TY - JOUR
T1 - Implementing an evidence-based fall prevention program in an outpatient clinical setting
AU - Li, Fuzhong
AU - Harmer, Peter
AU - Stock, Ronald
AU - Fitzgerald, Kathleen
AU - Stevens, Judy
AU - Gladieux, Michele
AU - Chou, Li Shan
AU - Carp, Kenji
AU - Voit, Jan
PY - 2013/12
Y1 - 2013/12
N2 - Objectives: To investigate the dissemination potential of a Tai Ji Quan-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 Tai Ji Quan training program for 24 weeks. Setting: Communities in Lane County, Oregon. 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 Tai Ji Quan-based program. The evidence-based program appears readily scalable and exportable, with potential for substantial clinical and public health effect.
AB - Objectives: To investigate the dissemination potential of a Tai Ji Quan-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 Tai Ji Quan training program for 24 weeks. Setting: Communities in Lane County, Oregon. 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 Tai Ji Quan-based program. The evidence-based program appears readily scalable and exportable, with potential for substantial clinical and public health effect.
KW - RE-AIM
KW - Tai Ji Quan
KW - dissemination
KW - falls
KW - older adults
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U2 - 10.1111/jgs.12509
DO - 10.1111/jgs.12509
M3 - Article
C2 - 24164465
AN - SCOPUS:84890565003
SN - 0002-8614
VL - 61
SP - 2142
EP - 2149
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 12
ER -