Integration of fall prevention into state policy in Connecticut.

PURPOSE OF STUDY: To describe the ongoing efforts of the Connecticut Collaboration for Fall Prevention (CCFP) to move evidence regarding fall prevention into clinical practice and state policy. METHODS: A university-based team developed methods of networking with existing statewide organizations to influence clinical practice and state policy. RESULTS: We describe steps taken that led to funding and legislation of fall prevention efforts in the state of Connecticut. We summarize CCFP's direct outreach by tabulating the educational sessions delivered and the numbers and types of clinical care providers that were trained. Community organizations that had sustained clinical practices incorporating evidence-based fall prevention were subsequently funded through mini-grants to develop innovative interventional activities. These mini-grants targeted specific subpopulations of older persons at high risk for falls. IMPLICATIONS: Building collaborative relationships with existing stakeholders and care providers throughout the state, CCFP continues to facilitate the integration of evidence-based fall prevention into clinical practice and state-funded policy using strategies that may be useful to others.

Step by step: integrating evidence-based fall-risk management into senior centers.

PURPOSE: Our purpose in this project was to conceptualize and implement evidence-based fall-prevention programming into senior centers. We present challenges to this process and strategies to overcome them. DESIGN AND METHODS: We carried out a dissemination project in nine diverse senior centers in Connecticut. Participants included investigators from the Connecticut Collaboration for Fall Prevention (CCFP), senior center administrators, and trained staff interventionists implementing a program of fall prevention based on the Yale Frailty and Injury Cooperative Studies of Intervention Trials (known as the Yale FICSIT). Using CCFP materials that were based on the stages of change, senior center staff developed methods to integrate fall-prevention programming into their centers. We extracted implementation challenges, and the strategies that senior center staff developed to overcome them, from the minutes of monthly work-group meetings. Monthly counts of individual assessments were also a source of data. RESULTS: Challenges included staffing and the delineation of authority, structural issues, engaging senior center membership, cultural issues, and the modification of existing practices. Each senior center devised site-specific methods to overcome these challenges when CCFP investigators convened work-group meetings. We developed creative strategies to inform senior center membership about fall prevention, and in the first 18 months, 4% of members scheduled individual assessments. IMPLICATIONS: The challenges of integrating evidence-based fall-prevention programming into existing senior center services can be negotiated by collaboration among senior center administrators, health providers, the center membership, and researchers. This experience suggests that senior centers may be important venues to reach older adults with fall-prevention programming.