{Reference Type}: Journal Article
{Title}: Outcomes associated with scale-up of the Stepping On falls prevention program: A case study in redesigning for dissemination.
{Author}: Mahoney JE;Gangnon R;Clemson L;Jaros L;Cech S;Renken J;
{Journal}: J Clin Transl Sci
{Volume}: 4
{Issue}: 3
{Year}: Mar 2020 4
暂无{DOI}: 10.1017/cts.2020.17
{Abstract}: <B>UNASSIGNED: </B>Translating complex behavior change interventions into practice can be accompanied by a loss of fidelity and effectiveness. We present the evaluation of two sequential phases of implementation of a complex evidence-based community workshop to reduce falls, using the Replicating Effective Programs Framework. Between the two phases, workshop training and delivery were revised to improve fidelity with key elements.<BR><B>UNASSIGNED: </B>Stepping On program participants completed a questionnaire at baseline (phase 1: n = 361; phase 2: n = 2219) and 6 months post-workshop (phase 1: n = 232; phase 2: n = 1281). Phase 2 participants had an additional follow-up at 12 months (n = 883). Outcomes were the number of falls in the prior 6 months and the Falls Behavioral Scale (FaB) score.<BR><B>UNASSIGNED: </B>Workshop participation in phase 1 was associated with a 6% reduction in falls (RR = 0.94, 95% CI 0.74-1.20) and a 0.14 improvement in FaB score (95% CI, 0.11- 0.18) at 6 months. Workshop participation in phase 2 was associated with a 38% reduction in falls (RR = 0.62, 95% CI 0.57-0.68) and a 0.16 improvement in FaB score (95% CI 0.14-0.18) at 6 months, and a 28% reduction in falls (RR = 0.72, 95% CI 0.65-0.80) and a 0.19 score improvement in FaB score (95% CI 0.17-0.21) at 12-month follow-up.<BR><B>UNASSIGNED: </B>Effectiveness can be maintained with widespread dissemination of a complex behavior change intervention if attention is paid to fidelity of key elements. An essential role for implementation science is to ensure effectiveness as programs transition from research to practice.