Ideas, Tools, and Resources to Maximize Your Impact … other information on falls and falls prevention •Support and stimulate the implementation, dissemination, and sustainability

1

Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging

Ideas, Tools, and Resources to

Maximize Your Impact on

Falls Prevention Awareness Day

and Beyond

August 13, 2015

2


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

3


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

Hawaii

AK

MT

ID

WA

CO

WY

NV

CA

NM AZ

MN

KS

TX

IA

WI

IL

KY

TN

IN OH

MI

AL MS

AR

LA

GA

FL

SC

WV VA

NC

PA

VT

RI

ME

NH OR

SD

ND

MO

OK

NE

NY

CT

MA

NJ

MD

DE

4


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

http://www.ncoa.org/healthy-aging/falls-prevention/





5


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

6


Ideas, Tools, and Resources to Maximize Your

Impact on Falls Prevention Awareness Day and

Beyond

Ellen Schneider, MBA

Research Scientist

UNC-Chapel Hill


Center for Healthy Aging, NCOA

August 13, 2015

7



• September 23, 2015 (first day of fall)

• Lots of tools and resources available!

2015 Theme:

Take a Stand to Prevent Falls http://www.ncoa.org/fpad

http://www.ncoa.org/fpad

8


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

9



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.!!!!!

10


NCOA FPAD Resources

Media toolkit

• Media tip sheet, media alert, press release

• Falls Fact Sheet

• Sample social media messages

– Facebook

– Twitter: #FPAD15




11


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


Click on “Media Toolkit”


12


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

13


13 http://www.aging.ohio.gov/news/agingconnection/20150709.asp

http://www.aging.ohio.gov/news/agingconnection/20150709.asp

14


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

15


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 [email protected]

https://www.ncoa.org/resources/falls-

preventionawareness-day-2014-a-compendium-

of-state-and-national-activities/

mailto:[email protected]

16


Additional Resources

• New CDC STEADI Online Training for Providers: http://www.cdc.gov/steadi/

• AOTA Tools: http://www.aota.org/Practice/Productive-Aging/Falls.aspx

• Kaiser Permanente/Hawaii Home Safety Video: https://www.youtube.com/watch?v=60hR0-0xapY

• Ohio Fall Prevention Resources: http://aging.ohio.gov/steadyu/resources/default.aspx

https://outlook.unc.edu/owa/redir.aspx?SURL=ZEbZ6s0Fyav9klyuJsVJ5oN3NSR00tv_hj3bHtMAwoo2Jdyt0JzSCGgAdAB0AHAAOgAvAC8AdwB3AHcALgBjAGQAYwAuAGcAbwB2AC8AcwB0AGUAYQBkAGkALwA.&URL=http://www.cdc.gov/steadi/



http://www.aota.org/Practice/Productive-Aging/Falls.aspx




https://www.youtube.com/watch?v=60hR0-0xapY




http://aging.ohio.gov/steadyu/resources/default.aspx



17


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 1st, 2nd, and 3rd place winners

• Send entries to Ellen Schneider: [email protected]

• More info at https://www.ncoa.org/healthy-aging/falls-prevention/falls-prevention-awareness-day/falls-free-photo-contest-2015/

• Deadline: August 24th

17


https://www.ncoa.org/healthy-aging/falls-prevention/falls-prevention-awareness-day/falls-free-photo-contest-2015/



















18


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 2nd, 2015

• More info and rules at: https://www.ncoa.org/healthy-aging/falls-prevention/falls-prevention-awareness-day/

Thanks to GSK for sponsoring the photo and video contests!

https://www.ncoa.org/healthy-aging/falls-prevention/falls-prevention-awareness-day/













19


Contact Info

Ellen Schneider, MBA


National Council on Aging

University of North Carolina-Chapel Hill

E-mail: [email protected]

My father, age 99


Elizabeth Burns, MPH

[email protected]

Division of Unintentional Injury Prevention

National Center for Injury Prevention and Control

Centers for Disease Control and Prevention

August 13, 2015

OLDER ADULT FALLS PREVENTION:

Resources from the CDC

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

• Psychoactive meds • 4+ medications • Risky behaviors • Inactivity

Environmental • Clutter & tripping

hazards • No stair railings or

grab bars • Poor lighting

Behavioral

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

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.

Oregon

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.

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.

• 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.

New York

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”

http://www.cdc.gov/STEADI

https://cdc.train.org/

https://cdc.train.org/

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: [email protected] 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.

David R. Brown, PhD, FACSM1 and

Basia Belza, PhD, RN, FAAN2

1,2 Physical Activity and Health Branch, Division of Nutrition, Physical Activity and

Obesity, Centers for Disease Control and Prevention, Atlanta, GA 2University 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.

Mall Walking and

Older Adults Falls 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 Illinois, Chicago

D Marquez, S Janicek

University of Washington

B Belza, D Rosenberg

University of Alaska, Anchorage

D King

West Virginia University D Jones

Washington University

P Allen

Methods

I. Conduct a literature (scoping) review

II. Conduct mall audits

III. Interview mall managers, program leaders and program participants

Led to the development of:

Mall Walking Program Resource Guide

http://www.ncoa.org/

http://www.mainehealth.org/mh_homepage.cfm?id=1

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

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

WALKERS (n=27) Community, no pressure

Companionship Health benefits

Safe Climate controlled Benches available

Walking route

Plus 9 interviews manager/leader

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 [email protected]

David Brown [email protected]

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

https://go4life.nia.nih.gov/month

https://go4life.nia.nih.gov/content/tell-us-about-your-go4life-month-event













24


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

http://www.ncoa.org/

25


Falls Free® National Action Plan

26


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.

27


Healthy People 2020 Objective

“Reduce the rate of

emergency department visits

due to falls among older adults

by 10 percent.”

28


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

29


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.

30


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

31


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.

32


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

33


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.

34


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

35


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.

36


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

37


Funding and Reimbursement Goal

• Increase available funding and reimbursement sources and mechanisms to support falls prevention programs, interventions, and activities.

38


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

39


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

40


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.

41


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

42


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.

43


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.

44


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

45


Thank You!

Kathleen A. Cameron, MPH

Senior Director


Center for Healthy Aging

National Council on Aging

E-mail: [email protected]

Tel: 571-527-3996


46


Thank You

Questions?

Ideas, Tools, and Resources to Maximize Your Impact … other information on falls and falls prevention •Support and stimulate the implementation, dissemination, and sustainability

Documents