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An important challenge for the field of injury prevention and control is the translation of research findings into effective community-based prevention programs and practices. The National Center for Injury Prevention and Control believes that dissemination research can overcome this challenge by providing insight into the structures and methods needed to translate injury control research into everyday practice. The proposed dissemination research study will rigorously assess whether the use of a "facilitative system" can successfully bridge the gap between injury prevention and control research and the implementation of evidence-driven, community-based programs, policies, and practices. The facilitative system links communities with academic partners to provide communities with the skills and resources needed to help facilitate the community health improvement process. The system identifies what assets are available within communities, as well as the skills and resources needed to work through the community health improvement process. The facilitative system will then provide technical assistance, best practices guides, and direct consultation in carrying out all phases of the community health improvement process. This information is designed to increase community capacity in community assessment, coalition development, accessing and interpreting local injury prevention data, searching and selecting evidence-based research, and program planning and evaluation. The study will use a randomized community trial design to evaluate fall injury occurrence and process measures of program implementation in three groups of communities:
We hypothesize that the Facilitative System program will be more effective at:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | No Intervention | a control group receiving no special resources or guidance related to fall injury prevention or the community health improvement process; | |
| Standard Program | Active Comparator | a "Standard Program" group receiving modest funding to implement an "evidence-based" fall prevention program in their local community; |
|
| Facilitative System | Experimental | a "Facilitative System" group receiving facilitative system support in addition to the resources provided the Standard Program group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| facilitative system | Other | The facilitative system links communities with academic partners to provide communities with the skills and resources needed to help facilitate the community health improvement process. The system identifies what assets are available within communities, as well as the skills and resources needed to work through the community health improvement process. The facilitative system will then provide technical assistance, best practices guides, and direct consultation in carrying out all phases of the community health improvement process. This information is designed to increase community capacity in community assessment, coalition development, accessing and interpreting local injury prevention data, searching and selecting evidence-based research, and program planning and evaluation. |
| Measure | Description | Time Frame |
|---|---|---|
| Emergency Department and In-patient Hospitalization for Fall Injury | Rates of fall injury diagnoses per 100 person-years (P-Y) were computed for the communities in each of the study groups for a 2 year baseline period, 2007-2008, and for a 2 year follow-up period corresponding to years 2010-2011. Change in fall injury rates and their 95% confidence intervals (CI) are reported. A mixed-effects Poisson regression model was used to test the presence of an interaction effect on the fall rate between study group and time period (baseline or follow-up). The test is intended to detect a differential time effect by study group. This model, with main effects for study group and time period and an interaction term, will be referred to as the primary model. Model coefficients and incidence rate ratios (IRR) with 95% confidence intervals (CI) are reported. | 2007-2008; 2010-2011 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Peter M Layde, MD | Medical College of Wisconsin | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medical College of Wisconsin | Milwaukee | Wisconsin | 53226 | United States |
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20 interested communities were randomized to one of the three groups using a block randomization method, taking into account whether the lead agency was a health department or aging agency and whether the community had 0 or 1 or more Stepping On fall prevention program leaders already.
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| ID | Title | Description |
|---|---|---|
| FG000 | Control | a control group receiving no special resources or guidance related to fall injury prevention or the community health improvement process; |
| FG001 | Standard Program | a "Standard Program" group receiving modest funding to implement an "evidence-based" fall prevention program in their local community; Standard Program: a "Standard Program" group receiving modest funding to implement an "evidence-based" fall prevention program in their local community; |
| FG002 | Facilitative System | a "Facilitative System" group receiving facilitative system support in addition to the resources provided the Standard Program group facilitative system: The facilitative system links communities with academic partners to provide communities with the skills and resources needed to help facilitate the community health improvement process. The system identifies what assets are available within communities, as well as the skills and resources needed to work through the community health improvement process. The facilitative system will then provide technical assistance, best practices guides, and direct consultation in carrying out all phases of the community health improvement process. This information is designed to increase community capacity in community assessment, coalition development, accessing and interpreting local injury prevention data, searching and selecting evidence-based research, and program planning and evaluation. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Average annual population over residents over 65 years of age.
