RFA-CE-22-006, Process and Outcome Evaluation of the Walk with Ease program for Fall Prevention

总结 拟议的项目将评估将物理治疗练习（初级） 预防策略）在一个既定的身体活动干预称为步行轻松（WWE），以减少 社区老年人福尔斯的发病率和风险。拟议的研究将直接在 与综合医院（玛丽格里利医疗中心- MGMC）和临床网络合作 （麦克法兰诊所）。合作和数据共享的承诺记录在以下正式信函中： 支持和这种伙伴关系将直接推动和促进拟议的研究。物理治疗师 将专门参与促进广泛的基于社区的筛选，以招募高风险的个人， 福尔斯，并对所有入组受试者的跌倒风险进行稳健评价。随机对照设计 我们将用来系统地测试标准的WWE实现模型，该模型提供通用的练习 建议反对一个增强版，将提供个人处方，物理治疗 演习析因设计也将使我们能够评估标准WWE的相对有效性 行为改变模块对一组增强模块的基础上，理论为基础，习惯的形成 接近。主要假设是，接受增强型WWE计划的参与者（即 个别规定的运动）将有较低的发生率福尔斯和更大的下降，在跌倒的风险比那些 在标准条件下（即一般练习）。第二个假设是， 增强的行为改变模块（基于习惯形成）将更好地遵守规定 运动，更高水平的身体活动，以及比标准中更好的跌倒风险降低结果 模块。根据RFA中的指导方针，我们将进行稳健的过程评估（目标1）， 结果评价（目标2），以提供WWE作为跌倒的潜在效用的全面视角 预防方案。过程数据将以总结性和形成性的方式使用， 评价过程数据的形成性评估将使我们的团队能够监控和调整程序 实施，以确保符合WWE实施的标准化指导方针。成品 然后可以将这些程序纳入培训材料， 组织实施增强的WWE以预防福尔斯跌倒。过程的总结性评价 数据还将用于帮助解释不同个人、群体或不同时间的方案成果差异。 因此，过程数据将直接并入到

Summary The proposed project will evaluate the effectiveness of incorporating physical therapy exercises (primary prevention strategy) within an established physical activity intervention called Walk with Ease (WWE) to reduce incidence and risk of falls in community-dwelling older adults. The proposed study will be done in direct collaboration with an integrated hospital (Mary Greeley Medical Center - MGMC) and clinical network (McFarland Clinic). The commitment to collaboration and data sharing are documented in formal letters of support and this partnership will directly enable and facilitate the proposed research. The physical therapists will be specifically involved to facilitate broad community-based screens to recruit individuals at high risk for falls and to conduct robust evaluations of fall risk for all enrolled participants. A randomized controlled design we will used to systematically test the standard WWE implementation model that provides generic exercise recommendations against an enhanced version that will provide individually-prescribed, physical therapy exercises. The factorial design will enable us to also evaluate the relative effectiveness of the standard WWE behavior change modules against an enhanced set of modules based on theory-based, habit formation approaches. The primary hypothesis is that the participants receiving the Enhanced WWE program (i.e. individually prescribed exercises) will have lower incidence of falls and larger reductions in fall risk than those in the Standard condition (i.e. generic exercises). The secondary hypothesis is that participants receiving Enhanced behavior change modules (based on habit formation) will have greater compliance to the prescribed exercise, higher levels of physical activity, and better fall risk reduction outcomes than those in the Standard modules. Consistent with guidelines in the RFA we will conduct a robust process evaluation (Aim 1) and outcome evaluation (Aim 2) to provide a comprehensive perspective of the potential utility of WWE as a fall prevention program. The process data will be used in both summative and formative ways to enhance the evaluation. The formative evaluation of the process data will enable our team to monitor and adjust program implementation to ensure alignment with the standardized guidelines for WWE implementation. The refined procedures could then be incorporated into training materials to build capacity in other community-based organizations to implement the enhanced WWE for falls prevention. The summative evaluation of the process data will also be used to help explain differences in program outcomes across individuals, groups or over time. Thus, the process data will be directly incorporated into the