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Healthy Steps for Older Adults (HSOA)

An Evidence-Based Practice

Description

Healthy Steps for Older Adults (HSOA), a program for adults ages 50 years and older and adults of any age with a disability, provides screening, assessment, and education to reduce the incidence of falls. The 4-hour intervention is offered to interested individuals at senior centers and allied sites. This intervention is done in three steps. First, participants complete a screening questionnaire regarding their current physical activity level or any challenges they encounter. Second, participants complete a series of fall risk assessments. After completion of these two assessments, participants are given an age- and gender-adjusted score indicating their fall risk. Thirdly, participants them complete a 2.5 hour workshop educating them about various aspects of fall prevention. This can include: home safety modifications, safe footwear, nutrition, exercise, medication management, and communication. Participants are given suggestions for an appropriate exercise program that can help prevent falls, based on their current fitness level and fall risk. With signed permission, HSOA staff notify participant's physician about his or her fall risk, which can help continue the prevention program. Participants are contacted after 4 weeks to determine if any changes are adopted based on the intervention.

Goal / Mission

The Pennsylvania Department of Aging offers this fall risk screening and prevention program to adults 50 years of age and older. The program is designed to raise awareness of falls, introduce steps on how to reduce falls, improve overall health, and provide referrals and resources.

Results / Accomplishments

From 2010 to 2011, older adults who completed participation in HSOA (n = 814), or who did not but attended the same senior center sites (n = 1019), were enrolled and followed monthly for up to 12 months. Falls were defined as any occasion when an individual ended up on the floor or ground without being able to stop or prevent it. In multivariate models, adjusted falls incidence rate ratios among HSOA participants were lower than in the comparator group for both total (incidence rate ratio [IRR], 0.83; 95% CI, 0.72-0.96) and activity-adjusted (IRR, 0.81; 95% CI, 0.70-0.93) months of follow-up. Additionally, using ED visits related to falls, HSOA was associated with reduced rates of ED treatment and hospitalization. The proportion reporting at least 2 falls was higher in the comparison arm than in individuals completing HSOA (14.4% vs 11.5%), and HSOA participants had less hospital care among individuals with 2 or more falls (16.3% vs 24.8%). The result was lower costs for HSOA participants. The expected costs per participant were $3013 in the HSOA arm and $3853 in the comparison condition

About this Promising Practice

Organization(s)
Pennsylvania Department of Aging
Primary Contact
Pennsylvania Department of Aging
Pennsylvania Department of Aging, 555 Walnut Street, 5th Floor Harrisburg, PA 17101-1919
(717) 783-1550
aging@pa.gov
https://www.aging.pa.gov/aging-services/health-wel...
Topics
Community / Public Safety
Health / Older Adults
Community / Social Environment
Organization(s)
Pennsylvania Department of Aging
Date of publication
10/14/2016
Location
Pennsylvania
For more details
https://www.ajmc.com/view/cost-effectiveness-of-a-...
https://acl.gov/sites/default/files/programs/2017-...
Target Audience
Older Adults

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.
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