CE25-027 - Evaluate STEADI-based Fall Prevention in Assisted Living Facilities

About This Grant

Falls are a serious problem among older adults, resulting in approximately 3.6 million emergency room visits and 1.1 million hospitalizations among persons ages 65 and older in 2022. Falls may pose even more significant risks to assisted living facility (ALF) residents. As compared to community-dwelling seniors, seniors in ALFs residents are older, have more chronic health conditions, and often have trouble with mobility, mental health, memory, and activities of daily living. Implementing the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) Initiative within ALFs has the potential to reduce falls and costs in these settings; however, until now, the feasibility and effectiveness of STEADI fall prevention in ALFs have not been sufficiently studied. We propose a plan to experimentally implement STEADI in eight ALFs and measure its feasibility, implementation fidelity, effectiveness, and cost-effectiveness through three aims: 1. Develop an experimentally designed Study Protocol, Implementation Plan, and Evaluation plan, and obtain IRB Approval. 2. Implement with fidelity all components of STEADI screening, assessment, intervention, and follow-up in recruited ALFs and collect study data on implementation feasibility, assessments, use of STEADI recommended preventive services, all falls, injurious falls, and implementation costs. 3. Analyze and evaluate study data to understand implementation quality and fidelity, its impact on fall outcomes, and its costs and cost-effectiveness, and stratify these analyses to account for important subpopulations such as those with memory and dementia needs and those from rural areas Implementing and experimentally evaluating STEADI fall prevention in ALFs is vital for public health improvement, yet it is challenging. Our proposal accounts for challenges through our study design, partner selection, and data capture. We propose a design to maximize the study’s power and increase implementation feasibility. We have partnered with an ALF organization that provides state-of-the-art EHR, MAR, and fall incident systems to track fall events (non-injurious and injurious), STEADI-recommended preventive services, comorbidities, medications, and medication adjustments. We additionally provide a plan to analyze additional Medicare claims data to increase the number of clusters measured and to help detect significant differences in medically treated falls. When successful, this study has the potential to contribute substantial evidence about the effectiveness, cost-effectiveness, and return on investment of STEADI fall prevention in ALFs.