Falls are the leading cause of unintentional home injury and death among older adults in the United States, accounting for 68% of the deaths. Over 50% of fatal and nonfatal fall injuries occur in the home. Senior centers are common in communities throughout the United States, with approximately 11,500 serving as gathering places and sources of both information and support for their clientele. As such, they are a potentially powerful mechanism for delivering injury control interventions to community-dwelling older adults. Learning about factors that contribute to successful dissemination of an injury program to these organizations will have utility not only for delivery of falls prevention programs but also for other injury interventions geared to seniors. Public health researchers and organizations recognize the need for more research aimed at gaining """"""""a better understanding of how best to speed up the dissemination and adoption of recommended interventions, including more knowledge of key barriers in practice settings and of the most useful dissemination strategies for different groups of key users"""""""". Despite these recommendations, a dearth of dissemination and adoption research exists in injury prevention. ? ? The proposed study aims to fill this gap by identifying effective methods of disseminating an older adult falls prevention program to senior centers to increase the likelihood of adoption and implementation of the program by both the senior centers, as well as older adults. It builds on a unique collaboration between the University of North Carolina Injury Prevention Research Center (UNC IPRC) and the Home Safety Council (HSC), a national nonprofit organization focused on promoting policy and practice to improve home safety. The objectives of this project are to describe senior center barriers to adoption and implementation of the program and to develop dissemination strategies to address those barriers. The central hypothesis is that senior centers are more inclined to adopt and implement a falls intervention program if it is better tailored to meet their specific needs, and this in turn will increase the likelihood that older adults will adopt and implement the program components.
The specific aims are to: (1) Assess the perceived needs for, and barriers to, adoption and implementation of Safe Steps in senior centers; (2) Examine the effectiveness of two enhanced dissemination strategies, compared with a mail-out only strategy, in promoting senior center and older adult adoption and implementation of Safe Steps; (3) Identify organizational-level factors that predict increased adoption and implementation of Safe Steps by senior centers; and, (4) Identify individual-level factors that predict increased adoption and implementation of Safe Steps by older adults. The first specific aim will be examined by conducting a needs assessment with a national sample of 510 senior centers. The second will be evaluated using a randomized controlled trial of 180 senior centers equally randomized into: (1) Safe Steps as a mail-out, (2) Safe Steps with a training component aimed at assisting senior center staff in program delivery, or (3) Safe Steps with a dissemination strategy to address the barriers identified in the needs assessment. ? ? ?
| Zachary, Ciara; Casteel, Carri; Nocera, Maryalice et al. (2012) Barriers to senior centre implementation of falls prevention programmes. Inj Prev 18:272-6 |
