Preventing Falls Among Older Adults in Primary Care: A Mixed Methods Process Evaluation Using the RE-AIM Framework

Area of Science:

• Public Health
• Gerontology
• Healthcare Management

Background:

• Falls are a major cause of injury and death in older adults.
• The Centers for Disease Control and Prevention's STEADI initiative offers a multifactorial approach to fall prevention.
• STEADI was adapted for primary care in upstate New York.

Purpose of the Study:

• To report process evaluation results of STEADI implementation using the RE-AIM framework.
• To examine the utility of the RE-AIM framework for assessing barriers and facilitators in fall prevention programs.
• To inform future implementations of STEADI-based fall prevention strategies.

Main Methods:

• Mixed-methods evaluation combining qualitative (interviews) and quantitative (surveys) approaches.
• Utilized the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework for process evaluation.
• Data collection occurred over 2 months, 18 months postimplementation.

Main Results:

• Key barriers included competing organizational priorities, patient care demands, and staff turnover.
• Primary facilitators were physician champions, staff training, and effective communication.
• Qualitative and quantitative findings showed high concordance.

Conclusions:

• The RE-AIM framework effectively assessed barriers and facilitators in STEADI implementation.
• Mixed methods provided rich data for optimizing future fall prevention program rollouts.
• Addressing identified barriers and leveraging facilitators can enhance the adoption and sustainability of fall prevention initiatives.