@article{ref1,
title="Outcomes associated with scale-up of the Stepping On falls prevention program: a case study in redesigning for dissemination",
journal="Journal of clinical and translational science",
year="2020",
author="Mahoney, Jane E. and Gangnon, Ron and Clemson, Lindy and Jaros, LaVerne and Cech, Sandy and Renken, Jill",
volume="4",
number="3",
pages="250-259",
abstract="INTRODUCTION: Translating complex behavior change interventions into practice can be accompanied by a loss of fidelity and effectiveness. We present the evaluation of two sequential phases of implementation of a complex evidence-based community workshop to reduce falls, using the Replicating Effective Programs Framework. Between the two phases, workshop training and delivery were revised to improve fidelity with key elements.   Methods: Stepping On program participants completed a questionnaire at baseline (phase 1: n = 361; phase 2: n = 2219) and 6 months post-workshop (phase 1: n = 232; phase 2: n = 1281). Phase 2 participants had an additional follow-up at 12 months (n = 883). Outcomes were the number of falls in the prior 6 months and the Falls Behavioral Scale (FaB) score.   Results: Workshop participation in phase 1 was associated with a 6% reduction in falls (RR = 0.94, 95% CI 0.74-1.20) and a 0.14 improvement in FaB score (95% CI, 0.11- 0.18) at 6 months. Workshop participation in phase 2 was associated with a 38% reduction in falls (RR = 0.62, 95% CI 0.57-0.68) and a 0.16 improvement in FaB score (95% CI 0.14-0.18) at 6 months, and a 28% reduction in falls (RR = 0.72, 95% CI 0.65-0.80) and a 0.19 score improvement in FaB score (95% CI 0.17-0.21) at 12-month follow-up.   Conclusions: Effectiveness can be maintained with widespread dissemination of a complex behavior change intervention if attention is paid to fidelity of key elements. An essential role for implementation science is to ensure effectiveness as programs transition from research to practice.<p /> <p>Language: en</p>",
language="en",
issn="2059-8661",
doi="10.1017/cts.2020.17",
url="http://dx.doi.org/10.1017/cts.2020.17"
}