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| ID | Title | Description |
|---|---|---|
| BG000 | Control | a control group of 10 communities and their residents over 65 years of age receiving no special resources or guidance related to fall injury prevention or the community health improvement process; |
| BG001 | Standard Program |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Adults age 65 years. |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Emergency Department and In-patient Hospitalization for Fall Injury | Rates of fall injury diagnoses per 100 person-years (P-Y) were computed for the communities in each of the study groups for a 2 year baseline period, 2007-2008, and for a 2 year follow-up period corresponding to years 2010-2011. Change in fall injury rates and their 95% confidence intervals (CI) are reported. A mixed-effects Poisson regression model was used to test the presence of an interaction effect on the fall rate between study group and time period (baseline or follow-up). The test is intended to detect a differential time effect by study group. This model, with main effects for study group and time period and an interaction term, will be referred to as the primary model. Model coefficients and incidence rate ratios (IRR) with 95% confidence intervals (CI) are reported. | Population of residents aged 65 and older for participating communities in each study arm for 2007-2008 baseline period and 2010-2011 follow-up period. | Posted | Number | 95% Confidence Interval | Fall Injury Rate per 100 person years | 2007-2008; 2010-2011 |
|
Five years for study period, 2007-2011.
We are not aware of any adverse events associated with this study.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Control | a control group receiving no special resources or guidance related to fall injury prevention or the community health improvement process; |
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E coding of injuries can be incomplete, but 99.7% of records with a diagnostic code in the range 800-995.89 had an E code. We may have included more than one admission for the same fall, but we excluded admissions from an acute care facility.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Peter Layde, MD, MSc | Medical College of Wisconsin | 414-955-8113 | playde@mcw.edu |
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|
| Standard Program | Other | a "Standard Program" group receiving modest funding to implement an "evidence-based" fall prevention program in their local community; |
|
a "Standard Program" group of five communities and their residents over 65 years of age receiving modest funding to implement an "evidence-based" fall prevention program in their local community;
Standard Program: a "Standard Program" group receiving modest funding to implement an "evidence-based" fall prevention program in their local community;
| BG002 | Facilitative System | a "Facilitative System" group of five communities and their residents over 65 years of age receiving support in addition to the resources provided the Standard Program group facilitative system: The facilitative system links communities with academic partners to provide communities with the skills and resources needed to help facilitate the community health improvement process. The system identifies what assets are available within communities, as well as the skills and resources needed to work through the community health improvement process. The facilitative system will then provide technical assistance, best practices guides, and direct consultation in carrying out all phases of the community health improvement process. This information is designed to increase community capacity in community assessment, coalition development, accessing and interpreting local injury prevention data, searching and selecting evidence-based research, and program planning and evaluation. |
| BG003 | Total | Total of all reporting groups |
| Participants |
|
| Sex/Gender, Customized | Number | participants |
|
| OG000 | Control | a control group receiving no special resources or guidance related to fall injury prevention or the community health improvement process; |
| OG001 | Standard Program | a "Standard Program" group receiving modest funding to implement an "evidence-based" fall prevention program in their local community; Standard Program: a "Standard Program" group receiving modest funding to implement an "evidence-based" fall prevention program in their local community; |
| OG002 | Facilitative System | a "Facilitative System" group receiving facilitative system support in addition to the resources provided the Standard Program group facilitative system: The facilitative system links communities with academic partners to provide communities with the skills and resources needed to help facilitate the community health improvement process. The system identifies what assets are available within communities, as well as the skills and resources needed to work through the community health improvement process. The facilitative system will then provide technical assistance, best practices guides, and direct consultation in carrying out all phases of the community health improvement process. This information is designed to increase community capacity in community assessment, coalition development, accessing and interpreting local injury prevention data, searching and selecting evidence-based research, and program planning and evaluation. |
|
|
|
| 0 |
| 12,494 |
| 0 |
| 12,494 |
| EG001 | Standard Program | a "Standard Program" group receiving modest funding to implement an "evidence-based" fall prevention program in their local community; Standard Program: a "Standard Program" group receiving modest funding to implement an "evidence-based" fall prevention program in their local community; | 0 | 14,842 | 0 | 14,842 |
| EG002 | Facilitative System | a "Facilitative System" group receiving facilitative system support in addition to the resources provided the Standard Program group facilitative system: The facilitative system links communities with academic partners to provide communities with the skills and resources needed to help facilitate the community health improvement process. The system identifies what assets are available within communities, as well as the skills and resources needed to work through the community health improvement process. The facilitative system will then provide technical assistance, best practices guides, and direct consultation in carrying out all phases of the community health improvement process. This information is designed to increase community capacity in community assessment, coalition development, accessing and interpreting local injury prevention data, searching and selecting evidence-based research, and program planning and evaluation. | 0 | 7,701 | 0 | 7,701 |
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