TY  - JOUR
PY  - 2018//
TI  - Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE): a cluster-randomized pragmatic trial of a multifactorial fall injury prevention strategy: design and methods
JO  - Journals of gerontology. Series A: Biological sciences and medical sciences
A1  - Bhasin, Shalender
A1  - Gill, Thomas M.
A1  - Reuben, David B.
A1  - Latham, Nancy K.
A1  - Gurwitz, Jerry H.
A1  - Dykes, Patricia
A1  - McMahon, Siobhan
A1  - Storer, Thomas W.
A1  - Duncan, Pamela W.
A1  - Ganz, David A.
A1  - Basaria, Shehzad
A1  - Miller, Michael E.
A1  - Travison, Thomas G.
A1  - Greene, Erich J.
A1  - Dziura, James
A1  - Esserman, Denise
A1  - Allore, Heather
A1  - Carnie, Martha B.
A1  - Fagan, Maureen
A1  - Hanson, Catherine
A1  - Baker, Dorothy
A1  - Greenspan, Susan L.
A1  - Alexander, Neil
A1  - Ko, Fred
A1  - Siu, Albert L.
A1  - Volpi, Elena
A1  - Wu, Albert W.
A1  - Rich, Jeremy
A1  - Waring, Stephen C.
A1  - Wallace, Robert
A1  - Casteel, Carri
A1  - Magaziner, Jay
A1  - Charpentier, Peter
A1  - Lu, Charles
A1  - Araujo, Katy
A1  - Rajeevan, Haseena
A1  - Margolis, Scott
A1  - Eder, Richard
A1  - McGloin, Joanne M.
A1  - Skokos, Eleni
A1  - Wiggins, Jocelyn
A1  - Garber, Lawrence
A1  - Clauser, Steven B.
A1  - Correa-De-Araujo, Rosaly
A1  - Peduzzi, Peter
SP  - 1053
EP  - 1061
VL  - 73
IS  - 8
N2  - BACKGROUND: Fall injuries are a major cause of morbidity and mortality among older adults. We describe the design of a pragmatic trial to compare the effectiveness of an evidence-based, patient-centered multifactorial fall injury prevention strategy to an enhanced usual care. <br><br>METHODS: Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) is a 40-month cluster-randomized, parallel-group, superiority, pragmatic trial being conducted at 86 primary care practices in 10 healthcare systems across USA. The 86 practices were randomized to intervention or control group using covariate-based constrained randomization, stratified by healthcare system. Participants are community-living persons, ≥70 years, at increased risk for serious fall injuries. The intervention is a co-management model in which a nurse Falls Care Manager performs multifactorial risk assessments, develops individualized care plans, which include surveillance, follow-up evaluation, and intervention strategies. Control group receives enhanced usual care, with clinicians and patients receiving evidence-based information on falls prevention. Primary outcome is serious fall injuries, operationalized as those leading to medical attention (non-vertebral fractures, joint dislocation, head injury, lacerations, and other major sequelae). Secondary outcomes include all fall injuries, all falls, and well-being (concern for falling; anxiety and depressive symptoms; physical function and disability). Target sample size was 5,322 participants to provide 90% power to detect 20% reduction in primary outcome rate relative to control. <br><br>RESULTS: Trial enrolled 5451 subjects in 20 months. Intervention and follow-up are ongoing. <br><br>CONCLUSIONS: The findings of the STRIDE study will have important clinical and policy implications for the prevention of fall injuries in older adults.<p />  <p>Language: en</p>
LA  - en
SN  - 1079-5006
UR  - http://dx.doi.org/10.1093/gerona/glx190
ID  - ref1
ER  -