UNC Chapel Hill Institute on Aging, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599–1030, USA.
J Safety Res. 2011 Dec;42(6):509-16. doi: 10.1016/j.jsr.2011.09.003. Epub 2011 Nov 18.
Exercise-based research interventions demonstrate reduced risk and rates of falls for community dwelling older adults; however, little is known about effective mechanisms for the translation, implementation, and maintenance of these interventions in community settings.
The RE-AIM framework was used to assess the translatability of an effective exercise-based research intervention in a community setting. Questions included: Reach - Would the target population attend? Effectiveness - What was the adherence and compliance to the program? Were there individual improvements in falls risk factors? Adoption: Would staff at the center adopt the program and offer it past the funding period? Implementation - What adaptations, including optimal frequency and duration, should be made to meet the community needs, still adhere to core elements and achieve similar outcomes? Maintenance - Would the program be sustained by our community partners?
The process of translating a controlled research intervention targeting older adults at risk of falls into a community setting was challenging. Licensed professionals developed the infrastructure to safely and effectively deliver the program. The end product was highly appealing program to our target audience, resulted in improved outcomes and was successfully adopted and maintained by the community partner.
Partnerships between community and healthcare providers are key to successful implementation of falls prevention interventions. Lessons learned from this experience can be applied to the translation of future exercise-based falls prevention interventions.
基于运动的研究干预措施表明,对于居住在社区的老年人来说,跌倒的风险和发生率降低了;然而,对于如何将这些干预措施在社区环境中进行有效的转化、实施和维持,人们知之甚少。
使用 RE-AIM 框架评估在社区环境中实施一项有效的基于运动的研究干预措施的可转化性。问题包括:覆盖范围 - 目标人群会参加吗?效果 - 对该计划的坚持和遵守程度如何?是否有个体在跌倒风险因素方面有所改善?采用 - 中心的工作人员是否会采用该计划,并在资金周期结束后继续提供?实施 - 为了满足社区需求,仍坚持核心要素并取得类似效果,应进行哪些调整,包括最佳频率和时长?维持 - 我们的社区合作伙伴是否会维持该计划?
将针对有跌倒风险的老年人的受控研究干预措施转化为社区环境的过程极具挑战性。持照专业人员构建了基础设施,以安全有效地提供该计划。最终产品对我们的目标受众极具吸引力,改善了结果,并被社区合作伙伴成功采用和维持。
社区和医疗保健提供者之间的伙伴关系是成功实施跌倒预防干预措施的关键。从这次经验中吸取的教训可以应用于未来基于运动的跌倒预防干预措施的转化。