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

将有效的跌倒预防计划转化为基于社区的实践

• 批准号: 8258061
• 负责人: FUZHONG LI
• 金额: $ 63.66万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8258061
• 关键词: Activities of Daily Living; Address; Admission activity; Adopted; Adoption; Adult; Beryllium; Centers for Disease Control and Prevention (U.S.); Cessation of life; Communities; Community Practice; Community Services; Country; Diffusion; Educational process of instructing; Effectiveness; Elderly; Equilibrium; Evaluation; Exercise; Fall prevention; Frequencies; Gait; Goals; Health; Incidence; Individual; Injury; Intervention; Knowledge; Life; Low income; Maintenance; Measures; Mediator of activation protein; Methods; Nursing Homes; Oregon; Outcome; Participant; Performance; Population; Prevention program; Process; Program Sustainability; Protocols documentation; Provider; Public Health; Quality of life; Randomized Controlled Trials; Research; Risk; SF-12; Services; Tai Ji; Target Populations; Translating; Translations; Work; aged; authority; base; community based practice; control trial; cost; disability; evidence base; fall risk; falls; follow-up; improved; intervention program; meetings; mortality; post intervention; prevent; programs; research to practice; secondary outcome; success; web site

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.

描述（由申请人提供）：科学对照试验表明，太极拳是一种促进平衡的运动，可以防止老年人跌倒，而跌倒对这一人群来说是一个严重的健康风险。作为一种基于证据的锻炼计划，太极拳现已被公共卫生和老年医学权威推荐，以改善老年人的平衡能力并预防跌倒（AGSBGS，2011；AoA，2011；CDC，2008）。为了促进将这些证据广泛转化为日常社区实践，以有效预防跌倒，我们的长期目标是为当地社区中心制定一项可实施、低成本、有物质支持的国家太极跌倒预防计划。在我们前景广阔的试点工作的基础上，我们提出了一个大规模的传播项目，以评估通过俄勒冈州当地社区传播合作伙伴（例如高级服务提供商）提供“太极拳：移动以获得更好的平衡”的潜在公共卫生影响，这是一项经过验证的跌倒预防计划。为此，我们将实施每周两次（每次 60 分钟）、为期 12 个月的单组太极拳干预，并在干预后进行 6 个月的随访。我们的主要目标是使用RE-AIM框架对我们的干预计划进行流程和结果评估，包括影响范围（老年人的参与率）、有效性（跌倒发生率的降低、功能能力和生活质量的改善）、采用（老年服务提供者的参与率）、实施（干预内容按预期交付的程度）和维护（提供干预的提供者和接受干预的参与者之间的计划的可持续性） 干涉）。我们还将解决与传播相关的问题，例如计划促进者/障碍、成本以及向公众提供的材料。预计拟议研究的结果将增加基于社区的循证太极跌倒预防计划的推动力和影响力，最终目标是使该计划在全国各地的社区中易于实施和可持续，以实现“健康人2020”预防和减少伤害以及增强老年人生活独立性的目标。 公共卫生相关性：在美国，每年有超过三分之一的 65 岁及以上成年人跌倒。跌倒相关伤害会导致严重的过早死亡、残疾、丧失独立性和过早入住疗养院。这项研究将确定基于证据的太极跌倒预防计划是否可以通过广泛的社区老年服务机构传播，这些服务机构通常为低收入、服务不足的社区居住的有跌倒风险的老年人提供服务。如果被证明既可实施又可持续，拟议的跌倒预防计划将提供有效、低成本、易于实施的干预措施，公共卫生从业者和社区组织可以使用该干预措施来解决老年人跌倒问题。