Ideas, Tools, and Resources to Maximize Your Impact on Falls Prevention Awareness Day and Beyond August 13, 2015 Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 1
About NCOA Our Mission: Improve the lives of millions of older adults, especially those who are struggling Our Social Impact Goal: Improve the health and economic security of 10 million older adults by 2020 Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 2
Falls Free Initiative A national effort led by NCOA to address the growing public health issue of falls and fall-related injuries and deaths in older adults. 2005 National Action Plan National Falls Free Coalition State Coalitions on Fall Prevention Workgroup Support for FPAD AK Hawaii WA OR NV CA ID AZ MT WY CO NM ND SD NE KS TX OK MN IA AR LA WI MO IL NH NY MA MI RI PA CT N IN OH DE J WV VA MD KY NC TN SC MS AL GA FL VT ME Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 3
National Falls Prevention Resource Center Funding: Administration for Community Living/Administration on Aging Purpose: Increase public awareness and educate consumers and professionals about falls risks and how to prevent falls. Serve as the national clearinghouse of tools, best practices, and other information on falls and falls prevention www.ncoa.org/healthy-aging/falls-prevention/ Support and stimulate the implementation, dissemination, and sustainability of evidence-based falls prevention programs and strategies Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 4
Agenda Welcome and Introductions - Kathleen Cameron, MPH, Senior Director, National Falls Prevention Resource Center, National Council on Aging (NCOA) Falls Prevention Awareness Day Resources - Ellen Schneider, MBA, Research Scientist, Center for Health Promotion and Disease Prevention, UNC at Chapel Hill, Consultant, National Falls Prevention Resource Center, NCOA Falls Prevention Resources from the CDC - Elizabeth Burns, MPH, Epidemiologist, Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC CDC s Mall Walking Guide - David Brown, PhD, National Center for Chronic Disease Prevention and Health Promotion, CDC NIA s Go4Life Program - Karen Pocinki, Director, Go4Life Campaign, Office of Communications and Public Liaison, National Institute on Aging NCOA s 2015 National Falls Prevention Action Plan - Kathleen Cameron Q&A Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 5
Ideas, Tools, and Resources to Maximize Your Impact on Falls Prevention Awareness Day and Beyond Ellen Schneider, MBA Research Scientist UNC-Chapel Hill National Falls Prevention Resource Center Center for Healthy Aging, NCOA August 13, 2015 Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 6
Falls Prevention Awareness Day September 23, 2015 (first day of fall) Lots of tools and resources available! http://www.ncoa.org/fpad 2015 Theme: Take a Stand to Prevent Falls Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 7
National Legislative Activities Pursuing a bi-partisan Senate resolution for FPAD, with Senator Susan Collins (R, ME) as lead Planning a falls prevention briefing on the Hill in September Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 8
Falls Prevention Awareness Day In 2007, 4 States observed FP Awareness Day In 2008, 11 States In 2009, 22 States In 2010: 34 States In 2011: 43 States and D.C. In 2012: 46 states and D.C. In 2013: 47 states and D.C.!!! In 2014: 48 states and D.C.!!! In 2015: All 50 states and D.C.!!!!! Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 9
NCOA FPAD Resources Media toolkit Media tip sheet, media alert, press release Falls Fact Sheet Sample social media messages Facebook Twitter: #FPAD15 http://www.ncoa.org/fpad Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 10
Consumer Products 6 Steps to Prevent a Fall graphic and new VIDEO 6 Steps to Protect Your Loved One From a Fall Debunking the Myths about Older Adult Falls http://www.ncoa.org/fpad Click on Media Toolkit Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 11
FPAD Digital News Release FPAD outreach materials wrapped in one simple package: a digital news release Resources are available directly from the news release, including Infographics New 6 Steps to Prevent A Fall Video 2015 Falls Free National Falls Prevention Action Plan Audio and video clips for TV press releases Link for the release will be available to share with your networks and local media for maximum exposure Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 12
http://www.aging.ohio.gov/news/agingconnection/20150709.asp 13 Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 13
