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Translating a Fall Prevention Intervention Into Practice: A Randomized Community Trial
Clare E Guse1, Donna J Peterson, Ann L Christiansen
1Clare E. Guse is with the Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee. Donna J. Peterson, Ann L. Christiansen, and Peter M. Layde are with the Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee. Jane Mahoney is with the Department of Medicine, Division of Geriatrics, University of Wisconsin School of Medicine and Public Health, Madison. Purushottam Laud is with the Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee. Clare E. Guse, Ann L. Christiansen, Purushottam Laud, and Peter M. Layde are also with the Injury Research Center, Medical College of Wisconsin, Milwaukee.
Objectives:
We examined whether community translation of an effective evidence-based fall prevention program via standard monetary support can produce a community-wide reduction in fall injuries in older adults and evaluated whether an enhanced version with added technical support and capacity building amplified the fall reduction effect.
Methods:
We completed a randomized controlled community trial among adults aged 65 and older in (1) 10 control communities receiving no special resources or guidance on fall prevention, (2) 5 standard support communities receiving modest funding to implement Stepping On, and (3) 5 enhanced support communities receiving funding and technical support. The primary outcome was hospital inpatient and emergency department discharges for falls, examined with Poisson regression.
Results:
Compared with control communities, standard and enhanced support communities showed significantly higher community-wide reductions (9% and 8%, respectively) in fall injuries from baseline (2007-2008) to follow-up (2010-2011). No significant difference was found between enhanced and standard support communities.
Conclusions:
Population-based fall prevention interventions can be effective when implemented in community settings. More research is needed to identify the barriers and facilitators that influence the successful adoption and implementation of fall prevention interventions into broad community practice.
