title: Step by step: integrating evidence-based fall-risk management into senior centers.
abstract: OBJECTIVE
  Our purpose in this project was to conceptualize and implement evidence-based fall-prevention programming into senior centers. We present challenges to this process and strategies to overcome them.
  
  
  METHODS
  We carried out a dissemination project in nine diverse senior centers in Connecticut. Participants included investigators from the Connecticut Collaboration for Fall Prevention (CCFP), senior center administrators, and trained staff interventionists implementing a program of fall prevention based on the Yale Frailty and Injury Cooperative Studies of Intervention Trials (known as the Yale FICSIT). Using CCFP materials that were based on the stages of change, senior center staff developed methods to integrate fall-prevention programming into their centers. We extracted implementation challenges, and the strategies that senior center staff developed to overcome them, from the minutes of monthly work-group meetings. Monthly counts of individual assessments were also a source of data.
  
  
  RESULTS
  Challenges included staffing and the delineation of authority, structural issues, engaging senior center membership, cultural issues, and the modification of existing practices. Each senior center devised site-specific methods to overcome these challenges when CCFP investigators convened work-group meetings. We developed creative strategies to inform senior center membership about fall prevention, and in the first 18 months, 4% of members scheduled individual assessments.
  
  
  CONCLUSIONS
  The challenges of integrating evidence-based fall-prevention programming into existing senior center services can be negotiated by collaboration among senior center administrators, health providers, the center membership, and researchers. This experience suggests that senior centers may be important venues to reach older adults with fall-prevention programming.
authors.affiliation: Department of Medicine, Yale University School of Medicine, New Haven, CT, USA. dorothy.baker@yale.edu
authors.forename: Dorothy I
authors.initials: DI
authors.lastname: Baker
authors.forename: Margaret
authors.initials: M
authors.lastname: Gottschalk
authors.forename: Luann M
authors.initials: LM
authors.lastname: Bianco
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D003237:Connecticut / Q000453:epidemiology; D019317:Evidence-Based Medicine; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D016730:Program Development; D012308:Risk Management / Q000379:methods / Q000458:organization & administration*