Dissemination of an evidence-based program to reduce fear of falling, South Carolina, 2006-2009.
BACKGROUND
Falls among older adults are a serious public health issue, and fear of falling can limit mobility, which in turn increases fall risk. A Matter of Balance/Volunteer Lay Leader Model is an evidence-based program designed to address fear of falling. The objective of this study was to describe implementation, dissemination, and outcomes of this program in 3 regions of South Carolina with a predominantly African American and largely underserved population.


METHODS
We developed partnerships throughout the state, organized master and lay leader trainings, and documented numbers of lay leaders, programs offered, demographic characteristics of participants, program fidelity, and attendance. Outcome measures were self-reported confidence to prevent and manage falls and a quantitative measure of functional mobility. Both measures were assessed at baseline and after program completion.


RESULTS
Older adults (N = 235) attended 18 classes at 16 sites. Barriers to implementation were program teams' limited familiarity with the concept of evidence-based programs and the importance of adhering to program content. Facilitators were state-level leadership and a history of state, regional, and local groups collaborating successfully on other projects. Outcomes indicated greater confidence in managing falls and carrying out activities of daily living. Mobility improved significantly, suggesting a reduced risk for falls.


CONCLUSIONS
Evidence-based programs such as A Matter of Balance/Volunteer Lay Leader Model can be successfully disseminated in underserved areas. Outcomes indicate that participation in fall prevention programs can benefit groups of predominantly African American older adults.
Clemson University, Clemson, South Carolina, USA.
Gerhild
G
Ullmann
Harriet G
HG
Williams
Cora F
CF
Plass
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001061:Appalachian Region / Q000453:epidemiology; D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data; D057189:Checklist; D055317:Evidence-Based Practice; D005239:Fear / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006284:Health Plan Implementation; D006801:Humans; D033181:Information Dissemination; D008124:Locomotion / Q000502:physiology; D008297:Male; D017533:Marital Status; D008507:Medically Underserved Area; D010353:Patient Education as Topic; D004856:Postural Balance / Q000502:physiology; D015397:Program Evaluation; D012923:Social Class; D013022:South Carolina / Q000453:epidemiology; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D001741:Black or African American