CE25-027 - Evaluate STEADI-based Fall Prevention in Assisted Living Facilities
openNCIPC - National Center for Injury Prevention and Control
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.
Up to $700K
health research