Using an academic-community partnership model to deliver evidence-based falls prevention programs in a metropolitan setting: A community case study.

Background: Prevention is an effective approach for mitigating the negative health outcomes associated with falls in older adults. The Administration for Community Living (ACL) has sponsored the implementation of evidence-based falls prevention programs (EBFPPs) across the United States through cooperative agreement grants to decrease the health and economic burden of falls. Marymount University received two of these grants to deliver three EBFPPs into the northern Virginia region. This community case study describes the development of a collaboration between a university and community-based organizations to adopt and implement multiple evidence-based programming in an area where none previously existed. Methods: Through an academic-community partnership, EBFPPs were introduced to and implemented by senior-focused organizations. Target adopters were senior and community centers, multi-purpose senior services organizations, recreational organizations, and residential facilities serving older adults. The three EBFPPs were (1) Stay Active and Independent for Life (SAIL), (2) a Matter of Balance (MOB) and (3) Otago Exercise Program (OEP). Key interdependent project elements included: (1) fostering ongoing community organization collaboration, (2) introducing programs in the community, (3) growing and sustaining delivery sites, (4) preparing trained program leaders, and (5) building community demand for the programs. Results: From August 2016-June 2022, 5,857 older adults participated in one of the three EBFPPs. SAIL classes were offered at 33 sites and MOB workshops at 31 with over 70% of them occurring at community or senior centers. OEP was offered at 4 sites. Factors that influenced the implementation of these programs included having: key advocates at host organizations, programs embedded into site workflows, sufficient capacity and workforce, engaged invested partners, and flexibility in working with a complex set of agencies and systems with different administrative structures. Conclusion: By connecting academic faculty with various community members from multiple sectors, new initiatives can be successfully implemented. Results from this ACL-funded project indicate that using an academic-community partnership model to build relationships and capacity for ongoing delivery of health promotion programming for older adults is feasible and effective in delivering EBFPPs. In addition, academic-community partnerships can develop a strong network of invested partners to foster continued support of fall prevention activities.

Young Adults' Perspectives on Advance Care Planning.

OBJECTIVE: To describe the knowledge, attitudes, beliefs, and behaviors of young adults regarding advance care planning (ACP). METHODS: A cross-sectional sample of young adults (N = 310) from a single metropolitan university during September to November 2016 completed an online survey about their knowledge, attitudes, beliefs, and behaviors regarding ACP. Descriptive statistics and correlation tests were conducted. RESULTS: Young adults lacked familiarity and knowledge regarding ACP. Those who were most familiar with ACP terminology were more likely to be older, female, enrolled in a graduate program, and employed full time. Although the majority of respondents had positive attitudes and beliefs about ACP, only one-third had talked with their family/loved ones about their wishes for end-of-life care. DISCUSSION: Our study findings suggest a strong need to inform and engage young adults in ACP and end-of-life care discussions. As young adults are likely to become a caregiver for an aging family member, they can have an important role in initiating and facilitating conversations with loved ones and be instrumental in ACP for older adults.

Determinants of utilization of physical rehabilitation services for persons with chronic and disabling conditions: an exploratory study.

OBJECTIVE: To determine which variables influence the receipt of physical rehabilitation services (ie, physical, occupational, speech therapy) for a population of people with chronic and disabling conditions. DESIGN: A convenience sample of 502 adults with cerebral palsy (CP), multiple sclerosis (MS), and spinal cord injury (SCI), drawn from diverse parts of the United States. SETTING: Respondents were surveyed in the general community. PARTICIPANTS: Persons (91% under the age of 65 y) with CP, MS, or SCI who responded to the 1999 component of a national longitudinal survey. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Self-reported need for physical rehabilitation services. Bivariate and multivariate analyses were used to examine variables that influenced utilization of services. RESULTS: Some 53% of respondents did not receive self-reported needed physical rehabilitation services. Respondents who had Medicaid were more likely than those with Medicare or private insurance to receive physical rehabilitation services. Respondents having a lower household income and poorer health were less likely to receive services. CONCLUSIONS: Our findings indicate that health care funding sources provide widely disparate coverage for physical rehabilitation services to persons with 3 specific chronic and disabling conditions. Policy-makers and health plan administrators should re-evaluate their coverage of physical rehabilitation services designed to enhance quality of life and reduce the burden of lost independence.