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Published in: Implementation Science 1/2014

Open Access 01-12-2014 | Study protocol

Protocol for disseminating an evidence-based fall prevention program in community senior centers: evaluation of translatability and public health impact via a single group pre-post study

Authors: Fuzhong Li, Peter Harmer

Published in: Implementation Science | Issue 1/2014

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Abstract

Background

Falls are the leading cause of injury death in older adults and present a significant public health problem and a major burden to healthcare. Although there is sufficient evidence from randomized controlled trials to indicate that exercise can prevent falls in older people, few effective, evidence-based fall prevention programs exist in community practice. Thus, there is a pressing need to translate and disseminate evidence-based exercise programs to community providers that serve older adults at increased risk of falling. The current study addresses this public health need by disseminating the evidence-based Tai Ji Quan: Moving for Better Balance (TJQMBB) program through community senior centers.

Methods/Design

The study uses a single-group design in which the TJQMBB program is being delivered to community-dwelling older adults through collaboration with senior centers in selected counties in Oregon, USA, for 48 weeks, followed by a 24-week post-intervention follow-up. Study process and outcome measures will be evaluated in accordance with the components of the RE-AIM framework that focus on Reach, Effectiveness, Adoption, Implementation and Maintenance.

Discussion

This study will determine whether the evidence-based TJQMBB fall prevention program can be disseminated through a broad spectrum of community-based senior centers that often cater to low-income, underserved community-dwelling older adults at risk of falling. If shown to be both practically implementable and sustainable, the TJQMBB program will provide an effective, potentially low-cost, easy-to-implement intervention that could be used by public health practitioners and community-based organizations to address the problem of falls among older adults.

