eSTEPS: Electronic Strategies for Tailored Exercise to Prevent FallS
Study Details
Study Description
Brief Summary
The goals of this project are to 1) develop primary care clinical eSTEPS decision support (CDS) to ensure that older adults at risk of falling receive appropriate exercise referrals, education and support from their provider and 2) to conduct a cluster randomized control trial in urban and rural primary care clinics to test the efficacy of the eSTEPS CDS intervention on falls and injurious falls in patients over age 65 at high risk for falls.
Detailed Description
This project will use traditional fall risk screening and machine learning approaches to accurately identify older adults at risk for falls. Investigators will then develop, CDS implemented into the electronic health record that helps primary care providers and older patients develop a tailored fall prevention exercise plan (eSTEPS). Investigators will conduct a cluster randomized control trial in urban and rural primary care clinics to test the efficacy of the eSTEPS CDS intervention. Development of the eSTEPS CDS within the widely adopted Epic Electronic Health Record will support dissemination of evidence for older adults, with a focus on rural elders.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: eSTEPS Clinical Decision Support Use of clinical decision support to assist in exercise-related fall prevention care planning will be compared to usual care. |
Behavioral: eSTEPS CDS
Primary care clinics at Brigham and Women's Hospital and Essentia Health will be randomized to receive the eSTEPS CDS or usual care
|
| No Intervention: Usual Care Usual primary care practices regarding exercise-related fall prevention planning |
Outcome Measures
Primary Outcome Measures
- All Falls [Up to 21 months]
Number of falls by treatment group
Secondary Outcome Measures
- Time to first fall [Up to 21 months]
Time to first fall by treatment group
- Fall-related injuries [Up to 21 months]
Number of fall-related injuries by treatment group
- Time to Fall-related injuries [Up to 21 months]
Time to fall-related injuries by treatment group
- Self-Efficacy for Exercise [Up to 4 months]
Self-efficacy for Exercise (SEE) change from baseline to final interview by treatment group. This scale has a range of total scores from 0-90. A higher score indicates higher self-efficacy for exercise.
- Outcome Expectancy for Exercise [Up to 4 months]
Multidimensional Outcome Expectations for Exercise (OEE) scale change from baseline to final interview by treatment group. This scale has a range of total scores from 15-75. A higher score indicates higher outcome expectancy for exercise.
- Overall Physical Activity Participation [Up to 4 months]
Telephone Assessment of Physical Activity (TAPA) change from baseline to final interview by treatment group
- Fall Prevention Exercise Participation [Up to 4 months]
Number of exercise sessions completed per week by treatment group
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Adult patient enrolled in participating practice
-
Age 65 or above
-
Positive screen for falls in annual wellness visit
Exclusion Criteria:
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Not fluent in English
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Unable to read or write
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Not community-dwelling (i.e. residents of long-term care facilities, prisoners etc.)
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Not able to provide consent due to cognitive impairment or other issues
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Terminal illness, not expected to survive for 1 year
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Brigham and Women's Hospital
- National Institute on Aging (NIA)
- National Institutes of Health (NIH)
- Essentia Health
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2020P002162