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Standing Strong in Tribal Communities: Assessing Elder Falls Disparity

Award Number: R01MD015003
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 04/21/2021
PERIOD OF PERFORMANCE END DATE: 04/30/2026

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Standing Strong in Tribal Communities: Assessing Elder Falls Disparity - Program Director/Principal Investigator (Last, First, Middle): Shah, Vallabh O and Herman Carla Native elders are essential to preserving the culture and history of tribal communities, but fall-related injuries can jeopardize their ability to age in place. The Zuni Pueblo is geographically isolated with limited access to rehabilitative and supportive services. Home health physical therapy services are unavailable at the Pueblo. Therefore, Zuni elders must choose between leaving their community and social network for rehabilitative care or remain in the community with unmet needs, and increased risk of not regaining their prior level of function. We propose to culturally tailor the traditional Physical Therapy delivered Otago Exercise Program (OEP), to evaluate its effectiveness in reducing falls risk and to empower elders and their families to engage in preventing falls in their community. Native Zuni CHRs will deliver OEP using novel consultation and telehealth with a Physical Therapist. The CHRs offer important advantage of speaking “Shiwi” (Zuni tribal language) and understanding Zuni traditions, family structures, and elders’ preferences for receiving health information. Our overall objective is to compare the effectiveness of a CHR-delivered, culturally-adapted OEP fall prevention program to the standard of care education-based fall risk management. Our disparity driven aims are: Aim 1: Foster a sustainable multi-directional, participatory collaboration between the Zuni’s tribal leadership, stakeholders, Zuni Indian Health Services, and University of New Mexico Health Sciences Center to enhance fall prevention training, education, and research; Aim 2: To culturally adapt the evidence-based OEP for use with the Zuni elder population. Approach: We will train CHRs to utilize the CDC STEADI toolkit for fall risk screening and education and CHRs will culturally adapt the education and OEP with input from Zuni elders; Aim 3: To compare the effectiveness of the adapted OEP to an education-based fall risk management usual care program in improving strength and balance and reducing falls risk. Approach: Screen 400 Zuni elders, aged 65yrs and older, to identify 200 elders with elevated fall risk. Randomize 200 Zuni elders at risk for falls into a 6-month OEP intervention versus education-based control; and Aim 4: To compare the effectiveness of the adapted OEP to an education-based fall risk management program in improving overall health status, self-management of daily activities, and social engagement. Approach: We will administer SF-12 Health Survey and Short Form PROMIS measures Self-Efficacy for Managing Daily Activities and Ability to Participate in Social Roles and Activities to all randomized participants, at baseline and 6 months, and during the final follow up visit at 12 months.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $543,214 )
2025	2025	UNIVERSITY OF NEW MEXICO	1 UNIVERSITY OF NEW MEXICO	ALBUQUERQUE	NM	87131	BERNALILLO	USA	Minority Health and Health Disparities Research	000	5	4/30/2025	NON-COMPETING CONTINUATION	$543,214
														Subtotal = $543,214

Issue Date FY: 2024 ( Subtotal = $524,240 )
2024	2024	UNIVERSITY OF NEW MEXICO	1 UNIVERSITY OF NEW MEXICO	ALBUQUERQUE	NM	87131	BERNALILLO	USA	Minority Health and Health Disparities Research	000	4	4/30/2024	NON-COMPETING CONTINUATION	$524,240
														Subtotal = $524,240

Issue Date FY: 2023 ( Subtotal = $540,356 )
2023	2023	UNIVERSITY OF NEW MEXICO	1 UNIVERSITY OF NEW MEXICO	ALBUQUERQUE	NM	87131	BERNALILLO	USA	Minority Health and Health Disparities Research	001	3	5/10/2023	NON-COMPETING CONTINUATION	$0
2023	2023	UNIVERSITY OF NEW MEXICO	1 UNIVERSITY OF NEW MEXICO	ALBUQUERQUE	NM	87131	BERNALILLO	USA	Minority Health and Health Disparities Research	000	3	4/22/2023	NON-COMPETING CONTINUATION	$540,356
														Subtotal = $540,356

Issue Date FY: 2022 ( Subtotal = $541,507 )
2022	2022	UNIVERSITY OF NEW MEXICO	2500 MARBLE DR NE	ALBUQUERQUE	NM	87131	BERNALILLO	USA	Minority Health and Health Disparities Research	002	2	4/21/2022	NON-COMPETING CONTINUATION	$54,152
2022	2022	UNIVERSITY OF NEW MEXICO	2500 MARBLE DR NE	ALBUQUERQUE	NM	87131	BERNALILLO	USA	Minority Health and Health Disparities Research	001	2	3/31/2022	NON-COMPETING CONTINUATION	$487,355
2022	2021	UNIVERSITY OF NEW MEXICO	2500 MARBLE DR NE	ALBUQUERQUE	NM	87131	BERNALILLO	USA	Minority Health and Health Disparities Research	000	1	3/31/2022	NEW	$0
														Subtotal = $541,507

Issue Date FY: 2021 ( Subtotal = $543,623 )
2021	2021	UNIVERSITY OF NEW MEXICO	2500 MARBLE DR NE	ALBUQUERQUE	NM	87131	BERNALILLO	USA	Minority Health and Health Disparities Research	000	1	4/21/2021	NEW	$543,623
2021	2021	UNIVERSITY OF NEW MEXICO	2500 MARBLE DR NE	ALBUQUERQUE	NM	87131	BERNALILLO	USA	Minority Health and Health Disparities Research	001	1	6/24/2021	NEW	$0
														Subtotal = $543,623

Grand Total All Awards = $2,692,940

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Standing Strong in Tribal Communities: Assessing Elder Falls Disparity

Award Number: R01MD015003

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 04/21/2021

PERIOD OF PERFORMANCE END DATE: 04/30/2026

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