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This study demonstrated that implementation of STEADI fall risk screening and prevention strategies among older adults in the primary care setting can reduce fall-related hospitalizations and may lower associated health care expenditures.

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Background and Objectives Falls are a leading cause of injuries and injury deaths for older adults. The Centers for Disease Control and Prevention’s Stopping Elderly Accidents Deaths and Injuries (STEADI) initiative, a multifactorial approach to fall prevention, was adapted for implementation within the primary care setting of a health system in upstate New York. The purpose of this paper is to: (a) report process evaluation results for this implementation using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and (b) examine the utility of RE-AIM for assessing barriers and facilitators. Research Design and Methods This evaluation used mixed methods. Qualitative evaluation involved semi-structured interviews with key stakeholders and intercept interviews with healthcare providers and clinic staff. Quantitative methods utilized surveys with clinic staff. Process evaluation tools were developed based on the AIM dimensions of the RE-AIM framework. The study was conducted over a 2-month period approximately 18 months post-implementation and complements previously published results of the program’s reach and effectiveness. Results Primary barriers by RE-AIM construct included competing organizational priorities (Adoption); competing patient care demands (Implementation); and staff turnover (Maintenance). Primary facilitators included having a physician champion (Adoption); preparing and training staff (Implementation); and communicating about STEADI and recognizing accomplishments (Maintenance). Discussion and Implications Results revealed a high degree of concordance between qualitative and quantitative analyses. The framework supported assessments of various stakeholders, multiple organizational levels, and the sequence of practice change activities. Mixed methods yielded rich data to inform future implementations of STEADI-based fall prevention.

The purpose of this article is to describe implementation of and lessons learned from the Broome County Sodium Reduction in Communities grocery store initiative. This pilot project was conducted in collaboration with a regional supermarket chain and endeavored to develop population-based strategies for reducing sodium intake. Key interventions included marketing strategies, taste test demonstrations, and a public media campaign. Project staff worked closely with corporate registered dietitian nutritionists, a nutrition specialist, and an advertising agency in its development and implementation. A social marketing approach was used to educate consumers about the hidden sources of dietary sodium, to raise awareness of the adverse health effects of excess sodium intake, to encourage consumers to read food labels, and to urge them to purchase food items lower in sodium. The lessons learned from this experience may be of assistance to other communities that seek to implement similar sodium-reduction strategies in the grocery store environment.