Evidence-Based Community Fall Prevention Programs at Senior Centers Near 10 US Academic Centers.

BACKGROUND/OBJECTIVES: The Centers for Disease Control and Prevention recommends that patients at risk of falling engage in evidence-based community fall prevention programs (EBCFPPs). EBCFPPs are often delivered in senior centers (SCs). This is the first independent assessment of availability of EBCFPPs in SCs. DESIGN: Cross-sectional study of four types of EBCFPPs in the 25-mile radius of 10 US academic centers (ACs). SETTING: SCs. PARTICIPANTS: SCs. INTERVENTION: None. MEASUREMENTS: Number and types of EBCFPPs offered at SCs. RESULTS: Across the 10 ACs, 249 SCs were sampled. Of the SCs, 35% offered zero, 54% offered at least one, 9% offered at least two, and 2% offered at least three EBCFPPs. Tai Chi of any type was offered in 59.8%, A Matter of Balance was offered in 8.9%, Stepping On was offered in 8.0%, and Staying Active and Independent for Life was offered in 1.2% of SCs sampled. SCs near Columbia University offered all four of the programs, while those near the University of Utah, Johns Hopkins University, and Seattle University only offered three of the programs. In univariate analysis, the number of local SCs was significantly associated with quantity of EBCFPPs (odds ratio [OR] = 2.2; 95% confidence interval [CI] = 1.9-2.6; P < .001), but not with diversity of EBCFPPs (OR = 1.0; 95% CI = 1.0-1.1; P = .13). In multivariate regression, city, sex distribution, and average household income did not correlate with the overall number or the diversity of EBCFPPs, whereas locales with more SCs offered more EBCFPPs (OR = 2.2; 95% CI = 1.7-2.9; P < .001). CONCLUSIONS: A significant number of SCs still do not offer any EBCFPPs. From those that do, few offer a diversity of these programs. Opportunities exist to increase access to EBCFPPs in SCs.

Rights-Based and Person-Centered Approaches to Supporting People With Intellectual Disability: A Dialectical Model.

Protecting human rights has increasingly become a focus of regulation regarding individuals with Intellectual Disability (ID). While this focus on rights has succeeded in protecting people with ID from many of the most insidious abuses of the past, an over-emphasis on the human rights of people with ID while ignoring other aspects of their personalities and environments can create challenges. This article proposes the use of a dialectical model to address challenges raised by the relationship between two equally valid but often unequally considered approaches, namely, rights-based and person-centered. Suggestions are provided for using this model to meaningfully support individuals to reach their person-centered goals while continuing to recognize and address their individual rights, responsibilities, and challenges.