S. Fantal1, K. Ladowski3, J. Vosswinkel3, R. Jawa3 1Stony Brook University,Program In Public Health,Stony Brook, NY, USA 3Stony Brook University Medical Center,Division Of Trauma,New York, NY, USA
Introduction:
Falls are the leading cause of injury-related morbidity/mortality in older adults. Despite demonstrated efficacy of fall prevention programs in randomized control trials, a gap remains between research and effective implementation and participant retention. The literature suggests interest in programs declines as distance, time, cost and effort to get to a class increase. Since 2012, our county has implemented community-based fall prevention programs. This study analyzed factors contributing to program completion.
Methods:
Evaluation was conducted on data from the Stepping On program, a multifaceted falls prevention program offered once/week, for 2 hours, over 7 weeks, free of charge. Program topics include exercise, vision, medication, and environmental risk factors. Variables examined include demographic data, program completion (≥5 classes), post program survey results, and census data.
Results:
Total of 869 participants mean age 80, white (94%), female (73%), married/widowed (82%), with high school diploma or higher (96%), enrolled in 41 programs, with mean class size of 21 participants. Overall program completion rate (CR) was 73% during the study period with 58% of participants completing the post program survey. Choropleth mapping was used to evaluate the relationship between participants' zip code to older adult population distribution. In multivariate logistic regression, Distance Traveled (OR=1.06 p=0.20), Age (OR=1.04 p=0.11), Gender (OR=0.52 p=0.17, ref=Female), Race (OR=1.25 p=0.90 ref=White), Education (Some College OR=1.95 p=0.18, ≤ High School OR=1.39 p=0.53, ref=≥College), and Marital Status (Divorced OR=0.60 p=0.38, Widowed OR=1.01 p=0.99, Single OR=0.52 p=0.43, ref=Married) were not significantly associated with program completion. There was a significant association between site type and program completion (8 Senior Centers n=170, CR=88%, 13 Libraries n=273, CR=76%, 1 Church n=21, CR=90%, 5 Assisted Living n=149, CR=83%, 12 Independent Living n=219, CR=86%, 2 Gyms n=37, CR=100%, p≤0.001). In univariate analysis, there were significant differences in completion rates between Senior Centers and Libraries (p=0.001) and Gyms and Libraries (p=0.002), but only Senior Centers remained significantly associated in multiple logistic regression analysis.
Conclusion:
The program was offered in areas of larger older adult populations. Estimated distance traveled to programs (mean=5.6 miles) did not significantly impact program completion. An association between site type and completion rates was noted. Senior Centers appear to be the best location to ensure program completion, as they explicitly serve an older adult population.
