Christine Moore Updates the Coalition on STRIDE: Strategies to Reduce Injuries and Develop Confidence in Elders
Christine Moore, RN, works as the STRIDE Project Manager at DaVita Health Care Partners, El Segundo, California- one of the ten national health care organizations that were selected to participate in this health enhancement project that includes a nursing-centric component to promote elder independence by helping to reduce fall-related injuries. The project is called, “STRIDE”—Strategies to Reduce Injuries and Develop Confidence in Elders.
From our STRIDE project, “I learned how devastating fall-related injuries can be. As a nurse, I felt valued that the National Institutes of Health and PCORI recognized the nurse’s role in being a prominent team-member to help reduce fall-related injuries. Also, I understood fall prevention and a fall’s clinical implications. As I listened to patients and caregivers involved with STRIDE, I realized the long-term, all-encompassing negative impact a fall can have on all areas of a patient’s life, including their caregivers and loved ones.”
To re-cap the STRIDE study using a more pragmatic approach was designed to evaluate the effectiveness of evidence-based strategies that reduce serious fall-related injuries and help develop a more consistent approach nationally to fall prevention in elders. Its patient-centered focus required a partnership between the sites and their patients and caregivers to deliver individually tailored interventions while ensuring the patient voice was heard in all aspects of the project.
Christine shared how this partnership is often accomplished through Councils comprised of the project team including a fall-care manager (BSN), medical assistant, physicians, health enhancement staff, applied researchers, patient/family advisors and various strategic community stakeholders designed to incorporate the perspective and lived experiences of each into project planning and implementation.
The STRIDE Study is supported by a grant award made by the National Institute on Aging (NIA) at the National Institutes of Health (NIH) in partnership with the Patient-Centered Outcomes Research Institute (PCORI), as part of the Falls Injuries Prevention Partnership of the organizations. The award support is $30 million dollars for 5 years. (Announcement)
The project strategy includes:
- screening to identify persons at high risk for falls,
- defining a person’s specific risk factors,
- implementing an evidence-based multifactorial, individually-tailored intervention aimed at mitigating specific risk factors, based on the patient-centered approach developed at Yale and incorporating elements of the CDC and American Geriatrics Society Guidelines, and the Otago Exercise Programme, (Otago, New Zealand strength and balance activities to enhance elder independence).
- reducing the risk of injury if the person falls (e.g., osteoporosis treatment) including teaching fall recovery.
- changing organizational and provider behavior to initiate care processes, based on ACOVE-2 practice redesign model to promote a nationally consistent way to promote elder independence and reduce fall-related injuries. [reference article for background]
Status of project: To date, our national research team has enrolled 5,451 adults age 70 and older, living in the community, with one or more modifiable risk factors for falls. The first year of the study was a pilot phase, during which many aspects of the intervention were tested and refined with small numbers of people across 10 clinical sites. The enrollment for the full trial started on August 1, 2015 and ended March 31, 2017. The participants will be followed for up to three years.
Christine adds, “I learned that patients and caregivers, diverse as they are, share experiences, challenges and successes and that the best solutions come from them. I also learned that a nurse trained specifically in fall prevention and care management can make the difference in preventing a fall and helping a patient recover should one occur. ABSN Falls Care Manager can track the many elements related to fall-risk, educate and ensure the patient receives the proper care and physical rehabilitation.”
During the next 2.5 years, STRIDE team members will monitor, document, and analyze data related to the primary outcomes – serious fall injuries, which are defined as those leading to medical attention, assessed at the patient level.
Results and Next Steps:
While outcome data and final protocols will not be disseminated for a few more years, the STRIDE team will continue to work with community partners for input on issues such as, retention. Also, interim preliminary publications are shaping up with our teams to help share learning lessons and promote enduring value. Dissemination activities may include lay literature, vignettes, peer-reviewed publications, conferences, and other modes of communication. Our California team will share our progress with the LA Falls Prevention Coalition and collaborate ongoing as we plan and implement the dissemination of findings and the final intervention tool kit that will have a positive effect on serious fall-related injuries.
Christine stresses that STRIDE will depend on partners, like the Falls Prevention Coalition, to disseminate findings, document best practices, and share resources. “We will tap into your subject expertise to share what we learn and so together we can help improve the health and well-being of older adults. As we continue the intervention phase of the project, I can speak for our entire team when I say we look forward to working with your coalition to share the best ways clinicians, patients and caregivers alike can enhance quality of life and increase independence for those at risk.”
For further information on STRIDE – with project description and public material: http://www.stride-study.org/