Progress 09/01/08 to 05/31/11
Outputs
OUTPUTS: Outputs: Surveyed service providers who deliver care along the continuum of intervention for reducing falls risks. An online survey with 44 service agency responses (57% response rate) indicated that risk of falling was a significant risk for their clients. Agencies included care facilities, faith organizations, hospitals, clinics, and community-based organizations. Most indicated they had policies and procedures in place from oral procedures to exercise programs. Over half of the respondents indicated they engaged in education and awareness efforts, risk assessments, counseling and case management, and home-based fall prevention services. But only a few offered education and management programs for the general public or clients they serve. Identified gaps along the intervention continuum and developed plans to fill gaps. Information from the survey was used to develop processes to enhance primary prevention of falls in Otter Tail County. Activities included developing a screening and referral tool for service providers, facilitating evidence-based self-management classes through Extension nutrition educators, disseminating program information at area health fairs, and providing Wii gaming systems along with Wii Fit games to long term care facilities. Educated health professionals and students about the continuum focusing on screening, available services, and referral mechanisms. Conducted community education to inform public about available services. A logo was developed of a maple leaf with the words "Right Side Up in Otter Tail County." It was used on relevant materials to promote the program among service providers and the general public. Several workshops for health professionals were held: 1) train-the-trainer workshops for evidence-based educational programs (27 people trained), 2) planning and program coordination for evidence-based programs with four community education providers (YMCA, University of Minnesota Extension, Lake Region Hospital, and Oaks Nursing Home, and three school districts), 3) fall prevention planning and program coordination with two hospital facilities (60 people), and 4) a statewide video conference to educate aging service providers. Provided evidence-based education targeted to the general public to help individuals develop action plans around fall prevention and chronic disease management (Matter of Balance, Chronic Disease Self-Management Program (CDSMP), and Wii Fit programs in long term care facilities). UMN Extension's nutrition educators facilitated 16 CDSMP classes reaching 96 individuals. CDSMP, developed by Stanford University, is an evidence-based, scripted, lay-led program that reinforces self-management of chronic disease through goal setting and action planning. Integrated health professions students into interprofessional care team. The project incorporated third year medical students, pharmacy residents, and nurse practitioners into an interdisciplinary falls assessment program; a team approach to fall prevention case management. In June 2011 the project was awarded Minnesota's Rural Health Hero Team Award for its falls prevention work at the state Rural Health Conference. PARTICIPANTS: Principal Investigator: Karen Shirer, PhD, Associate Dean for Extension, University of Minnesota. Dr. Shirer oversees the project work plan, submits needed reports, and oversees the project budget. Lastly, she will serve on the coordinating team for the project and as a member of the Advisory Council. Co-Principal Investigator: Pamela Van Zyl York, MPH, PhD, RD, LN. Dr. York currently works in the areas of prevention and management of chronic disease and healthy aging, and nutrition and physical activity programs at the Minnesota Department of Health and is Project Director for Minnesota's Arthritis Program. Dr. York provides key leadership in coordination of continuum services and overall achievement of project objectives. Laurissa Stigen, MS, Executive Director, Central Minnesota AHEC, received her Bachelor of Arts Degree in Rural Health and Wellness from the University of Minnesota, and received a Masters of Science of Health and Human Development with a focus on Community Health at Montana State University. Ms. Stigen serves as the AHEC subaward administrator, coordinating activities between all core partners. Ms. Stigen will play a lead role in connecting health professions students to the local projects. Todd A. Johnson, PharmD, a faculty member of the University of Minnesota College of Pharmacy since 1976, serves as the Director of Clinical Pharmacy at Lake Region Healthcare Corporation, C.E.O. of Consultant Pharmacists Inc. Dr. Johnson identified local potential stakeholders in developing a falls assessment, referral, and prevention continuum. He coordinates a local interprofessional team and corresponding student involvement in the project, oversees the medication therapy assessment aspects, and assists with health professional