Developing an Efficacious and Cost-Effective Fall Prevention Program

制定有效且具有成本效益的跌倒预防计划

• 批准号: 9041475
• 负责人: FUZHONG LI
• 金额: $ 63.7万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-15 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9041475
• 关键词: Address; Admission activity; Adopted; Adult; Advocate; Aging; American; Centers for Disease Control and Prevention (U.S.); Communities; Community Services; Cost Effectiveness Analysis; Decision Making; Economics; Effectiveness; Elderly; Equilibrium; Evidence based intervention; Exercise; Fall prevention; Funding; Gait; Geriatrics; Goals; Health; Health Care Costs; Health Personnel; Health Planning; Healthcare; Healthcare Systems; Healthy People 2020; High Prevalence; Hospitals; Injury; Intervention; Investments; Knowledge; Life; Light; Measures; Nursing Homes; Outcome; Outcome Measure; Participant; Performance; Physical Function; Physical Performance; Policy Maker; Policy Making; Premature Mortality; Prevention program; Preventive Intervention; Preventive service; Provider; Proxy; Public Health; Public Policy; Quality of life; Quality-Adjusted Life Years; Randomized Controlled Trials; Research; Services; Societies; Stretching; Tai Ji; Testing; Training; Training Programs; United States; Work; aged; base; comparative effectiveness; comparative efficacy; cost; cost effective; cost effectiveness; disability; disorder prevention; efficacy testing; evidence base; exercise program; fall risk; falls; follow-up; health economics; improved; intervention program; meetings; post intervention; prevent; programs; research to practice; secondary outcome; strength training; therapy design

DESCRIPTION (provided by applicant): Falls among older adults have become a serious public health problem because they result in inevitable injuries, increase hospital admissions, threaten independence, and reduce quality of life. Falls, however, are preventable and can be reduced through exercise. There are currently a number of effective exercise-based fall interventions recommended by the Centers for Disease Control and Prevention (CDC) that can be used to address the problem of falls in older adults. However, there is little informed information on best practices in terms of comparative efficacy and cost effectiveness among the recommended intervention programs. This lack of information hinders policy makers, public health practitioners, health planners, aging service providers, and others in making decisions on how to effectively invest funds to implement the "best" evidence-based fall prevention programs. This project is intended to narrow this knowledge gap. Our long-term goal is to create an effective, low-cost, scalable community-based Tai Chi program to help public health practitioners and community-based organizations address the problem of falls among older adults and to help older adults maintain their health and independence in the community, thereby reducing the drain on health care spending. The overall objective of this proposal is to conduct a comparative efficacy and cost-effectiveness study of an evidence-based fall prevention program-Tai Chi: Moving for Better Balance (TCMBB). Specifically, research in this proposal will address the following two questions of parallel importance: will TCMBB be more effective compared to a CDC-recommended Strength Training program? If so, will the TCMBB be more cost effective in terms of cost per fall prevented and quality adjusted life year gained? These questions will be addressed by conducting a randomized controlled trial aimed at testing the efficacy of TCMBB and Strength Training programs relative to a Stretching control on reducing fall rate and improving balance and physical functioning. It will also evaluate whether TCMBB, compared to Strength Training, will be more cost-effective, relative to the Stretching program. The study will also address the sustainability of the effects of TCMBB intervention on the proposed outcomes. At the conclusion of the study, we will have bridged an important research-to-practice gap on the cost effectiveness of different fall prevention programs and expanded our knowledge regarding how to best invest funds for intervention programs to address the pressing problems of falls in older adults and to meet Healthy People 2020 goals for improving the health, function, and life independence of community- dwelling older adults.

描述（由申请人提供）：老年人跌倒已成为一个严重的公共卫生问题，因为它们不可避免地造成伤害，增加住院人数，威胁独立性，降低生活质量。然而，跌倒是可以预防的，可以通过锻炼来减少。目前，美国疾病控制与预防中心（CDC）推荐了一些有效的基于运动的跌倒干预措施，可用于解决老年人跌倒的问题。然而，在推荐的干预方案中，关于比较疗效和成本效益的最佳做法的信息很少。这种信息的缺乏阻碍了政策制定者、公共卫生从业人员、卫生计划人员、老龄化服务提供者和其他人员就如何有效地投资资金以实施“最佳”基于证据的预防跌倒项目做出决定。该项目旨在缩小这一知识差距。我们的长期目标是创建一个有效的、低成本的、可扩展的社区太极项目，帮助公共卫生从业者和社区组织解决老年人跌倒的问题，帮助老年人在社区中保持健康和独立，从而减少医疗保健支出的消耗。本提案的总体目标是对以证据为基础的预防跌倒项目——太极：促进更好的平衡（TCMBB）——进行比较疗效和成本效益研究。具体来说，本提案中的研究将解决以下两个同等重要的问题：与cdc推荐的力量训练计划相比，TCMBB是否更有效？如果是这样，从预防每次跌倒的成本和获得的质量调整寿命年而言，TCMBB是否更具成本效益？这些问题将通过进行一项随机对照试验来解决，该试验旨在测试TCMBB和力量训练计划相对于拉伸控制在减少跌倒率和改善平衡和身体功能方面的功效。它还将评估与力量训练相比，TCMBB是否比拉伸项目更具成本效益。该研究还将探讨TCMBB干预对拟议结果的影响的可持续性。在这项研究的结论中，我们将在不同的跌倒预防项目的成本效益上弥合一个重要的研究到实践的差距，并扩大我们关于如何最好地为干预项目投资资金，以解决老年人跌倒的紧迫问题，并实现“健康人2020”的目标，即改善社区居住老年人的健康、功能和生活独立性。