Implementing an Evidence-Based Fall Prevention Program in an Outpatient Clinical Setting

Details

• Alternative Title:
  J Am Geriatr Soc
• Personal Author:
  Li, Fuzhong ; Harmer, Peter ; Stock, Ronald ; Fitzgerald, Kathleen ; Stevens, Judy ; Gladieux, Michele ; Chou, Li-Shan ; Carp, Kenji ; Voit, Jan
• Description:
  Objectives
  
  Few evidence-based fall prevention programs have been evaluated for adoption in clinical settings. This study investigated the dissemination potential of a Tai Ji Quan-based program, previously shown efficacious for reducing risk of falls in older adults, through outpatient clinical settings.
  
  Design
  
  A single-group pre-post design in which participants attended a twice weekly Tai Ji Quan training program for 24 weeks.
  
  Setting
  
  Communities in Lane County, Oregon.
  
  Participants
  
  Referral patients (N = 379) aged 65 and older living independently.
  
  Measurements
  
  Using the RE-AIM framework, the primary outcome was the proportion of participating healthcare providers who made referrals. Secondary outcomes were the proportion of referred patients agreeing to participate and enrolling in the program, and measures of program implementation, maintenance, and effectiveness (on measures of falls, balance, gait, physical performance, and balance efficacy).
  
  Results
  
  Of the 252 providers invited to participate, 157 made referrals (62% adoption rate). Of 564 patients referred, 379 (67% reach) enrolled in the program, which was successfully implemented in senior/community centers with good fidelity. Of the total number of participants, 283 completed the program (75% retention) and 212 of these attended ≥75% of the total (48) sessions. Participants reported a reduction in falls with an incidence rate of 0.13 falls per person-month and showed significant improvement from baseline in all outcome measures. A 3-month post-intervention follow-up indicated encouraging levels of program maintenance among providers, patients, and community centers.
  
  Conclusion
  
  A protocol to refer patients at increased risk of falling to a Tai Ji Quan-based program was successfully implemented among healthcare providers. The evidence-based program appears readily scalable and exportable with potential for substantial clinical and public health impact.
  
  
• Keywords:
  Accidental Falls Aged Aged, 80 And Over Ambulatory Care Dissemination Evidence-Based Medicine Female Humans Male Older Adults Oregon Program Development Program Evaluation RE-AIM Tai Ji

  More +
• Source:
  J Am Geriatr Soc. 61(12):2142-2149
• Pubmed ID:
  24164465
• Pubmed Central ID:
  PMC4707656
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/ ; R18 CE001723/CE/NCIPC CDC HHSUnited States/ ; 5R18CE001723/CE/NCIPC CDC HHSUnited States/
• Volume:
  61
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:819d6a9606d278bfa9ddfe6c841145de59ea1f84a03458f51883dec762066c74
• Download URL:
  https://stacks.cdc.gov/view/cdc/37443/cdc_37443_DS1.pdf
• File Type:
  [PDF - 536.56 KB ]