Other State FPAD Event Examples Many states: Governor s Proclamations GA: Flash mob in front of CNN Center HI: 51 pharmacy locations on 5 islands are offering free medication reviews and balance testing with materials, flyers, and balance test sheets MA: Planning an event at the State House in Boston More examples in the 2014 FPAD Compendium Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 14
FPAD Compendium All state FP leads will be surveyed to gauge impact Please send your FPAD activities to your state falls prevention lead If you don t know your lead, please email fallsfree@ncoa.org https://www.ncoa.org/resources/fallspreventionawareness-day-2014-a-compendiumof-state-and-national-activities/ Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 15
Additional Resources New CDC STEADI Online Training for Providers: http://www.cdc.gov/steadi/ AOTA Tools: http://www.aota.org/practice/producti ve-aging/falls.aspx Kaiser Permanente/Hawaii Home Safety Video: https://www.youtube.com/watch?v=60 hr0-0xapy Ohio Fall Prevention Resources: http://aging.ohio.gov/steadyu/resourc es/default.aspx Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 16
NCOA Falls Free Photo Contest Images must be clear, sharp, and depict older adults participating in a falls prevention program Need a signed consent form $300, $250, $200 for 1 st, 2 nd, and 3rd place winners Send entries to Ellen Schneider: ellen.schneider@ncoa.org More info at https://www.ncoa.org/healthy-aging/fallsprevention/falls-prevention-awareness-day/falls-free-photocontest-2015/ Deadline: August 24th Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 17 17
NCOA Video Contest Clear, uplifting, high resolution videos depicting some aspect of older adult fall prevention. Some ideas: Evidence-based programs Falls risk screenings Flash mobs Testimonials No longer than 1 minute and 15 seconds $600, $500, $400 for 1st, 2nd, and 3rd place winners Deadline: November 2 nd, 2015 More info and rules at: https://www.ncoa.org/healthyaging/falls-prevention/falls-prevention-awareness-day/ Thanks to GSK for sponsoring the photo and video contests! Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 18
Contact Info Ellen Schneider, MBA National Falls Prevention Resource Center National Council on Aging University of North Carolina-Chapel Hill E-mail: ellen.schneider@ncoa.org My father, age 99 Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 19
OLDER ADULT FALLS PREVENTION: Resources from the CDC Elizabeth Burns, MPH ync7@cdc.gov Division of Unintentional Injury Prevention National Center for Injury Prevention and Control Centers for Disease Control and Prevention August 13, 2015 National Center for Injury Prevention and Control Division of Unintentional Injury Prevention
Falls: A Public Health Concern The leading cause of injury deaths among older adults. 25,000 older adults die each year from a fall 1 every 20 minutes. Every 13 seconds, an older adult is treated in an ED for a fall. $34 billion is spent on direct medical costs related to falls. Among people who fall, less than half talk to their healthcare provider about it.
Age-Adjusted Fall Death Rate for persons 65+ are on the Rise, 2000-2012 NCHS, Vital Records, 2000-2013
Modifiable Risk Factors Biological Leg weakness Mobility problems Problems w balance Poor vision Environmental Clutter & tripping hazards No stair railings or grab bars Poor lighting Behavioral Psychoactive meds 4+ medications Risky behaviors Inactivity
CDC s Strategies to Address Older Adult Falls
Supporting Clinical Screening, Assessment, Treatment, Referral & Follow Up
Algorithm for Fall Risk Assessment & Intervention Adapted from AGS/BGS Clinical Practice Guidelines, 2010
STEADI: Older Adult Fall Prevention
Use to Link Clinical Practice with Community Programs Change clinical practice Community fall prevention or exercise programs
CDC Compendium
CDC How To Guide
Oregon Tai Chi classes in every county in the state. Collaboration with Oregon Health Sciences University to integrate STEADI into the internal medicine practice. Launching STEADI as a standardized fall risk screen to be included in all Medicare Annual Wellness Visits. Working with VA System and Providence Health Care to offer Stepping On as a member benefit.
Colorado Colorado partnered with Denver based trauma centers to create a sustainable system to deliver Stepping On. 14 new classes offered in 2015. Launching new website to connect older adults with fall prevention programs.
