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

描述(申请人提供)：“踩踏”是一种有效的预防跌倒干预措施，已在澳大利亚进行了测试。然而，关于这种干预在美国的使用情况的数据是缺乏的。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、老年住房或老年中心，在为期7周的课程后，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员提供的模式的有效性。遵守情况和结果可能会因实施环境、领导者和服务人群的不同而有所不同。我们建议以美国为背景来开发“踩在脚下”的场景，保持与原始程序的保真度。我们的程序将从焦点小组开始，以评估现有材料并就修订提出建议。此外，我们将征求曾在威斯康星州几个地点进行过“踩踏”试验的领导者和学习者的意见。内容专家将协助完善材料，所有材料和评估工具将再次与焦点小组一起进行测试。我们将在我们的第一个设置中试行实施 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“踩踏”。在所有情况下，我们将评估实施的可行性、服务的人群、对原始模型的忠诚度、参与者出勤率、参与者对锻炼日志和建议的遵守情况以及参与者的结果。在第一个设置中，一个高级公寓社区，由一名健康程度的专业领导实施，然后由一名非健康程度的专业领导实施。第二和第三个地点将测试一名教区护士和一个老年中心的实施情况，一个地点在城市，一个地点在农村。每组中的第一组将在7次会议后接受一次家庭访问，第二组将接受电话访问，而不是家庭访问。根据我们的评估结果，我们将制定一套最终的“踏板”方案，在全国范围内广泛传播和使用。这项提议建立在我们之前与克莱姆森博士合作在威斯康星州实施“踩在脚下”的基础上。此外，我们为这项提案带来了学术和社区在预防跌倒方面合作的强大历史，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带来了在伤害预防传播研究方面的既定记录。

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.