Developing an Efficacious and Cost-Effective Fall Prevention Program

描述（由申请人提供）：老年人中的福尔斯已成为一个严重的公共卫生问题，因为它们导致不可避免的伤害，增加住院率，威胁独立性，并降低生活质量。然而，福尔斯是可以预防的，可以通过锻炼来减少。目前，疾病控制和预防中心（CDC）推荐了一些有效的基于运动的跌倒干预措施，可用于解决老年人的福尔斯问题。然而，很少有知情的信息，最佳做法的比较效果和成本效益的建议干预方案。信息的缺乏阻碍了政策制定者、公共卫生从业者、卫生规划者、老龄服务提供者和其他人就如何有效投资资金以实施“最佳”循证跌倒预防计划做出决策。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，可扩展的社区太极计划，以帮助公共卫生从业者和社区组织解决老年人中的福尔斯问题，并帮助老年人在社区中保持健康和独立性，从而减少医疗保健支出的流失。本提案的总体目标是对一项基于证据的跌倒预防计划-太极拳：移动以获得更好的平衡（TCMBB）进行比较有效性和成本效益研究。具体来说，本提案中的研究将解决以下两个平行的重要问题：与CDC推荐的力量训练计划相比，TCMBB是否更有效？如果是这样的话，从预防跌倒的成本和获得的质量调整生命年来看，中药BB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降低跌倒率和改善平衡和身体功能方面的有效性。它还将评估与力量训练相比，TCMBB是否比拉伸计划更具成本效益。该研究还将讨论中药BB干预对拟议结果的影响的可持续性。在研究结束时，我们将弥合不同跌倒预防计划的成本效益方面的重要研究与实践差距，并扩大我们关于如何最好地投资干预计划资金的知识，以解决老年人福尔斯的紧迫问题，并实现2020年健康人目标，以改善社区居住老年人的健康，功能和生活独立性。

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.