Trial registration

ClinicalTrials.gov Identifier: NCT01854931
Literature
4.
go back to reference Bell AJ, Talbot-Stern JK, Hennessy A: Characteristics and outcomes of older patients presenting to the emergency department after a fall: a retrospective analysis. Med J Aust. 2000, 173 (4): 176-177. Bell AJ, Talbot-Stern JK, Hennessy A: Characteristics and outcomes of older patients presenting to the emergency department after a fall: a retrospective analysis. Med J Aust. 2000, 173 (4): 176-177.
5.
go back to reference Murphy SL: Deaths: Final Data from 1998. National Vital Statistics Reports; vol 48 no. 11. 2000, Hyattsvill, Maryland: National Center for Health Statistics Murphy SL: Deaths: Final Data from 1998. National Vital Statistics Reports; vol 48 no. 11. 2000, Hyattsvill, Maryland: National Center for Health Statistics
6.
go back to reference Stevens JA, Corso P, Finkelstein E, Miller T: The costs of fatal and nonfatal falls among older adults. Inj Prevent. 2006, 12: 290-295. 10.1136/ip.2005.011015.CrossRef Stevens JA, Corso P, Finkelstein E, Miller T: The costs of fatal and nonfatal falls among older adults. Inj Prevent. 2006, 12: 290-295. 10.1136/ip.2005.011015.CrossRef
7.
go back to reference Thomas KE, Stevens JA, Sarmiento K, Wald MM: Falls-related traumatic brain injury deaths and hospitalizations among older adults – United States, 2005. J Safety Res. 2008, 39: 269-272. 10.1016/j.jsr.2008.05.001.CrossRefPubMed Thomas KE, Stevens JA, Sarmiento K, Wald MM: Falls-related traumatic brain injury deaths and hospitalizations among older adults – United States, 2005. J Safety Res. 2008, 39: 269-272. 10.1016/j.jsr.2008.05.001.CrossRefPubMed
8.
go back to reference American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention: Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001, 49: 664-672. 10.1046/j.1532-5415.2001.49115.x.CrossRef American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention: Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001, 49: 664-672. 10.1046/j.1532-5415.2001.49115.x.CrossRef
9.
go back to reference Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society: Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011, 59 (1): 148-157.CrossRef Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society: Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011, 59 (1): 148-157.CrossRef
10.
go back to reference Englander F, Hodson TJ, Terregrossa RA: Economic dimensions of slip and fall injuries. J Forensic Sci. 1996, 41: 733-746.CrossRefPubMed Englander F, Hodson TJ, Terregrossa RA: Economic dimensions of slip and fall injuries. J Forensic Sci. 1996, 41: 733-746.CrossRefPubMed
11.
go back to reference Sogolow E, Sleet D, Saul J: Dissemination, implementation, and widespread use of injury prevention interventions. Handbook of Injury and Violence Prevention. Edited by: Doll LS, Bonzo SE, Mercy JA, Sleet DA. 2007, New York, NY: Springer, 493-510.CrossRef Sogolow E, Sleet D, Saul J: Dissemination, implementation, and widespread use of injury prevention interventions. Handbook of Injury and Violence Prevention. Edited by: Doll LS, Bonzo SE, Mercy JA, Sleet DA. 2007, New York, NY: Springer, 493-510.CrossRef
12.
go back to reference Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RC, Close JCT: Effective exercise for prevention of falls: A systematic review and meta-analysis. J Am Geriatr Soc. 2008, 56 (12): 2234-2243. 10.1111/j.1532-5415.2008.02014.x.CrossRefPubMed Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RC, Close JCT: Effective exercise for prevention of falls: A systematic review and meta-analysis. J Am Geriatr Soc. 2008, 56 (12): 2234-2243. 10.1111/j.1532-5415.2008.02014.x.CrossRefPubMed
13.
go back to reference Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE: Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012, 9 (11): CD007146-PubMed Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE: Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012, 9 (11): CD007146-PubMed
14.
go back to reference Li F, Harmer P, Fisher KJ, McAuley E, Chaumeton N, Eckstrom E, Wilson NL: Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2005, 60: 187-194. 10.1093/gerona/60.2.187.CrossRefPubMed Li F, Harmer P, Fisher KJ, McAuley E, Chaumeton N, Eckstrom E, Wilson NL: Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2005, 60: 187-194. 10.1093/gerona/60.2.187.CrossRefPubMed
15.
go back to reference Wolf SL, Barnhart HX, Kutner NG, McNeely E, Coogler C, Xu T: Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Am Geriatr Soc. 1996, 44: 489-497.CrossRefPubMed Wolf SL, Barnhart HX, Kutner NG, McNeely E, Coogler C, Xu T: Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Am Geriatr Soc. 1996, 44: 489-497.CrossRefPubMed
16.
go back to reference Li F, Harmer P, Fitzgerald K, Eckstrom E, Stock R, Galver J, Maddalozzo G, Batya S: Tai Chi and postural stability in patients with Parkinson’s Disease. N Engl J Med. 2012, 366: 511-519. 10.1056/NEJMoa1107911.CrossRefPubMedPubMedCentral Li F, Harmer P, Fitzgerald K, Eckstrom E, Stock R, Galver J, Maddalozzo G, Batya S: Tai Chi and postural stability in patients with Parkinson’s Disease. N Engl J Med. 2012, 366: 511-519. 10.1056/NEJMoa1107911.CrossRefPubMedPubMedCentral
17.
