Optimizing a technology-based body and mind intervention to prevent falls and reduce health disparities in low-income populations.

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PROPOSAL SUMMARY/ABSTRACT Falls and fear of falling are the leading cause of injury, disability, and hospitalization in racially diverse low- income older adults. Our parent grant (R01MD018025) targets maladaptive fall risk appraisal (FRA)- a condition expressed in more than half of older adults, in which there is a discrepancy between perceived fall risk and physiological fall risk. The parent grant aims to prevent falls, improve physical activity, facilitate a shift from maladaptive to adaptive FRA, and reduce health disparities for ethnically diverse low-income older adults using our developed in-home Physio-fEedback Exercise pRogram (PEER), which includes a) physio-feedback using a real-time portable innovative technology—the BTrackS Balance System: BBS; b) cognitive reframing based on a novel fall risk appraisal matrix; and c) peer-led exercise by focusing on balance and strength training. We use a two-arm clustered randomized controlled trial, and the intervention is offered at the low- income independent living communities/units in Central Florida. We collect data (N=340) at baseline and measure outcomes after program completion, follow-up at 3 months, and 6 months. The purposes of this Administrative Supplements to Recognize Excellence in Diversity, Equity, Inclusion, and Accessibility (DEIA) Mentorship are thus to 1) enhance our current parent study with an additional subproject led by a postdoctoral researcher titled “Associations between Physical Activity, Sleep, Circadian Rhythmicity, Health Disparities, and Falls; 2) support our current three graduate students from DEIA backgrounds to focus on cognitive reframing and primary outcomes of the parent grant including falls and health disparities; and 3) add two predoctoral trainees from DEIA backgrounds to focus on technology-based physio feedback and peer-led exercise training. The interdisciplinary mentoring will include three broad sets of activities across two years: 1) coursework; 2) research, including data collection, data analysis, preparation of manuscripts and research proposal or dissertation/ thesis defense; and 3) professional development led by the parent study PI and her interdisciplinary team. While the training will focus heavily on research skills, it will also include professional development activities relevant to their roles and career progression within the biomedical and behavioral research enterprise. As a first-generation college graduate growing up in a rural underserved area and experiencing personal and professional challenges in achieving and maintaining academic and scientific success, the PI has committed to sharing and mentoring the next generation of biomedical scientists from DEIA backgrounds. The parent grant and this supplement award will provide an excellent example of how an interdisciplinary team representing nursing, kinesiology, neuropsychology, engineering, and data science can successfully collaborate to produce impactful outcomes on improving minority health and enhancing diversity, equity, inclusion, and accessibility in the biomedical and health sciences.