CE25-027 - From Screening to Safety: Implementing the AL-STEADI Initiative in Assisted Living Communities

Brown University, Providence RI

Investigators

Abstract

PROJECT SUMMARY Falls are a major cause of injury and disability for older adults. In assisted living communities, 50% of residents fall each year and 25% will have a fall that requires transfer to the hospital. Falls are a common reason for residents to transfer from assisted living to nursing homes. Approximately 30% of falls can be avoided with proper screening and intervention. STEADI is an evidence-based falls prevention program developed by the CDC and tested in several community-based setting. STEADI involves universal fall screening, followed by personalized assessments and tailored interventions. Common, potentially modifiable causes of falls evaluated in STEADI include medication interactions or side effects, environmental hazards (e.g., floor rugs, thresholds), untreated visual impairment, low vitamin D, ill-fitting footwear, or low blood pressure. The goal of this research is to adapt STEADI to the assisted living setting. First, we will conduct structured observations of current processes for fall risk evaluation and interview staff about how best to adapt STEADI to the assisted living environment. Next, we will draft a modified version of STEADI, with technical expert and assisted living corporation input. Finally, we will test the new assisted living (AL)-STEADI in seven communities. New and existing residents will be randomly assigned to AL-STEADI (intervention) or a usual fall prevention control. We will evaluate the effect of the intervention on the number of falls per 12 months. Planned and unplanned adaptations to the AL-STEADI protocol will be systematically. The outcome of this work will be AL-STEADI, an Implementation Plan, Toolkit, and training materials adapted to the needs of the ALC environment, with preliminary evidence for its effectiveness. In addition to traditional dissemination routes, we will publish an implementation guide for ALCs, which highlights the technical support needs which would make AL-STEADI more scalable and help adhere to state-specific ALC regulations.