public health practitioners and community-based organizations to address the problem of falls among older adults.