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Implementing an Evidence‐Based Fall Prevention Program in an Outpatient Clinical Setting
Author(s) -
Li Fuzhong,
Harmer Peter,
Stock Ronald,
Fitzgerald Kathleen,
Stevens Judy,
Gladieux Michele,
Chou LiShan,
Carp Kenji,
Voit Jan
Publication year - 2013
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12509
Subject(s) - medicine , fall prevention , physical therapy , fear of falling , health care , gerontology , family medicine , poison control , injury prevention , medical emergency , economics , economic growth
Objectives To investigate the dissemination potential of a T ai J i Q uan–based program, previously shown to be 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 T ai J i Q uan training program for 24 weeks. Setting Communities in L ane C ounty, O regon. Participants Independently living individuals (N = 379) aged 65 and older. Measurements Using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, the primary outcome was the proportion of participating healthcare providers who made referrals. Secondary outcomes were the proportion of referred individuals 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 individuals referred, 379 (67% reach) enrolled in the program, which was successfully implemented in senior and community centers with good fidelity, 283 completed the program (75% retention), and 212 of these attended 75% or more of the 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 postintervention follow‐up indicated encouraging levels of program maintenance among providers, participants, and community centers. Conclusion Healthcare providers successfully implemented a protocol to refer individuals at risk of falling to a T ai J i Q uan–based program. The evidence‐based program appears readily scalable and exportable, with potential for substantial clinical and public health effect.