Physical Therapists and Physical Therapist Assistants' Knowledge and Use of the STEADI for Falls Risk Screening of Older Adults in Physical Therapy Practice in the United States.

Fall-risk screening and prevention is within the scope of physical-therapy practice. Prior research indicates United States-based physical therapists (PTs) and physical-therapist assistants (PTAs) use the Centers for Disease Control and Prevention's STEADI (Stopping Elderly Accidents, Deaths, and Injuries) toolkit for community-based fall-risk screenings of older adults. However, clinically based fall-risk screenings and knowledge and use of the STEADI by PTs and PTAs is unknown.

Clinical-Community Connections: Incorporating Evidence-Based Programs for Improved Patient Outcomes.

Incorporating evidence-based community programs into clinical care recommendations and goals may help bridge the clinic-to-community transition for older adults. Engagement in evidence-based programs can help older adults manage chronic conditions and reduce fall risk through behavior change and self-management following a clinical episode of care. This paper describes evidence-based fall prevention and physical activity programs, provides resources to locate programs, and strategies to match older adults to the right programs.

Physical Therapists as Partners for Community Fall Risk Screenings and Referrals to Community Programs.

Physical therapists (PTs) are integral team members in fall prevention in clinical settings; however, few studies have investigated PTs' engagement in pro-bono community-based falls prevention. Therefore, we aimed to describe the characteristics of PTs and physical therapist assistants (PTAs) in the United States who conduct community-based fall screenings, the reach of screenings, their knowledge and utilization of the Centers for Disease Control and Prevention's fall-risk screening toolkit (STEADI, Stopping Elderly Accidents, Deaths, and Injuries), and therapists' knowledge and referrals to evidence-based programs (EBPs) and community resources. A cross-sectional survey distributed to a convenience sample of PTs/PTAs in the United States through news-blasts, and social media.

Stand Tall-A Virtual Translation of the Otago Exercise Program.

Background And Purpose: The Otago Exercise Program (OEP) is effective at preventing falls and fall-related injuries. The resources and personnel required for program delivery and challenges inherent in monitoring participant adherence and compliance pose significant barriers to increasing the number of older adults participating in the OEP. Alternative delivery systems using virtual platforms may pose a solution.

Examination of sustainability indicators for fall prevention strategies in three states.

With 1-in-4 older adults suffering a fall each year, fall prevention efforts have emerged as a public health priority. Multi-level, evidence-based fall prevention programs have been promoted by the CDC and other government agencies. To ensure participants and communities receive programs' intended benefits, organizations must repeatedly deliver the programs over time and plan for program sustainability as part of 'scaling up' the initiative.

Feasibility of Assessing Falls Risk and Promoting Falls Prevention in Beauty Salons.

Falls are a major public health risk and a leading cause of emergency room visits for people of all ages. Finding ways to increase access to information and evidence-based falls prevention strategies is critically important across the lifespan. We tested the feasibility of conducting a falls risk assessment and awareness program among customers who attend beauty salons.

Reported Systems Changes and Sustainability Perceptions of Three State Departments of Health Implementing Multi-Faceted Evidence-Based Fall Prevention Efforts.

Although the concepts of systems change and sustainability are not new, little is known about the factors associated with systems change sustaining multi-state, multi-level fall prevention efforts. This exploratory study focuses on three State Departments of Health (DOH) that were awarded 5-year funding from the Centers for Disease Control and Prevention to simultaneously implement four separate yet related evidence-based fall prevention initiatives at the clinical, community, and policy level. The purpose of this study was to examine changes in partnerships and collaborative activities that occurred to accomplish project goals (examining changes in the context of "before funding" and "after funding was received").

The Otago Exercise Program: Innovative Delivery Models to Maximize Sustained Outcomes for High Risk, Homebound Older Adults.

Background: It is estimated one in two adults age 80 and over fall each year, resulting in substantial morbidity and mortality rates among this oldest-old population. The Otago Exercise program (OEP) is an evidence-based fall prevention program shown to reduce falls by 35% among high-risk older adults. The OEP was designed to be delivered in the home by physical therapists.

Otago Exercise Program in the United States: Comparison of 2 Implementation Models.

Background: The Otago Exercise Program (OEP) is an evidence-based fall prevention program delivered by a physical therapist in 6 visits over a year. Despite documented effectiveness, there has been limited adoption of the OEP by physical therapists in the United States. To facilitate dissemination, 2 models have been developed: (1) the US OEP provided by a physical therapist or physical therapist assistant in the home or outpatient setting and (2) the community OEP provided by a non–physical therapist and a physical therapist consultant.

Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study.

Background: Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration.