New York United Health Services integrating STEADI into its primary care practices. Modified EHR to incorporate the STEADI algorithm and provide point-of-care clinical decision support. Early Successes 17 primary care practices using the EHR-based tools. 70% of patients aged 65+ were screened for falls. 76% of those screened received assessments.
Upcoming CDC Releases Clinical decision support modules for Electronic Health Records
Integrating STEADI with Electronic Health Record (EHR) systems Piloting projects in local health systems Oregon Health and Science University (OHSU) [EPIC] University of Oklahoma (OU) [GE Centricity] Working with national vendors to disseminate
Next Steps Drafting EHR specifications for other vendors Building out a medication management module Developing STEADI evaluation framework
Learn more about older adult fall prevention: www.cdc.gov/steadi To enroll in online training visit: https://cdc.train.org and search for STEADI
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Mall Walking and Older Adults Falls Prevention David R. Brown, PhD, FACSM 1 and Basia Belza, PhD, RN, FAAN 2 1,2 Physical Activity and Health Branch, Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA 2 University of Washington, Seattle, WA The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Funded by CDC #DP09-0010501SUPP13
SIP 13-070 Sept 2013 - Sept 2014 Are mall walking programs effective or efficacious? Do mall walking programs have the potential to be scaled up as a public health intervention to promote and increase walking?
Barriers to Physical Activity that Mall Walking Programs can address Weather (too hot, too cold, too inclement) Neighborhood safety - fear of crime Fear of injury Lack of access to a gym or health club Lack of social support Lack of skills or experience with exercising Lack of available and clean restrooms
A Multi-State Approach to Collaboration University of Washington B Belza, D Rosenberg University of Illinois, Chicago D Marquez, S Janicek University of Alaska, Anchorage D King West Virginia University D Jones Washington University P Allen
Methods I. Conduct a literature (scoping) review II. III. Conduct mall audits Interview mall managers, program leaders and program participants Led to the development of: Mall Walking Program Resource Guide
Findings from the Scoping Review Safe, accessible, affordable Features: leaders, blood pressure checks, warm-up exercises Outcomes: improved fitness, social support, improved moods Barrier: transportation Farren et al. (in press). Mall Walking Environments, Programmatic Features, and Benefits. Preventing Chronic Disease.
Findings from Environmental Audits Features: public transit, accessible parking, wayfinding aids, walking routes, flat surfaces, benches, clean restrooms Sites varied: hours of access, programming, hazards/traffic near entrances, lighting King et al. (in press). Safe, Affordable, Convenient Environmental Features of Malls and Other Public Spaces Used by Older Adults for Walking, Journal of Physical Activity and Health.
Findings from Interviews Belza et al., (in CDC clearance). Building Community: Stakeholder Perspectives on Walking in Malls and Other Venues WALKERS (n=27) Community, no pressure Companionship Health benefits Safe Climate controlled Benches available Walking route Plus 9 interviews manager/leader PROGRAM LEADERS (n=5) Sense of community Inclusivity Health benefits Climate controlled MALL MANAGERS (n=6) Health benefits Business benefits: ripple effect Extra eyes on the ground Climate controlled Link wellness and venue
How we integrate Physical Activity Falls Prevention Efforts into Mall Walking Programs We have effective fall prevention programs that can reduce falls Fall prevention programs may involve exercise (stand-alone or as part of multicomponent interventions) Programs can be delivered in clinical, group & home settings [and community settings e.g., in synergy with mall walking programs].
