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（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，可以预防老年人跌倒，而老年人是这一人群的严重健康风险。作为一项基于证据的运动项目，太极拳现已被公共卫生和老年权威机构推荐用于改善老年人的平衡和预防跌倒（AGSBGS, 2011; AoA, 2011； CDC, 2008）。为了促进将这些证据广泛转化为有效预防跌倒的日常社区实践，我们的长期目标是为当地社区中心制定一个可实施的、低成本的、物质支持的国家太极拳预防跌倒计划。在我们有前景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（如高级服务提供者）提供太极：移动更好的平衡，一个经过验证的预防跌倒项目的潜在公共卫生影响。为此，我们将实施每周两次（每次60分钟），为期12个月的单组太极干预，干预后随访6个月。我们的主要目标是使用RE-AIM框架对我们的干预计划进行过程和结果评估：Reach（老年人的参与率）、有效性（减少跌倒发生率、改善功能能力和生活质量）、采用（高级服务提供者的参与率）、实施（干预组件按预期交付的程度）、维护（项目在提供干预的提供者和接受干预的参与者之间的可持续性）。我们还将解决与传播有关的问题，如项目促进者/障碍、成本和向公众提供材料的情况。预计该研究的结果将增加基于证据的太极拳跌倒预防项目在社区传播的动力和影响，最终目标是使该项目在全国社区易于实施和可持续，以实现健康人2020目标，预防和减少伤害，提高老年人的生活独立性。