Disseminating the Otago Exercise Program in the United States: Perceived and Actual Physical Performance Improvements From Participants.

The Otago Exercise Program (OEP) is an evidence-based fall prevention program disseminated internationally. Little is known about the implementation or effectiveness of the OEP in the United States. The purposes were to (a) identify characteristics of older adults enrolled in OEP, and (b) examine perceived and actual functional performance changes after participation in 8 weeks of the program.

Are Virtual Rehabilitation Technologies Feasible Models to Scale an Evidence-Based Fall Prevention Program? A Pilot Study Using the Kinect Camera.

Background: Falls in older adults are a significant public health issue. Interventions have been developed and proven effective to reduce falls in older adults, but these programs typically last several months and can be resource intensive. Virtual rehabilitation technologies may offer a solution to bring these programs to scale.

State Fall Prevention Coalitions as Systems Change Agents: An Emphasis on Policy.

Background: Falls among older adults are an escalating public health issue, which requires a multidisciplinary and multilevel approach to affect systems change to effectively address this problem. The National Council on Aging established the Falls Free® Initiative, enfolding and facilitating statewide Fall Prevention Coalitions. Fall Free® activities included developing the State Policy Toolkit for Advancing Falls Prevention to promote sustainable change by supporting the dissemination and adoption of evidence-based strategies.

Gait Speed among Older Participants Enrolled in an Evidence-Based Fall Risk Reduction Program: A Subgroup Analysis.

Background: Functional decline is a primary risk factor for institutionalization and mortality among older adults. Although community-based fall risk reduction programs have been widely disseminated, little is known about their impact on gait speed, a key indicator of functional performance. Changes in functional performance between baseline and post-intervention were examined by means of timed up and go (TUG), a standardized functional assessment test administered to participants enrolled in A Matter of Balance/Volunteer Lay Leader (AMOB/VLL) model, an evidence-based fall risk reduction program.

Management of falls in community-dwelling older adults: clinical guidance statement from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association.

Background: Falls in older adults are a major public health concern due to high prevalence, impact on health outcomes and quality of life, and treatment costs. Physical therapists can play a major role in reducing fall risk for older adults; however, existing clinical practice guidelines (CPGs) related to fall prevention and management are not targeted to physical therapists.

Objective: The purpose of this clinical guidance statement (CGS) is to provide recommendations to physical therapists to help improve outcomes in the identification and management of fall risk in community-dwelling older adults.

Developing an evidence-based fall prevention curriculum for community health workers.

This perspective paper describes processes in the development of an evidence-based fall prevention curriculum for community health workers/promotores (CHW/P) that highlights the development of the curriculum and addresses: (1) the need and rationale for involving CHW/P in fall prevention; (2) involvement of CHW/P and content experts in the curriculum development; (3) best practices utilized in the curriculum development and training implementation; and (4) next steps for dissemination and utilization of the CHW/P fall prevention curriculum. The project team of CHW/P and content experts developed, pilot tested, and revised bilingual in-person training modules about fall prevention among older adults. The curriculum incorporated the following major themes: (1) fall risk factors and strategies to reduce/prevent falls; (2) communication strategies to reduce risk of falling and strategies for developing fall prevention plans; and (3) health behavior change theories utilized to prevent and reduce falls.

Translation of the otago exercise program for adoption and implementation in the United States.

Background: The Otago Exercise Program (OEP) is an evidence-based fall prevention program developed, evaluated, and disseminated in New Zealand. The program was designed for delivery in the home by physical therapists (PTs). It was not known if American PTs would require additional training and resources to adopt the OEP.

Trained community providers conduct fall risk screenings with fidelity: an effective model for expanding reach.

Reliable and valid tools are available for health care providers to screen older adults for fall risk. Proficient administration of these tools by lay or community providers (individuals without formal medical training) may be a viable channel to expand the reach of fall risk screenings. However, the ability of community providers to administer screens is not known.

An effective community-academic partnership to extend the reach of screenings for fall risk.

Older adults should be screened for fall risk annually. Community providers (people without formal medical training who work with older adults in senior centers or aging services) may be a viable group to expand the reach of screenings. Our community-academic partnership developed a program to increase and assess fall risk screenings by community providers.

Complexities of fall prevention in clinical settings: a commentary.

Falls and associated injury and mortality are of increasing concern among aging Americans. Effective fall risk management is a complicated process requiring involvement by both health care professionals and older adults for three related actions: (a) early screening to detect risk factors; (b) prescription of tailored interventions; and (c) implementation of, adherence to, and compliance with the intervention by the older adult. Early detection of fall risk can prevent future falls; however, uptake of evidence-based screening and assessment protocols in the clinical setting has been limited.