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- Title
Outcomes associated with scale-up of the Stepping On falls prevention program: A case study in redesigning for dissemination.
- Authors
Mahoney, Jane E.; Gangnon, Ron; Clemson, Lindy; Jaros, LaVerne; Cech, Sandy; Renken, Jill
- Abstract
Introduction: Translating complex behavior change interventions into practice can be accompanied by a loss of fidelity and effectiveness. We present the evaluation of two sequential phases of implementation of a complex evidence-based community workshop to reduce falls, using the Replicating Effective Programs Framework. Between the two phases, workshop training and delivery were revised to improve fidelity with key elements. Methods: Stepping On program participants completed a questionnaire at baseline (phase 1: n = 361; phase 2: n = 2219) and 6 months post-workshop (phase 1: n = 232; phase 2: n = 1281). Phase 2 participants had an additional follow-up at 12 months (n = 883). Outcomes were the number of falls in the prior 6 months and the Falls Behavioral Scale (FaB) score. Results: Workshop participation in phase 1 was associated with a 6% reduction in falls (RR = 0.94, 95% CI 0.74–1.20) and a 0.14 improvement in FaB score (95% CI, 0.11– 0.18) at 6 months. Workshop participation in phase 2 was associated with a 38% reduction in falls (RR = 0.62, 95% CI 0.57–0.68) and a 0.16 improvement in FaB score (95% CI 0.14–0.18) at 6 months, and a 28% reduction in falls (RR = 0.72, 95% CI 0.65–0.80) and a 0.19 score improvement in FaB score (95% CI 0.17–0.21) at 12-month follow-up. Conclusions: Effectiveness can be maintained with widespread dissemination of a complex behavior change intervention if attention is paid to fidelity of key elements. An essential role for implementation science is to ensure effectiveness as programs transition from research to practice.
- Subjects
ACCIDENTAL fall prevention; BEHAVIOR; ADULT education workshops; CASE studies; LOYALTY
- Publication
Journal of Clinical & Translational Science, 2020, Vol 4, Issue 3, p250
- ISSN
2059-8661
- Publication type
Article
- DOI
10.1017/cts.2020.17