FRAIL (Fall Risk & Adult Intervention Linkages) Training
Background and History
The FRAIL (Fall Risk & Adult Intervention Linkages) 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). The project was led by Iowa State University of Science and Technology and was carried out in collaboration with the Iowa Community Hub. The screening and referral process is based on the STEADI protocol developed by the CDC and was refined through a clinical trial (NCT05693025) conducted with oversight from CDC program officers from the National Center for Injury Prevention and Control.
The process was adopted by the Iowa Falls Prevention Coalition to standardize screening methods and referrals across the state. An online course (available through Workday Learning) has been developed by our U-TuRN team to facilitate training and use. Registration is coordinated by the Walk with Ease research team so visit the Walk with Ease website for details. You can email our team at uturn@iastate.edu with questions.
Overview of the FRAIL Training Course:
The online course provides foundational training on the STEADI fall risk screening protocol developed by the Centers for Disease Control (CDC) as well as information on evidence-based interventions and how to effectively refer individuals to these programs through the Iowa Community HUB. The course is appropriate for a range of professionals (both clinicians and non-clinicians) since screening can be conducted with different levels of sophistication. The course is free in Iowa as part of linkages to a state arthritis project supported by the CDC as there are clear co-morbidities and linkages between frailty, arthritis and fall prevention. However, it is available for others through an associated fee-for-service model ($20/person). The course has been approved for continuing medical education (CME credits) to promote applications by clinicians and this can be requested for an additional $50 fee. Details on the CE are provided below:
Des Moines University Medicine and Health Sciences is the accredited provider and has approved this activity for AMA PRA Category 1 Credit™, American Osteopathic Association credit, and continuing education contact hours. The speaker(s) will disclose if any pharmaceuticals, medical procedures, or devices discussed are investigational or unapproved for use by the U.S. Food and Drug Administration (FDA). The activity director is responsible for determining educational content and selecting speakers. No ineligible company provided financial support for this continuing education activity. If you have questions regarding continuing education credit, please email cme@dmu.edu
It is important to emphasize that the online training course only provides foundational exposure to the process and the methods. Supplemental training based on our ‘live intensive’ approach is recommended to provide practical experience and to build capacity for coordinated implementation. This training is intended to promote the adoption and use of CDC-recommended best practices for STEADI in both clinical and community settings, and to specifically encourage the development of clinic-community partnerships for coordinated fall prevention efforts. The course/process is relevant for an array of clinical and community applications, and the ‘live intensive’ approach is designed to help address the specific needs of individuals, groups, coalitions or clinics. The programming is directly aligned with recommended screening and referral practices endorsed by the Iowa Falls Prevention Coalition which coordinates programming through the Iowa Community HUB; however, the training and content is relevant to applications in other states and health care models. Details on the four modules are provided below:
- Module 1 – Introduction to Fall Risks: This module covers the national prevalence of falls among older adults, their health and financial implications, and the importance of early intervention and prevention strategies.
- Module 2 – Screening, Assessment, and Intervention: This module describes how to administer the CDC’s Stay Independent questionnaire and how to use and score physical performance assessments including the Timed Up and Go (TUG) Test, 4-Stage Balance Test, and the 30-Second Sit to Stand. The module includes demonstration videos and printable handouts. It also guides participants in interpreting results and providing personalized recommendations for intervention based on risk level.
- Module 3 – Processing and Referral: This module describes how to apply screening protocols in both clinical and community settings and outlines available support services and referral pathways via the Iowa Community HUB; however, applications can be adapted to other systems or partners.
- Module 4 – Evidence-Based Program (EBP) Referrals: This module describes elements of EBPs (e.g. Tai Chi for Arthritis and Falls Prevention, Stepping On, A Matter of Balance, and Walk with Ease) that are designed to reduce risks of falling.
Questions can be addressed through the project manager (Ms. Abbie Coniglio – abbiec@iastate.edu). You can also learn more about our research on fall risk and our innovative scoring methods and supplemental support through by visiting the FRAIL page on our website.