4. Putting all the Pieces Together: Multifactorial Fall Prevention: The InSTEP Model Projects

The evidence for effective fall prevention programs has grown in recent years. However, questions concerning optimal program components, intensities, priority populations, and relative cost-effectiveness remain. Based on studies demonstrating efficacy for multifactorial program components (fall risk assessment, physical activity, and environmental modification), we developed a prescriptive demonstration project, the InSTEP (Improving Stability through Evaluation and Practice) model program, to help answer these questions. This demonstration is implementing the multifactorial components within 6 southern California senior centers at high, medium, or low intensity. Three sites will have a behavioral modification component added. Participants are assessed at baseline and at 3-, 6-, and 12-month follow-ups using the Fullerton Advanced Balance scale, Falls Behavior Scale, Falls Efficacy Scale, Health and Activity Questionnaire, Self-Efficacy Exercise Scale, Falls and Balance Questionnaire, Yale Physical Activity Survey for Older Adults, and the Fall Home Assessment Tool. To date, 3 senior centers are participating (2 high intensity and 1 medium intensity sites) with 58 participants enrolled. This presentation will report preliminary findings and lessons learned from implementing efficacious multifactorial fall prevention components into senior center programming. Implementation lessons learned include recruiting participants, integrating components, working with partner agencies, funding and service delivery issues with home modifications, and obtaining IRB approval.