2008 Physical Activity Guidelines for Americans Adults and Older Adults Aerobic Physical Activity Guidelines 150 minutes of moderate-intensity aerobic activity per week; or 75 minutes of vigorous-intensity aerobic activity per week; or Equivalent combination of moderate- and vigorous-intensity physical activity Muscle-strengthening Guideline Adults should also do muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on 2 or more days a week Older adults should do exercises that maintain or improve balance if they are at risk of falling. http://www.health.gov/paguidelines
Integrating Physical Activity Falls Prevention Efforts into Mall Walking Programs Programming Options Do strength and balance activities before or after walking in the mall (e.g., balance activities or tai chi as a 10 minute warm-up walk 20-30 minutes do some muscle strengthening activities for 10-minutes after walking Do mall walking 3 days a week and strength and balance activities 2-4 times a week on separate days Offer a mall walking program with an option for people to participate in an evidenced-based falls prevention program. Offer stand alone programs for community members Mall Walking Evidenced-based Falls Prevention Program
Discussants Thank you! Basia Belza basiab@uw.edu David Brown Dbrown@cdc.gov http://www.cdc.gov/physicalactivity/downloads/mallwalking-guide.pdf
www.nia.nih.gov/go4life
Everyday Fitness Ideas from the National Institute on Aging at NIH Go4Life encourages sedentary older adults to make exercise and physical activity part of their daily lives. The Go4Life campaign is based on studies showing the health benefits of exercise and physical activity for older adults, including those with chronic health conditions. Go4Life reaches out to older adults, who traditionally have not embraced exercise, and shows them ways that even those with physical limitations can exercise safely. Go4Life is a registered trademark of the U.S. Department of Health and Human Services.
Get Started
Exercises to Try
Sample Exercise
Motivational Tools Go4Life virtual coaches Choose from 2 coaches Receive motivational messages via e-mail either weekly or monthly Tips on nutrition, safety, exercises to try and more Printable tools to track progress Finding your starting point Goal-setting Making an exercise plan Progress test
Tip Sheets Free materials to print or share on social media on topics like: Activities & general fitness Health benefits of exercise Safety Nutrition Tracking tools Motivation Spanish-language materials
More Free Stuff! Workout to Go a sample exercise routine to do anywhere! Go4Life posters to motivate people to be active every day. Go4Life bookmarks to hand out at health fairs, waiting rooms, or other client settings.
Be Active Every Day! go4life.nia.nih.gov/month
Go4Life Month Planning Tools Background information on Go4Life Month Event planning guide Social media tip sheet and messages Media outreach ideas Sample media materials Feature story Media alert Drop-in newsletter article Other free materials
Join organizations nationwide by holding events and promoting Go4Life materials Let us help you! Visit https://go4life.nia.nih.gov/month to find everything you need: Activity ideas Event planning tools and materials Social media posts Media outreach ideas Free materials and certificates Tell Us About Your Event at https://go4life.nia.nih.gov/content/tell -us-about-your-go4life-month-event
Falls Prevention Summit April 30, 2015 in Arlington, VA Experts from the public and private sectors from across the U.S. convened to update the 2005 Falls Free National Action Plan PowerPoint is available at www.ncoa.org New plan was released on July 28, 2015 Supported by Archstone Foundation and Walmart Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 24
Falls Free National Action Plan Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 25
Vision and Goal Vision: Older adults will have fewer falls and fall-related injuries, maximizing their independence and quality of life. Goal: To implement a National Action Plan with specific goals and strategies to affect sustained initiatives that reduce falls among older adults. Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 26
Healthy People 2020 Objective Reduce the rate of emergency department visits due to falls among older adults by 10 percent. Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 27
National Action Plan 12 Goals, 40 strategies and 242 action steps Physical Mobility Medication Management Home Safety Environmental Safety Public Awareness and Education Funding and Reimbursement Expansion of Evidence-based Programs Policy and Advocacy Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 28
Physical Mobility Goals All older adults will have knowledge of, and access to, effective programs and services that preserve or improve their physical mobility and lower the risk of falls. Health care and other service providers will be more aware of, and actively promote strategies and community resources/programs designed to improve older adult physical mobility and lower the risk of falls. Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 29
Physical Mobility Strategies Promote physical mobility for healthy aging, wellness, independent living Recognize and disseminate physical mobility programs Develop/expand directories that help people find programs that match their abilities/needs Expand the reach of programs across diverse populations Create on-line clearinghouse of programs for professionals Provide information to professionals to evaluate programs and make appropriate recommendations Develop a mechanism to help local communities develop an action plan related to physical mobility Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 30
Medications Management Goals All older adults will become aware that falling is a common adverse effect of some prescription and nonprescription medications and discuss these effects with their health care provider. Health care providers will be aware that falling is a common adverse effect of some prescription and nonprescription medications, and therefore will adopt a standard of care that balances the benefits and harms of older adult medication use. Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 31
