PROPOSAL SUMMARY/ABSTRACT
Falls and fear of falling are the leading cause of injury, disability, and hospitalization in racially diverse low-
income older adults. Our parent grant (R01MD018025) targets maladaptive fall risk appraisal (FRA)- a
condition expressed in more than half of older adults, in which there is a discrepancy between perceived fall
risk and physiological fall risk. The parent grant aims to prevent falls, improve physical activity, facilitate a shift
from maladaptive to adaptive FRA, and reduce health disparities for ethnically diverse low-income older adults
using our developed in-home Physio-fEedback Exercise pRogram (PEER), which includes a) physio-feedback
using a real-time portable innovative technology—the BTrackS Balance System: BBS; b) cognitive reframing
based on a novel fall risk appraisal matrix; and c) peer-led exercise by focusing on balance and strength
training. We use a two-arm clustered randomized controlled trial, and the intervention is offered at the low-
income independent living communities/units in Central Florida. We collect data (N=340) at baseline and
measure outcomes after program completion, follow-up at 3 months, and 6 months. The purposes of this
Administrative Supplements to Recognize Excellence in Diversity, Equity, Inclusion, and Accessibility (DEIA)
Mentorship are thus to 1) enhance our current parent study with an additional subproject led by a postdoctoral
researcher titled “Associations between Physical Activity, Sleep, Circadian Rhythmicity, Health Disparities, and
Falls; 2) support our current three graduate students from DEIA backgrounds to focus on cognitive reframing
and primary outcomes of the parent grant including falls and health disparities; and 3) add two predoctoral
trainees from DEIA backgrounds to focus on technology-based physio feedback and peer-led exercise training.
The interdisciplinary mentoring will include three broad sets of activities across two years: 1) coursework; 2)
research, including data collection, data analysis, preparation of manuscripts and research proposal or
dissertation/ thesis defense; and 3) professional development led by the parent study PI and her
interdisciplinary team. While the training will focus heavily on research skills, it will also include professional
development activities relevant to their roles and career progression within the biomedical and behavioral
research enterprise. As a first-generation college graduate growing up in a rural underserved area and
experiencing personal and professional challenges in achieving and maintaining academic and scientific
success, the PI has committed to sharing and mentoring the next generation of biomedical scientists from
DEIA backgrounds. The parent grant and this supplement award will provide an excellent example of how an
interdisciplinary team representing nursing, kinesiology, neuropsychology, engineering, and data science can
successfully collaborate to produce impactful outcomes on improving minority health and enhancing diversity,
equity, inclusion, and accessibility in the biomedical and health sciences.
