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

描述(申请人提供)：科学对照试验表明，太极是一种促进平衡的运动，可以防止老年人跌倒，这对这一人群的健康构成严重威胁。作为一项循证锻炼计划，太极现在已被公共卫生和老年当局推荐用于改善老年人的平衡和防止跌倒(AGSBGS，2011；AOA，2011；CDC，2008)。为了促进将这些证据广泛地转化为日常社区实践中的有效预防跌倒，我们的长期目标是为当地社区中心开发一个可实施的、低成本的、由材料支持的全国性太极预防跌倒计划。在我们前景看好的试点工作的基础上，我们提出了一个大规模的传播项目，以评估提供太极的潜在公共健康影响：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)，走向更好的平衡，这是一个经过验证的摔倒预防计划。为此，我们将实施每周两次(60分钟/节)的单组太极拳干预，为期12个月，并在干预后6个月进行随访。我们的主要目标是使用RE-AIM框架对我们的干预计划进行过程和结果评估，该框架包括REACH(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)、采纳率(老年服务提供者的参与率)、实施(干预组件按预期交付的程度)和维护(提供干预的提供者和接受干预的参与者之间计划的可持续性)。我们还将解决与传播相关的问题，如计划促进者/障碍、成本和向公众提供材料。预计拟议研究的结果将增加以社区为基础传播以证据为基础的太极摔倒预防计划的动力和影响，最终目标是使该计划在全国各地的社区易于实施和可持续，以实现健康人2020年预防和减少伤害以及提高老年人生活独立性的目标。

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.