Medications Management Strategies Increase numbers of older adults who receive a medication review Maximize opps to address falls risk as part of Medicare Part D Conduct a consumer education campaign to increase awareness of falls risks associated with medications Empower older adults and family members to take responsibility for med management Assure that self-management programs include a component on meds and falls risk Improve education of health care professionals related to med use in older adults Support health care providers to implement periodic med reviews Improve IT and pharmacy software for med management and identification of falls risk Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 32
Home Safety Goals All older adults will have knowledge of and access to effective home safety measures that reduce home hazards, improve independent functioning, and lower the risk of falls. Health care, the aging network, housing, and other service providers will become more aware of and promote home safety measures that reduce home hazards, improve independent functioning, and lower the risk of falls. Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 33
Home Safety Strategies Raise awareness and disseminate info about home safety practices and options and support consumer adoption of home modifications Identify funding sources and community-based resources for home assessments and modifications Develop a database of programs and practices in home modifications and home safety measures Identify gaps in resources and develop an advocacy plan for enhanced funding and attention to home safety/modifications Expand and enhance the delivery system for home safety/modifications Create, translate and disseminate knowledge tailored to specific professional groups Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 34
Environmental Safety Goals All older adults will have access to community environments that lower the risk of falls and facilitate full participation, mobility, and independent functioning. Public officials such as community and transportation planners, community service providers, and those responsible for maintenance and repairs, will be aware of and actively promote community environments that lower the risk of falls. Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 35
Environmental Safety Strategies Promote the wider use of risk identification and reporting tools Develop a social marketing campaign to increase demand for senior-friendly communities Identify research gaps related to role of the environment and falls Identify best practices to reduce falls outside the home Improve info gathering and comprehensive assessment of community hazards Increase awareness of policy makers and regulators at all levels of the scope and impact of falls Provide tools for community improvement Focus on sidewalk safety at the national and local levels Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 36
Funding and Reimbursement Goal Increase available funding and reimbursement sources and mechanisms to support falls prevention programs, interventions, and activities. Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 37
Funding and Reimbursement Strategies Leverage various quality indicators and other measures in support of falls prevention screening, assessment and interventions Build a business case for falls Leverage Medicare s Annual Wellness Visit Develop payor options and approaches for reimbursing providers for falls prevention programs Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 38
Expansion of Programs Goal: Expand the availability of evidence-based falls prevention programs Strategies: Leverage new opportunities under the ACA Expand the falls prevention evidence-based program infrastructure Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 39
Public Awareness and Education Goal Effectively move the falls prevention communications and marketing agenda/action plan forward. Strategy Develop a research-based social marketing campaign that will reframe the outdated view that falls are an inevitable consequence of aging to an actionable view that falls are caused by known risks and can be prevented. Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 40
Public Policy and Advocacy Goals: Effectively move the Falls Free National Falls Prevention Action Plan forward through policy and advocacy efforts. Strategies: Develop/expand a public policy agenda to promote falls prevention at the national, state and local levels Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 41
Next Steps Broadly disseminate the plan Encourage ownership and adoption of the plan s strategies and action steps Collaborate with and involve key stakeholder organizations to further disseminate and implement the strategies and action steps. Seek funding to support key strategies, alone or in conjunction with stakeholders organizations. Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 42
Next Steps Partner with and/or advise organizations to support public policy and advocacy initiatives related to the reduction of falls risk factors and falls prevention. Track progress by identifying national and state initiatives related to the implementation of the plan s strategies and action steps and their outcomes. Develop follow-up report three years after the 2015 National Falls Prevention Action Plan is released, to summarize action taken or underway related to these strategies. Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 43
It Takes A Village It takes a village of stake holders working together to prevent falls and reduce falls risk, tasks that no one stakeholder can accomplish alone Ganz,DA, Alkema,GE, and Wu,E. Injury Prevention, 2008 Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 44
Thank You! Kathleen A. Cameron, MPH Senior Director National Falls Prevention Resource Center Center for Healthy Aging National Council on Aging E-mail: Kathleen.cameron@ncoa.org Tel: 571-527-3996 Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 45
Thank You Questions? Improving the lives of 10 million older adults by 2020 2015 National Council on Aging 46