For information on these and other research projects, contact Jill Renken at firstname.lastname@example.org.
WIHA was awarded an implementation grant from the UW School of Medicine's Wisconsin Partnership Program. Titled Bringing Healthy Aging to Scale: Improving Wisconsin's Capacity to Implement and Sustain Evidence-Based Prevention Programs for Older Adults, WIHA and its aging network and other community and health care partners are working with Dr. Jane Mahoney, the UW School of Medicine and Public Health, and the UW School of Engineering to increase the ability of rural counties to implement and sustain Stepping On and Living Well, WIHA's two flagship programs in falls prevention and living with chronic conditions, respectively.
The project incorporates the NIATx process improvement method developed at the Center for Health Enhancement Systems Studies, a research center in the Department of Engineering at the University of Wisconsin. For more information, contact Betsy Abramson.
This community-based pharmacist intervention is designed to decrease falls among high-risk older adults. People who have completed the Stepping On program are recruited for this intervention which includes a one-hour session with a pharmacist. The goal of the session is to identify and modify (e.g., remove drugs, switch drugs, and lower doses) use of any fall risk-increasing drugs and provide education about disease management and falls prevention.
Intervention: First, using information collected during the pre-intervention survey, the pharmacist conducts a medication therapy review (MTR) talking with the patient about the appropriateness of each medication (prescription, OTC, and herbal), identifying any adverse drug events experienced by the patient, and providing education to improve medication self-management. Based on the MTR, the pharmacist develops a medication-related action plan (MAP) and communicates recommendations for medication modification to patients and corresponding prescribers.
Partners: The Aging & Disability Resource Center (ADRC) of Brown County developed a partnership with a UW Madison School of Pharmacy researcher as well as a local pharmacist. Together, they identified the community need of medication review as they recognized a high rate of adverse drug interactions and ultimately falls. Once the partnership and idea for the intervention was determined, CAARN has been available for project advice and bringing on additional community partners as the project moves forward.
Current research status: Stage 2
Stepping On is an effective small-group behavior change program based on self-efficacy and adult learning theory that has been widely disseminated. There is no such program available for Spanish-speaking older adults. The goals of this project are to culturally and linguistically adapt Stepping On into Pisando Fuerte -- a falls prevention program for Hispanic seniors that will result in behavior change to reduce falls and be feasible to disseminate in Wisconsin and across the country.
Stepping On was designed in Australia, then brought to United States and adapted by Dr. Jane Mahoney and community partners (initially the ADRC of Kenosha County). After implementation of the program in Wisconsin and nationwide, WIHA saw a need to translate the program for the Latino population. CAARN then facilitated discussions between UW-Madison partners and multiple community partners on the adaptation of the program to be culturally appropriate for the Latino older adult community.
Intervention: Stepping On is an effective 7-week small-group behavior change program based on self-efficacy and adult learning theory that has been widely disseminated. During the 2-hour sessions, participants learn basic exercises to improve strength and balance as well as discuss how to address multiple factors related to falls risk such as hazards at home and in the community, vision impairment, medication management, and communicating with health professionals. Some sessions include experts such as a physical therapist, a pharmacist, a low-vision expert and a community safety expert. The program will be culturally- and linguistically-adapted from Stepping On into Pisando Fuerte, an 8-9 week falls prevention program for Hispanic seniors that will result in behavior change to reduce falls and be feasible to disseminate in Wisconsin and nationwide.
Partners: The research project is funded through UW-Madison Institute for Clinical and Translational Research funds, Dissemination grant. Community Partners: UCC Milwaukee, Centro Hispano, Dane County North/Eastside Senior Coalition
Dissemination Research: We will pilot the program at the United Community Center in Milwaukee for the purpose of completing the translation and cultural adaptation. Pisando Fuerte will then be implemented in Madison’s senior Hispanic population with a bilingual health professional as leader, and in Milwaukee’s Centro Hispano with a trained promotor as leader. We will gather preliminary data (reach, effectiveness, adoption, implementation and maintenance) to apply for a future dissemination research study. Once dissemination research is complete, we will be ready for statewide (and future nationwide) dissemination through WIHA.
Current status: Dissemination research