Enhancing Training and Evaluation of Fall Risk Programming
Preventing falls in older adults is a critical public health priority. Approximately 1 in 4 older adults falls each year, and the consequences can be significant—especially for those who are frail and more susceptible to fractures and other complications. Many older adults experience a loss of independence and reduced quality of life after a fall, making fall prevention a major focus in public health. The Centers for Disease Control and Prevention (CDC) has developed a formal, evidence-based protocol called STEADI (Stopping Elderly Accidents, Deaths, and Injuries) for fall risk screening. STEADI offers a standardized approach to fall prevention; however, barriers to its use have limited its overall impact. Updated recommendations have called for team-based approaches and a modified screening process to increase referrals to interventions.
Through a CDC-funded trial, we developed and tested an integrated training model called FRAIL© (Fall Risk & Adult Intervention Linkages), which provides foundational training on fall risk screening and referrals. The development of the FRAIL screening and referral process was conceptualized and evaluated through a Cooperative Agreement with the Centers for Disease Control and Prevention (CDC) focused on community–based fall prevention programming (1U01CE003490-01: Process and Outcome Evaluation of the Walk with Ease program for Fall Prevention). The conceptualization of the training course was completed in collaboration with the program officers on the project from the National Center for Injury Prevention and Control and followed guidelines for appropriate use and dissemination of STEADI resources and methods. The training course was created to facilitate dissemination of best practices for screening and prevention of falls in older adults. Questions about the course and training methods can be addressed through the project leader (Dr. Greg Welk – gwelk@iastate.edu).
A co-leader of the FRAIL research team (Dr. Nick Lamoureux) has also developed a novel scoring metric (based on modifiable risks for falling) that provides a more robust method for evaluating short-term risk of falls (i.e. in the next year) and a more effective indicator for evaluating change in risk over time. The Modifiable Fall Risk Score (MFRS) is being used in the Walk with Ease trial to evaluate outcomes and is also being used to evaluate fall risk profiles in individuals that are screened through the FRAIL process in Iowa.
Details of the FRAIL scoring metric are available in the published paper (Development of a Modifiable Fall Risk Score for evaluating changes in fall risk over time). Questions about the scoring metric and how to apply it in practice can be directed to Dr. Nick Lamoureux (lamoureuxn@unk.edu)
