Developing an Efficacious and Cost-Effective Fall Prevention Program

制定有效且具有成本效益的跌倒预防计划

• 批准号: 9041475
• 负责人: FUZHONG LI
• 金额: $ 63.7万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-15 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9041475
• 关键词: Address; Admission activity; Adopted; Adult; Advocate; Aging; American; Centers for Disease Control and Prevention (U.S.); Communities; Community Services; Cost Effectiveness Analysis; Decision Making; Economics; Effectiveness; Elderly; Equilibrium; Evidence based intervention; Exercise; Fall prevention; Funding; Gait; Geriatrics; Goals; Health; Health Care Costs; Health Personnel; Health Planning; Healthcare; Healthcare Systems; Healthy People 2020; High Prevalence; Hospitals; Injury; Intervention; Investments; Knowledge; Life; Light; Measures; Nursing Homes; Outcome; Outcome Measure; Participant; Performance; Physical Function; Physical Performance; Policy Maker; Policy Making; Premature Mortality; Prevention program; Preventive Intervention; Preventive service; Provider; Proxy; Public Health; Public Policy; Quality of life; Quality-Adjusted Life Years; Randomized Controlled Trials; Research; Services; Societies; Stretching; Tai Ji; Testing; Training; Training Programs; United States; Work; aged; base; comparative effectiveness; comparative efficacy; cost; cost effective; cost effectiveness; disability; disorder prevention; efficacy testing; evidence base; exercise program; fall risk; falls; follow-up; health economics; improved; intervention program; meetings; post intervention; prevent; programs; research to practice; secondary outcome; strength training; therapy design

DESCRIPTION (provided by applicant): Falls among older adults have become a serious public health problem because they result in inevitable injuries, increase hospital admissions, threaten independence, and reduce quality of life. Falls, however, are preventable and can be reduced through exercise. There are currently a number of effective exercise-based fall interventions recommended by the Centers for Disease Control and Prevention (CDC) that can be used to address the problem of falls in older adults. However, there is little informed information on best practices in terms of comparative efficacy and cost effectiveness among the recommended intervention programs. This lack of information hinders policy makers, public health practitioners, health planners, aging service providers, and others in making decisions on how to effectively invest funds to implement the "best" evidence-based fall prevention programs. This project is intended to narrow this knowledge gap. Our long-term goal is to create an effective, low-cost, scalable community-based Tai Chi program to help public health practitioners and community-based organizations address the problem of falls among older adults and to help older adults maintain their health and independence in the community, thereby reducing the drain on health care spending. The overall objective of this proposal is to conduct a comparative efficacy and cost-effectiveness study of an evidence-based fall prevention program-Tai Chi: Moving for Better Balance (TCMBB). Specifically, research in this proposal will address the following two questions of parallel importance: will TCMBB be more effective compared to a CDC-recommended Strength Training program? If so, will the TCMBB be more cost effective in terms of cost per fall prevented and quality adjusted life year gained? These questions will be addressed by conducting a randomized controlled trial aimed at testing the efficacy of TCMBB and Strength Training programs relative to a Stretching control on reducing fall rate and improving balance and physical functioning. It will also evaluate whether TCMBB, compared to Strength Training, will be more cost-effective, relative to the Stretching program. The study will also address the sustainability of the effects of TCMBB intervention on the proposed outcomes. At the conclusion of the study, we will have bridged an important research-to-practice gap on the cost effectiveness of different fall prevention programs and expanded our knowledge regarding how to best invest funds for intervention programs to address the pressing problems of falls in older adults and to meet Healthy People 2020 goals for improving the health, function, and life independence of community- dwelling older adults.

描述（由申请人提供）：老年人跌倒已成为一个严重的公共卫生问题，因为跌倒会导致不可避免的伤害、增加住院人数、威胁独立性并降低生活质量。然而，跌倒是可以预防的，并且可以通过锻炼来减少。目前，美国疾病控制与预防中心 (CDC) 推荐了许多有效的基于运动的跌倒干预措施，可用于解决老年人跌倒问题。然而，在推荐的干预计划中，关于比较功效和成本效益方面的最佳实践的知情信息很少。这种信息的缺乏阻碍了政策制定者、公共卫生从业者、健康规划者、老龄服务提供者和其他人就如何有效投资资金来实施“最佳”循证跌倒预防计划做出决定。该项目旨在缩小这一知识差距。我们的长期目标是创建一个有效、低成本、可扩展的社区太极项目，帮助公共卫生从业者和社区组织解决老年人跌倒问题，帮助老年人保持健康和独立社区，从而减少医疗保健支出的消耗。该提案的总体目标是对基于证据的跌倒预防计划——太极：移动以获得更好的平衡（TCMBB）进行比较功效和成本效益研究。具体来说，本提案中的研究将解决以下两个同等重要的问题：与 CDC 推荐的力量训练计划相比，TCMBB 是否更有效？如果是这样，就预防每次跌倒的成本和获得的质量调整生命年而言，TCMBB 是否更具成本效益？这些问题将通过进行一项随机对照试验来解决，该试验旨在测试 TCMBB 和力量训练计划相对于拉伸控制在降低跌倒率、改善平衡和身体功能方面的功效。它还将评估 TCMBB 与力量训练相比是否更具成本效益（相对于伸展计划）。该研究还将探讨 TCMBB 干预对拟议结果影响的可持续性。在研究结束时，我们将弥合不同跌倒预防计划的成本效益方面的研究与实践之间的重要差距，并扩大我们对如何最好地为干预计划投资资金以解决老年人跌倒的紧迫问题的了解。并实现“健康人 2020”目标，即改善社区老年人的健康、功能和生活独立性。