PROJECT SUMMARY/ ABSTRACT
In the US today, the most common non-medical approach to fall prevention is a referral to scientifically validated
community-based fall prevention program. These evidence-based programs are well validated, effectively reduce fall risk,
provide a significant return on investment, and reduce healthcare utilization. They consist of a fall risk reduction education
and balance/strengthening exercises; and they are usually disseminated through faith-based organizations, civic
organizations, libraries, affordable housing sites, community centers, and the home. They are typically funded through
the Older Americans Act Title IIID. The Problem: While these programs serve an important resource and intervention for
older adults at risk for falling, and the benefits of attending the workshops are well established, they are costly, lack
scalability, do not address access needs of older adults living outside metropolitan areas, their uptake ranges from low to
moderate, they fail to track long-term outcomes, and they do not provide population health metrics that can be used by
funders and health insurance providers to ensure the older adults receives the most appropriate fall prevention
intervention. The primary objective of this Phase IIB application is to complete two pragmatic clinical trials to demonstrate
the effectiveness of our NIH funded Health in Motion Fall Prevention Platform to addresses the limitations of existing
programs when deployed in community-centers (study 1) and in the home (study 2). The long-term objective is to obtain
approval by the Administration for Community Living as an evidence-based fall prevention program and to reduce falls on
a wide-scale basis. If successful, this study will ensure Health in Motion’s commercial success as it would be eligible for
Title IIID funding across the U.S. and it will demonstrate our value proposition. Specific Aims: 1) Complete additional
development needed for the planned pragmatic clinical trials in Aims 2 and 3. 2) Determine the effectiveness and
economic benefit of Health in Motion when disseminated in the community and when used as after community-based
fall prevention workshops as a wraparound benefit. 3) Determine the effectiveness and economic benefit of Health in
Motion when disseminated in the home. Research Design: For Aim 2, we will complete a 3-month, parallel group, cluster-
randomized pragmatic clinical trial (PrCT) with a 9-month non-randomized extension and follow-up study. Participants will
attend at least one community-based fall prevention program and will be invited to use the Health in Motion Health Diary
to collect information related to falls and healthcare utilization for 9-months post class. For Aim 3, we complete a
prospective longitudinal (12-month) observational cohort study. Participants will self-select to complete the home-based
Health in Motion-Otago Fall Prevention Program or no program. All participants will complete all assessments using Health
in Motion. Health relatedness: This project is directly aligned with the National Institutes on Aging mission to improve the
health and well-being of older adults through biomedical, social and behavioral research. This application is written in
response to the NIA’s request for solutions that address behavioral interventions for older adults to maintain
independence, well-being, and prevent disease/disability.