2016年，使用美国疾病控制与预防中心的《保持独立检查表》来参与美国印第安人社区并提高对跌倒风险的认识。
Using the Centers for Disease Control and Prevention's Stay Independent Checklist to Engage a Community of American Indians and Raise Awareness About Risk of Falls, 2016.
作者信息
Popp Janet, Waters Debra L, Leekity Karen, Ghahate Donica, Bobelu Jeanette, Tsikewa Ross, Herman Carla J, Shah Vallabh
机构信息
School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
Dunedin School of Medicine and School of Physiotherapy, University of Otago, Dunedin, New Zealand.
出版信息
Prev Chronic Dis. 2017 Jan 19;14:E05. doi: 10.5888/pcd14.160395.
BACKGROUND
The unintentional death rate from falls is higher among American Indians from the US Southwest than from other regions in the country. The Zuni Pueblo is a geographically isolated, rural American Indian community located in western New Mexico. Education and screening for falls risk is lacking in this community and may be needed to reduce falls and falls-related illness and death.
COMMUNITY CONTEXT
Building on a 17-year relationship with the Zuni Health Initiative, meetings were held with Zuni tribal leadership, staff from the Zuni Senior Center and Zuni Home Health Services, members of the Zuni Comprehensive Community Health Center, Indian Health Service, and Zuni community health representatives (CHRs) to discuss elder falls in the community. Existing infrastructure, including CHRs who were already trained and certified in diabetes education and prevention, provided support for the study.
METHODS
Tribal leadership agreed that CHRs would be trained to administer the Centers for Disease Control and Prevention's (CDC's) Stay Independent checklist to assess falls risk. They administered the checklist during one-on-one interviews in Shiwi (Zuni native language), English, or both to a convenience sample of 50 Zuni elders.
OUTCOMES
Mean age of participants was 72 (standard deviation, 7.4) years, and 78% were women. Fifty-two percent reported at least 1 fall during the past year; 66% scored 4 or more on the CDC Stay Independent checklist, indicating elevated risk for falls. CHRs reported that the checklist was easy to administer and culturally accepted by the elder participants.
INTERPRETATION
This study broadened the Zuni Health Initiative to include falls risk screening. Self-reported falls were common in this small sample, and the incidence was significantly higher than the national rate. These results highlight the need for community engagement, using culturally acceptable falls screening, to promote falls education and implement falls prevention programs.
背景
美国西南部的美国印第安人的意外跌倒死亡率高于该国其他地区。祖尼普韦布洛是位于新墨西哥州西部的一个地理上孤立的乡村美国印第安人社区。该社区缺乏针对跌倒风险的教育和筛查，可能需要开展此类活动以减少跌倒及与跌倒相关的疾病和死亡。
社区背景
基于与祖尼健康倡议长达17年的合作关系，研究人员与祖尼部落领导层、祖尼老年中心和祖尼家庭健康服务机构的工作人员、祖尼综合社区健康中心成员、印第安健康服务机构以及祖尼社区健康代表（CHR）举行了会议，讨论社区中的老年人跌倒问题。现有的基础设施，包括已经接受过糖尿病教育和预防培训并获得认证的CHR，为该研究提供了支持。
方法
部落领导层同意对CHR进行培训，使其能够使用美国疾病控制与预防中心（CDC）的“保持独立”检查表来评估跌倒风险。他们在一对一访谈中，用希维语（祖尼语）、英语或两种语言结合的方式，对50名祖尼老年人的便利样本进行了该检查表的评估。
结果
参与者的平均年龄为72岁（标准差为7.4岁），78%为女性。52%的人报告在过去一年中至少跌倒过1次；66%的人在CDC“保持独立”检查表上的得分达到4分或更高，表明跌倒风险较高。CHR报告称，该检查表易于实施，并且老年参与者在文化上能够接受。
解读
本研究扩展了祖尼健康倡议，将跌倒风险筛查纳入其中。在这个小样本中，自我报告的跌倒情况很常见，且发生率显著高于全国水平。这些结果凸显了通过采用文化上可接受的跌倒筛查方式，促进社区参与以开展跌倒教育并实施跌倒预防项目的必要性。
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