and community falls education programs. Diane Thorson, MS, RN, PhN, has been the Director of Public Health for Ottertail County for more than 29 years. She serves as liaison between this project and department staff who can link elderly persons at risk for falls into the Ottertail County Healthy Aging Collaborative continuum of care. Public health nurses provide the long term care consultations for persons at risk for entering nursing homes. This consultation includes a falls assessment. Kari Benson, MA, is the Health Promotion and Nutrition Consultant for the Minnesota Board on Aging (MBA), managing the Minnesota Falls Prevention Initiative. She coordinates a group of state level partners to mobilize their local members in support of falls prevention efforts and other healthy aging activities. Abby Gold, PhD, MPH, RD, University of Minnesota Extension, Center for Family Development, Health and Nutrition, with research team developed initial fall prevention organizational gap analysis, participated in program planning , and completed overall program evaluation. Sara Van Offelen, MPH, RD, University of Minnesota Extension, Center for Family Development, Health and Nutrition, supervised NEAs who facilitated CDSMP, participated in program planning, facilitated organizational network training, and assisted in establishing program sustainability. TARGET AUDIENCES: Nursing Homes-Broen Memorial Home, Perham Memorial Home, Good Samaritan Homes in Battle Lake and Pelican Rapids Non-Profit Organizations-OAKS Living at Home Block Nurse Program, YMCA. Senior Citizen Centers in Fergus Falls and Henning. Parish Nurse programs in Henning, Perham, and Dent Foster Homes/Senior Housing-Autumn Manor in Perham, Riverview Heights, River Bend, Page House, Hospitals-Lake Region Healthcare, Memorial Hospital and Homes, and Tri County Hospital in Wadena. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
Outcomes 1. Multiple sources of information were used to assess the project, allowing for triangulation to compare multiple sources and enhance the analysis. Artifacts were collected throughout the project. Case study questionnaires were sent via email to key individuals involved with the project. Finally, follow-up phone interviews were conducted and transcribed for data analysis. 14 individuals involved in the project completed a case study evaluation questionnaire, designed to evaluate the process of developing a comprehensive community care coordination to prevent and minimize the incidence of falls in later life. The case study method was used to investigate from the participants' point of view how the project evolved over time, why it was important to implement in this particular region, and also to consider ways to maintain it over time. 2. The County was mobilized to deal with falls after they occurred but not for addressing prevention. This project consolidated services across multiple organizations, by influencing service providers to improve communication between groups when exchanging patient information. Six meetings held with service providers and sponsored by Public Health, brought a variety of entities all working on issues such as housing and home health together to network with each other on fall prevention strategies. Organizations that had not previously worked together now view one another as important and trusted collaborators. 3. Provided evidence-based educational services to help individuals develop action plans around fall prevention and chronic disease management. The UMN Extension's Simply Good Eating Program is designed to provide targeted nutrition education to Supplemental Nutrition Assistance Program (SNAP) eligible individuals. Through this grant, Extension was able to train the nutrition educators (NEAs) to be CDSMP facilitators. One NEA described her experience facilitating CDSMP: "I have run through our sessions and absolutely feel that what we did would fit under the criteria of our program. They all had action plans that were increasing fruits and vegetables, eating breakfast, stretching or deep breathing, walking or exercising more and increasing water daily." Post-evaluation surveys (n of 125) of the CDSMP participants reveal that overall 13 per. were better able to set and achieve goals such as: manage pain (19 per.), continue to work on daily activities (10 per.), cope with feelings (15 per.), prevent falls (14 per.), manage stress (11 per.), eat healthier (7 per.), perform more physical activity (8 per.), and set and achieve goals (8 per.). 4. This grant placed Wii machines and Wii Fit programs in 11 agencies. Wii Fit has been shown to increase agility and balance in those who use the program. Pre/Post data collection was collected on Wii Fit Age and Center of Balance for the right and left sides from 61 individuals. Average user age was 64 years; a paired t-test analysis of the pre/post data showed no significant difference in Wii Fit Age and center of balance over a one month period of time.