go back to reference Harmer P: So much research, so little application: Barriers to dissemination and practical implementation of Tai Ji Quan. J Sport Health Sci. 2014, 3: 16-20. 10.1016/j.jshs.2013.10.005.CrossRefPubMed Harmer P: So much research, so little application: Barriers to dissemination and practical implementation of Tai Ji Quan. J Sport Health Sci. 2014, 3: 16-20. 10.1016/j.jshs.2013.10.005.CrossRefPubMed
18.
go back to reference Li F, Harmer P, Glasgow R, Mack KA, Sleet D, Fisher KJ, Kohn MA, Millet LM, Mead J, Xu J, Lin M-L, Yang T, Sutton B, Tompkins Y: Translation of an effective Tai Chi intervention into a community-based falls prevention program. Am J Public Health. 2008, 98 (7): 1195-1198. 10.2105/AJPH.2007.120402.CrossRefPubMedPubMedCentral Li F, Harmer P, Glasgow R, Mack KA, Sleet D, Fisher KJ, Kohn MA, Millet LM, Mead J, Xu J, Lin M-L, Yang T, Sutton B, Tompkins Y: Translation of an effective Tai Chi intervention into a community-based falls prevention program. Am J Public Health. 2008, 98 (7): 1195-1198. 10.2105/AJPH.2007.120402.CrossRefPubMedPubMedCentral
19.
go back to reference Li F, Harmer P, Stock R, Fitzgerald K, Stevens J, Gladieux M, Chou L-S, Carp K, Voit J: Implementing an evidence-based fall prevention program in an outpatient clinical setting. J Am Geriatr Soc. 2013, 61: 2142-2149. 10.1111/jgs.12509.CrossRefPubMedPubMedCentral Li F, Harmer P, Stock R, Fitzgerald K, Stevens J, Gladieux M, Chou L-S, Carp K, Voit J: Implementing an evidence-based fall prevention program in an outpatient clinical setting. J Am Geriatr Soc. 2013, 61: 2142-2149. 10.1111/jgs.12509.CrossRefPubMedPubMedCentral
20.
go back to reference Li F: Transforming traditional Tai Ji Quan techniques into integrative movement therapy Tai Ji Quan: Moving for Better Balance. J Sport Health Sci. 2014, 3: 9-15. 10.1016/j.jshs.2013.11.002.CrossRefPubMedPubMedCentral Li F: Transforming traditional Tai Ji Quan techniques into integrative movement therapy Tai Ji Quan: Moving for Better Balance. J Sport Health Sci. 2014, 3: 9-15. 10.1016/j.jshs.2013.11.002.CrossRefPubMedPubMedCentral
22.
go back to reference Glasgow RE, Emmons KM: How can we increase translation of research into practice? Types of evidence needed. Ann Rev Public Health. 2007, 28: 413-433. 10.1146/annurev.publhealth.28.021406.144145.CrossRef Glasgow RE, Emmons KM: How can we increase translation of research into practice? Types of evidence needed. Ann Rev Public Health. 2007, 28: 413-433. 10.1146/annurev.publhealth.28.021406.144145.CrossRef
25.
go back to reference Folstein MF, Folstein SE, McHugh PR: Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. J Psychiatrics Res. 1975, 12 (3): 189-198. 10.1016/0022-3956(75)90026-6.CrossRef Folstein MF, Folstein SE, McHugh PR: Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. J Psychiatrics Res. 1975, 12 (3): 189-198. 10.1016/0022-3956(75)90026-6.CrossRef
26.
go back to reference Li F, Fisher KJ, Harmer P, Irbe D, Tearse RG, Weimer C: Tai Chi and self-rated quality of sleep and daytime sleepiness in older adults: A randomized controlled trial. J Am Geriatr Soc. 2004, 52: 892-900. 10.1111/j.1532-5415.2004.52255.x.CrossRefPubMed Li F, Fisher KJ, Harmer P, Irbe D, Tearse RG, Weimer C: Tai Chi and self-rated quality of sleep and daytime sleepiness in older adults: A randomized controlled trial. J Am Geriatr Soc. 2004, 52: 892-900. 10.1111/j.1532-5415.2004.52255.x.CrossRefPubMed
27.
go back to reference Li F, Harmer P, Liu Y, Chou L-S: Tai Ji Quan and global cognitive function in older adults with cognitive impairment: A pilot study. Arch Gerotol Geriatr. 2014, 3: 434-439.CrossRef Li F, Harmer P, Liu Y, Chou L-S: Tai Ji Quan and global cognitive function in older adults with cognitive impairment: A pilot study. Arch Gerotol Geriatr. 2014, 3: 434-439.CrossRef
28.
go back to reference Podsiadlo D, Richardson S: The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991, 39: 142-148.CrossRefPubMed Podsiadlo D, Richardson S: The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991, 39: 142-148.CrossRefPubMed
29.
go back to reference Newton R: Validity of the multidirectional reach test: A practical measure for limits of stability in older adults. J Gerontol Med Sci. 2001, 56A: M248-M252.CrossRef Newton R: Validity of the multidirectional reach test: A practical measure for limits of stability in older adults. J Gerontol Med Sci. 2001, 56A: M248-M252.CrossRef
30.
go back to reference Lord SR, Murray SM, Chapman K, Munro B, Tiedemann A: Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. J Gerontol A Biol Sci Med Sci. 2002, 57: M539-M543. 10.1093/gerona/57.8.M539.CrossRefPubMed Lord SR, Murray SM, Chapman K, Munro B, Tiedemann A: Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. J Gerontol A Biol Sci Med Sci. 2002, 57: M539-M543. 10.1093/gerona/57.8.M539.CrossRefPubMed
Metadata
Title
Protocol for disseminating an evidence-based fall prevention program in community senior centers: evaluation of translatability and public health impact via a single group pre-post study
Authors
Fuzhong Li
Peter Harmer
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2014
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/1748-5908-9-63

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