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Implementing an evidence-based fall prevention program in an outpatient clinical setting.

Fuzhong Li1, Peter Harmer2, Ronald Stock3

  • 1Oregon Research Institute, Eugene, Oregon.

Journal of the American Geriatrics Society
|October 30, 2013
PubMed
Summary

This study shows that healthcare providers can successfully refer older adults to a Tai Ji Quan program, reducing falls. The evidence-based fall prevention program is scalable and has a significant public health impact.

Keywords:
RE-AIMTai Ji Quandisseminationfallsolder adults

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Area of Science:

  • Gerontology
  • Public Health
  • Rehabilitation Medicine

Background:

  • Tai Ji Quan programs are effective in reducing fall risk in older adults.
  • Disseminating evidence-based fall prevention programs into clinical settings is crucial for public health.
  • Outpatient clinical settings offer a potential avenue for widespread program adoption.

Purpose of the Study:

  • To assess the dissemination potential of an efficacious Tai Ji Quan program within outpatient clinical settings.
  • To evaluate the adoption, reach, implementation, and maintenance of a fall prevention program.
  • To determine the program's scalability and exportability for broader public health impact.

Main Methods:

  • A single-group pre/post design was employed, with 379 participants aged 65+ attending a 24-week Tai Ji Quan program.
  • The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework guided outcome assessment.
  • Primary outcomes included provider referral rates and participant enrollment; secondary outcomes measured program fidelity, retention, and effectiveness.

Main Results:

  • A 62% provider adoption rate and 67% participant reach were achieved.
  • The program demonstrated high fidelity, 75% retention, and significant improvements in falls, balance, and physical performance.
  • Post-intervention follow-up indicated sustained program maintenance among providers, participants, and centers.

Conclusions:

  • Healthcare providers successfully implemented a referral protocol for a Tai Ji Quan fall prevention program.
  • The evidence-based program is readily scalable and exportable, showing potential for substantial clinical and public health benefits.
  • This model facilitates the integration of effective fall prevention strategies into routine healthcare.