Journal article
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
The journals of gerontology. Series A, Biological sciences and medical sciences, Vol.73(8), pp.1053-1061
07/09/2018
DOI: 10.1093/gerona/glx190
PMCID: PMC6037050
PMID: 29045582
Abstract
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.
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 health care systems across United States. The 86 practices were randomized to intervention or control group using covariate-based constrained randomization, stratified by health care system. Participants are community-living persons, ≥70 years, at increased risk for serious fall injuries. The intervention is a comanagement 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 (nonvertebral 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.
Trial enrolled 5,451 subjects in 20 months. Intervention and follow-up are ongoing.
The findings of the STRIDE study will have important clinical and policy implications for the prevention of fall injuries in older adults.
Details
- Title: Subtitle
- 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
- Creators
- Shalender Bhasin - Pepper Older Americans Independence Center, Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Boston, MassachusettsThomas M Gill - Pepper Older Americans Independence Center, Yale University, New Haven, ConnecticutDavid B Reuben - Multicampus Program in Geriatrics Medicine and Gerontology, David Geffen School of Medicine at UCLA, Los Angeles, CaliforniaNancy K Latham - Pepper Older Americans Independence Center, Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Boston, MassachusettsJerry H Gurwitz - Meyers Primary Care Institute, Reliant Medical Group, Worcester, MassachusettsPatricia Dykes - Brigham and Women's Hospital, Boston, MassachusettsSiobhan McMahon - School of Nursing, University of Minnesota, MinneapolisThomas W Storer - Pepper Older Americans Independence Center, Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Boston, MassachusettsPamela W Duncan - Wake Forest University, Winston-Salem, North CarolinaDavid A Ganz - Multicampus Program in Geriatrics Medicine and Gerontology, David Geffen School of Medicine at UCLA, Los Angeles, CaliforniaShehzad Basaria - Pepper Older Americans Independence Center, Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Boston, MassachusettsMichael E Miller - Wake Forest University, Winston-Salem, North CarolinaThomas G Travison - Hebrew SeniorLife, Harvard Medical School, Boston, MassachusettsErich J Greene - Yale Center for Analytical Sciences, Yale University, New Haven, ConnecticutJames Dziura - Yale Center for Analytical Sciences, Yale University, New Haven, ConnecticutDenise Esserman - Yale Center for Analytical Sciences, Yale University, New Haven, ConnecticutHeather Allore - Yale Center for Analytical Sciences, Yale University, New Haven, ConnecticutMartha B Carnie - Brigham and Women's Hospital, Boston, MassachusettsMaureen Fagan - Brigham and Women's Hospital, Boston, MassachusettsCatherine Hanson - University of Michigan, Ann ArborDorothy Baker - Pepper Older Americans Independence Center, Yale University, New Haven, ConnecticutSusan L Greenspan - Pepper Older Americans Independence Center, Division of Geriatrics and Gerontology, University of Pittsburgh, PennsylvaniaNeil Alexander - University of Michigan, Ann ArborFred Ko - Mount Sinai School of Medicine, New York, New YorkAlbert L Siu - Mount Sinai School of Medicine, New York, New YorkElena Volpi - University of Texas Medical Branch, GalvestonAlbert W Wu - Johns Hopkins University, Baltimore, MarylandJeremy Rich - HealthCare Partners, El Segundo, CaliforniaStephen C Waring - Essentia Health, Duluth, MinnesotaRobert Wallace - University of Iowa, Iowa CityCarri Casteel - University of Iowa, Iowa CityJay Magaziner - University of Maryland, BaltimorePeter Charpentier - Yale Center for Analytical Sciences, Yale University, New Haven, ConnecticutCharles Lu - Yale Center for Analytical Sciences, Yale University, New Haven, ConnecticutKaty Araujo - Yale Center for Analytical Sciences, Yale University, New Haven, ConnecticutHaseena Rajeevan - Yale Center for Analytical Sciences, Yale University, New Haven, ConnecticutScott Margolis - Pepper Older Americans Independence Center, Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Boston, MassachusettsRichard Eder - Pepper Older Americans Independence Center, Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Boston, MassachusettsJoanne M McGloin - Pepper Older Americans Independence Center, Yale University, New Haven, ConnecticutEleni Skokos - Pepper Older Americans Independence Center, Yale University, New Haven, ConnecticutJocelyn Wiggins - University of Michigan, Ann ArborLawrence Garber - Meyers Primary Care Institute, Reliant Medical Group, Worcester, MassachusettsSteven B Clauser - Patient Centered Outcomes Research Institute, Washington, District of ColumbiaRosaly Correa-De-Araujo - National Institute on Aging, Bethesda, MarylandPeter Peduzzi - Yale Center for Analytical Sciences, Yale University, New Haven, Connecticut
- Resource Type
- Journal article
- Publication Details
- The journals of gerontology. Series A, Biological sciences and medical sciences, Vol.73(8), pp.1053-1061
- DOI
- 10.1093/gerona/glx190
- PMID
- 29045582
- PMCID
- PMC6037050
- NLM abbreviation
- J Gerontol A Biol Sci Med Sci
- ISSN
- 1758-535X
- eISSN
- 1758-535X
- Publisher
- United States
- Grant note
- P30 AG024827 / NIA NIH HHS UL1 TR000142 / NCATS NIH HHS P30 AG024832 / NIA NIH HHS UL1 TR001102 / NCATS NIH HHS P30 AG028748 / NIA NIH HHS P30 AG021332 / NIA NIH HHS UL1 TR000114 / NCATS NIH HHS K08 AG050808 / NIA NIH HHS K07 AG052668 / NIA NIH HHS U01 AG048270 / NIA NIH HHS P30 AG021342 / NIA NIH HHS P30 AG031679 / NIA NIH HHS KL2 TR000113 / NCATS NIH HHS K07 AG043587 / NIA NIH HHS P30 AG024824 / NIA NIH HHS P30 AG028747 / NIA NIH HHS
- Language
- English
- Date published
- 07/09/2018
- Academic Unit
- Occupational and Environmental Health; Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9983997453402771
Metrics
25 Record Views