Publications
- No publications reported this period
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Progress 09/01/08 to 08/31/09
Outputs
OUTPUTS: Surveyed service providers who deliver care along the continuum of intervention for reducing falls risks. An online survey with 44 service agency responses (57% response rate) indicated that risk of falling is very or somewhat significant for their clients. Agency types included long-term care facilities, faith organizations, hospitals, clinics, and community-based non-profit organizations. Most indicated they had policies and procedures in place from oral procedures to exercise programs. Although over half of the respondents indicated they engaged in education and awareness efforts, risk assessments, counseling and case management, and home-based fall prevention services, only a few respondents offered education and management programs for the general public or clients they serve. Identified gaps along the intervention continuum and developed plans to fill gaps. Information from the survey was used to develop processes to enhance primary prevention of falls in Otter Tail County. Activities included developing a screening and referral tool for service providers, facilitating evidence-based self-management classes through Extension nutrition educators, disseminating program information at area health fairs, and providing Wii gaming systems along with Wii Fit games to long term care facilities. Educated health professionals and students about the continuum focusing on screening, available services, and referral mechanisms. Conducted community education to inform the public about available services. A logo was developed of a maple leaf with the words "Right Side Up in Otter Tail County." This logo was used on relevant materials to promote the program among service providers and the general public. Several workshops for health professionals were held in four different veins: 1) train-the-trainer workshops for evidence-based educational programs (15 people trained), 2) planning and program coordination for evidence-based programs with four community education providers (YMCA, University of Minnesota Extension, Lake Region Hospital, and Oaks Nursing Home, and three school districts), 3) fall prevention planning and program coordination with two hospital facilities (60 people), and 4) a statewide video conference to educate the Area Agency on Aging and other relevant providers. Provided evidence-based education targeted to the general public to help individuals develop action plans around fall prevention and chronic disease management (Matter of Balance, Chronic Disease Self-Management Program (CDSMP), and Wii Fit programs in long term care facilities). UMN Extension's nutrition educators facilitated 16 CDSMP classes reaching 96 individuals. CDSMP, developed by Stanford University, is an evidence-based, scripted, lay-led program that reinforces self-management of chronic disease through goal setting and action planning. Integrated health professions students into interprofessional care team. The project incorporated third year medical students, pharmacy residents, and nurse practitioners into an interdisciplinary falls assessment program; a team approach to fall prevention case management. PARTICIPANTS: Principal Investigator: Karen Shirer, PhD, Associate Dean for Extension, University of Minnesota. Dr. Shirer oversees the project work plan, submits needed reports, and oversees the project budget. Lastly, she will serve on the coordinating team for the project and as a member of the Advisory Council. Co-Principal Investigator: Pamela Van Zyl York, MPH, PhD, RD, LN. Dr. York currently works in the areas of prevention and management of chronic disease and healthy aging, and nutrition and physical activity programs at the Minnesota Department of Health and is Project Director for Minnesota's Arthritis Program. Dr. York provides key leadership in coordination of continuum services and overall achievement of project objectives. Laurissa Stigen, MS, Executive Director, Central Minnesota AHEC, received her Bachelor of Arts Degree in Rural Health and Wellness from the University of Minnesota, and received a Masters of Science of Health and Human Development with a focus on Community Health at Montana State University. Ms. Stigen serves as the AHEC subaward administrator, coordinating activities between all core partners. Ms. Stigen will play a lead role in connecting health professions students to the local projects. Todd A. Johnson, PharmD, a faculty member of the University of Minnesota College of Pharmacy since 1976, serves as the Director of Clinical Pharmacy at Lake Region Healthcare Corporation, C.E.O. of Consultant Pharmacists Inc. Dr. Johnson identified local potential stakeholders in developing a falls assessment, referral, and prevention continuum. He coordinates a local interprofessional team and corresponding student involvement in the project, oversees the medication therapy assessment aspects, and assists with health professional and community falls education programs. Diane Thorson, MS, RN, PhN, has been the Director of Public Health for Ottertail County for more than 29 years. She serves as liaison between this project and department staff who can link elderly persons at risk for falls into the Ottertail County Healthy Aging Collaborative continuum of care. Public health nurses