Delivery of Fall Prevention Interventions for At-Risk Older Adults in Rural Areas: Findings from a National Dissemination

Smith, Matthew Lee; Towne, Samuel D.; Herrera-Venson, Angelica; Cameron, Kathleen A.; Horel, Scott; Ory, Marcia G.; Gilchrist, C; Schneider, E; DiCocco, Casey; Skowronski, Shannon

doi:10.3390/ijerph15122798

Cited by 44 publications

(48 citation statements)

References 39 publications

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“…Telephone survey provides a more accurate assessment of what older adults hear when they inquire about EBCFPPs from SCs compared to only prior publications of ACL‐funded programs, as there are many EBCFPPs that are not funded by the ACL . Additional sources of funding may include research grants, local government, and managed care programs .…”

Section: Discussioncontrasting

confidence: 95%

“…It is possible that in the compendium, not all the EBCFPPs were offered in the state in 2016, either because they were funded by the ACL but not enumerated at this particular document or because they were funded by sources other than ACL. This may lend support to the prior suggestions that gathering data on EBCFPPs exclusively from ACL‐funded sources may underestimate the actual number of these programs offered at SCs and, therefore, a direct telephone survey method may be superior.…”

Section: Discussionmentioning

confidence: 99%

“…A prior study showed significant geographic disparities in delivery of EBCFPPs across the United States. Similarly, we found differences between the offerings of these programs across the 10 ACs: SCs near CU offered all four programs sampled, whereas those near UNM or UCLA offered only one.…”

Section: Discussionmentioning

confidence: 99%

“…Our regression analysis did not account for meaningful variables, like population density, within the 25‐mile radius, frequency of EBCFPPs offered, or access to EBCFPPs outside of SCs. Although our finding that TC, SO, and MO are the most commonly offered EBCFPPs is consistent with prior literature, it is likely our finding that TC is the most commonly offered EBCFPP is an overestimation since we counted different types of TC as one, even if they were not evidence based, such as TCA or TJQ.…”

Section: Discussionmentioning

confidence: 99%

“…Despite ongoing funding of EBCFPPs and the CDC's STEADI guideline recommendation to utilize them, little is known about current availability of EBCFPPs in local community organizations, like SCs. A recent analysis from a national repository of 39 ACL grantees described self‐reported delivery of EBCFPP workshops offered across different community organizations and found that approximately 80% of EBCFPPs were delivered in metropolitan areas; the most were delivered in SCs (26%), with MO, SO, TJQ, and TCA being the most commonly offered programs in descending order …”

Section: List Of Abbreviations Used Throughout the Articlementioning

confidence: 99%

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Evidence‐Based Community Fall Prevention Programs at Senior Centers Near 10 US Academic Centers

Hamel

Hekmatjah

Hakakian

et al. 2019

J American Geriatrics Society

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BACKGROUND/OBJECTIVES The Centers for Disease Control and Prevention recommends that patients at risk of falling engage in evidence‐based community fall prevention programs (EBCFPPs). EBCFPPs are often delivered in senior centers (SCs). This is the first independent assessment of availability of EBCFPPs in SCs. DESIGN Cross‐sectional study of four types of EBCFPPs in the 25‐mile radius of 10 US academic centers (ACs). SETTING SCs. PARTICIPANTS SCs. INTERVENTION None. MEASUREMENTS Number and types of EBCFPPs offered at SCs. RESULTS Across the 10 ACs, 249 SCs were sampled. Of the SCs, 35% offered zero, 54% offered at least one, 9% offered at least two, and 2% offered at least three EBCFPPs. Tai Chi of any type was offered in 59.8%, A Matter of Balance was offered in 8.9%, Stepping On was offered in 8.0%, and Staying Active and Independent for Life was offered in 1.2% of SCs sampled. SCs near Columbia University offered all four of the programs, while those near the University of Utah, Johns Hopkins University, and Seattle University only offered three of the programs. In univariate analysis, the number of local SCs was significantly associated with quantity of EBCFPPs (odds ratio [OR] = 2.2; 95% confidence interval [CI] = 1.9‐2.6; P < .001), but not with diversity of EBCFPPs (OR = 1.0; 95% CI = 1.0‐1.1; P = .13). In multivariate regression, city, sex distribution, and average household income did not correlate with the overall number or the diversity of EBCFPPs, whereas locales with more SCs offered more EBCFPPs (OR = 2.2; 95% CI = 1.7‐2.9; P < .001). CONCLUSIONS A significant number of SCs still do not offer any EBCFPPs. From those that do, few offer a diversity of these programs. Opportunities exist to increase access to EBCFPPs in SCs.

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: List Of Abbreviations Used Throughout the Articlementioning

confidence: 99%

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Evidence‐Based Community Fall Prevention Programs at Senior Centers Near 10 US Academic Centers

Hamel

Hekmatjah

Hakakian

et al. 2019

J American Geriatrics Society

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Remotely Delivered Exercise to Rural Older Adults With Knee Osteoarthritis: A Pilot Study

Patel

Hoffman

Phelan

et al. 2022

ACR Open Rheumatology

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Objective EnhanceFitness (EF) is an evidence‐based exercise program recommended for management of osteoarthritis (OA). However, access to EF is limited in rural areas. Accordingly, we evaluated the feasibility and acceptability of remotely delivered EF (tele‐EF) in rural, community‐dwelling older adults with symptomatic knee OA. Methods A single‐arm pilot trial of tele‐EF classes was conducted. Videoconferencing was used to livestream the instructor‐led, 1‐hour EF classes 3 days/week for 12 weeks. Outcomes were assessed at baseline and immediately post intervention. Results A total of 15 of 27 potential participants (55%) were screen eligible and enrolled into the trial. Participants had a median age of 70 years (interquartile range: 67‐75), and 14 (93%) were women. The median EF class attendance rate was 91% (interquartile range: 85%‐94%). Knee pain, as measured by the Knee Injury and Osteoarthritis Outcome Score (KOOS), improved significantly from baseline to the 12‐week end point (mean difference = −11.4 [95% confidence interval (CI): −20.9 to −2.0]; P = 0.02). In addition, participants’ self‐reported knee function improved significantly (mean difference in KOOS function score = −11.8 [95% CI: −18.4 to −5.2]; P < 0.01) as well as their physical capacity (mean difference in Timed Up and Go test time = 1.8 seconds [95% CI: 0.2‐3.4]; P = 0.03). All participants (100%) were very satisfied with tele‐EF classes, and 12 participants (86%) reported that their condition had much improved or very much improved since beginning the EF exercise program. Lastly, there were no serious adverse events. Conclusion Findings from this pilot trial indicate that tele‐EF is feasible and acceptable in rural older adults with knee OA.

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Falls

Vieira

Silva

Clemson

et al. 2021

Encyclopedia of Gerontology and Population Aging

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Delivery of Fall Prevention Interventions for At-Risk Older Adults in Rural Areas: Findings from a National Dissemination

Cited by 44 publications

References 39 publications

Evidence‐Based Community Fall Prevention Programs at Senior Centers Near 10 US Academic Centers

Evidence‐Based Community Fall Prevention Programs at Senior Centers Near 10 US Academic Centers

Remotely Delivered Exercise to Rural Older Adults With Knee Osteoarthritis: A Pilot Study

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