provide the long term care consultations for persons at risk for entering nursing homes. This consultation includes a falls assessment. Kari Benson, MA, is the Health Promotion and Nutrition Consultant for the Minnesota Board on Aging (MBA), managing the Minnesota Falls Prevention Initiative. She coordinates a group of state level partners to mobilize their local members in support of falls prevention efforts and other healthy aging activities. Abby Gold, PhD, MPH, RD, University of Minnesota Extension, Center for Family Development, Health and Nutrition, with research team developed initial fall prevention organizational gap analysis, participated in program planning , and completed overall program evaluation. Sara Van Offelen, MPH, RD, University of Minnesota Extension, Center for Family Development, Health and Nutrition, supervised NEAs who facilitated CDSMP, participated in program planning, facilitated organizational network training, and assisted in establishing program sustainability. TARGET AUDIENCES: Nursing Homes-Broen Memorial Home, Perham Memorial Home, Good Samaritan Homes in Battle Lake and Pelican Rapids Non-Profit Organizations-OAKS Living at Home Block Nurse Program, YMCA. Senior Citizen Centers in Fergus Falls and Henning. Parish Nurse programs in Henning, Perham, and Dent Foster Homes/Senior Housing-Autumn Manor in Perham, Riverview Heights, River Bend, Page House, Hospitals-Lake Region Healthcare, Memorial Hospital and Homes, and Tri County Hospital in Wadena. PROJECT MODIFICATIONS: This grant placed Wii machines and Wii Fit programs in 11 agencies during 2010, which was not a part of the original plan. Wii Fit has been shown to increase agility and balance in those who use the program. Pre/Post data collection was collected on Wii Fit Age and Center of Balance for the right and left sides from 61 individuals. Average user age was 64 years; a paired t-test analysis of the pre/post data showed no significant difference in Wii Fit Age and center of balance over a one month period of time. However, comments from the program administrators reveal that much learning and fun occurred.
Impacts
1. Multiple sources of information were used to assess the project, allowing for triangulation to compare multiple sources and enhance the analysis. Artifacts were collected throughout the project. Case study questionnaires were sent via email to key individuals involved with the project. Finally, follow-up phone interviews were conducted and transcribed for data analysis. 14 individuals involved in the project completed a case study evaluation questionnaire, designed to evaluate the process of developing a comprehensive community care coordination to prevent and minimize the incidence of falls in later life. The case study method was used to investigate from the participants' point of view how the project evolved over time, why it was important to implement in this particular region, and also to consider ways to maintain it over time. 2. The County was mobilized to deal with falls after they occurred but not for addressing prevention. This project consolidated services across multiple organizations, by influencing service providers to improve communication between groups when exchanging patient information. Six meetings held with service providers and sponsored by Public Health, brought a variety of entities all working on issues such as housing and home health together to network with each other on fall prevention strategies. Organizations that had not previously worked together now view one another as important and trusted collaborators. 3. Provided evidence-based educational services to help individuals develop action plans around fall prevention and chronic disease management. The UMN Extension's Simply Good Eating Program is designed to provide targeted nutrition education to Supplemental Nutrition Assistance Program (SNAP) eligible individuals. Through this grant, Extension was able to train the nutrition educators (NEAs) to be CDSMP facilitators. One NEA described her experience facilitating CDSMP: "I have run through our sessions and absolutely feel that what we did would fit under the criteria of our program. They all had action plans that were increasing fruits and vegetables, eating breakfast, stretching or deep breathing, walking or exercising more and increasing water daily." Post-evaluation surveys (n of 125) of the CDSMP participants reveal that overall 13 per. were better able to set and achieve goals such as: manage pain (19 per.), continue to work on daily activities (10 per.), cope with feelings (15 per.), prevent falls (14 per.), manage stress (11 per.), eat healthier (7 per.), perform more physical activity (8 per.), and set and achieve goals (8 per.). 4. This grant placed Wii machines and Wii Fit programs in 11 agencies. Wii Fit has been shown to increase agility and balance in those who use the program. Pre/Post data collection was collected on Wii Fit Age and Center of Balance for the right and left sides from 61 individuals. Average user age was 64 years; a paired t-test analysis of the pre/post data showed no significant difference in Wii Fit Age and center of balance over a one month period of time. However, comments from the program administrators reveal that much learning and fun occurred.
Publications
- No publications reported this period
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