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Oregon Healthy Aging Network

History of your state’s Fall Prevention Coalition:
Fall prevention activities are an outgrowth of work done by the state Healthy Aging Network and the Injury and Violence Prevention Program. Historically in Oregon there has been an effort to integrate healthy aging programs and activities rather than silo the efforts. The concept that drives this effort was initiated by leadership at the Centers for Disease Control and Prevention Chronic Disease Prevention Program through their grant program. The state Health Promotion and Chronic Disease Program reorganized previously siloed efforts into a fully integrated program. As a result, when the state Injury and Violence Prevention Program approached the Healthy Aging Network partners to discuss the development of a Fall Prevention Coalition there was no interest in developing a separate effort, but great interest in integrating any work on fall prevention into the Healthy Aging Network structure. The long range vision includes development and implementation of comprehensive healthy aging community based programming. As a result of these infrastructure changes and the overall long range vision Oregon refers to the Healthy Aging Network as the state Fall Prevention Coalition.

In 2005, the Injury and Violence Prevention Program report and state plan identified falls among seniors in Oregon as one of the top four injury prevention problems. The Oregon Injury Prevention Community Planning Workgroup met to prioritize activities for prevention of falls. In 2007 staff from the Oregon IVPP began contacts with Oregon Research Institute to learn about Tai Chi Moving for Better Balance. In 2007, staff from the Injury and Violence Prevention Program began meeting with the Healthy Aging Network to support development of fall prevention activities in local communities with mini-grants to counties. Tai Chi Moving for Better Balance was implemented as part of the mini-grant projects. In 2008, the IVPP published an in depth report on falls among Oregon seniors to promote better understanding of the problem and support prevention efforts    (http://public.health.oregon.gov/DiseasesConditions/InjuryFatalityData/Pages/reports.aspx).  In 2009, the IVPP received funds from the Centers for Disease Control and Prevention to implement Tai Chi Moving for Better Balance. In 2010, the IVPP submitted a request for a Governor’s proclamation on senior fall prevention as part of the state’s first observance of national fall prevention day. In 2010, members of the Network supported the development of a fall prevention grant proposal that was funded by the Centers for Disease Prevention and Control.

Organizations that took the lead in developing the Fall Prevention Coalition:  
Oregon Seniors and People with Disabilities Program
Oregon Health Promotion and Chronic Disease Program
Oregon Injury and Violence Prevention Program

Goals and objectives of the Fall Prevention Coalition:  
The Network has no formally adopted goals and objectives, however, the IVPP has developed fall prevention goals and objectives that are published in the state Injury and Violence Prevention Plan (http://public.health.oregon.gov/DiseasesConditions/InjuryFatalityData/Documents/OregonInjuryPreventionPlan.pdf).

The overall goal:

Reduce fall mortality among older adults (65 and older) to less than 65 per 100,000 (age 65 and older)—a 13% reduction from the 2007 baseline of 74.6 per 100,000.

Fall prevention should largely focus on the population of older adults in Oregon, due to the high rate of mortality and hospitalization and the existence of evidence-based prevention programs.

Strategies include:

In the Community:

  • Implement evidence-based group exercise that decreases falls, and increases strength, mobility, coordination, balance, and overall physical fitness.
  • Educate older adults and their families about falls.
  • Conduct environmental assessments to reduce fall hazards and improve safety in the homes of older adults and in institutions.

In the Healthcare Sector:

  • Screen each senior for falls at every primary care visit.
  • Promote regular eye exams for seniors.
  • Conduct medication review and assess for dangerous interactions in primary care, pharmacies, and other settings.
  • Conduct fall assessment in annual primary care visits for those aged 55 and older to enable prevention before a fall occurs.

In Public Health:

  • Obtain resources necessary to implement community based primary prevention strategies and public health surveillance and research.

Outcomes being monitored:
Hospitalization and death among seniors that is related to falls through Hospital Discharge Data and Death Certificates
Self report of falls by seniors through the state Behavioral Risk Factor Surveillance System

All funding sources for the Fall Prevention Coalition (please be specific):
There is no funding for the state fall prevention coalition activities.

Organizations that are playing a key role in the Fall Prevention Coalition:
Oregon Seniors and People with Disabilities Program
Oregon Health Promotion and Chronic Disease Program
Oregon State University Extension Service
Oregon Health Sciences University Geriatrics Education Center
Oregon Research Institute
Multnomah County Aging Services
Northwest Portland Ministries
Providence Hospital Elder Place
Native American Family Services
Southeast Impact
Urban League
Think First
Tai Chi instructors
Elders in Action

Leadership structure and function of the coalition:
State program staff from the Health Promotion and Chronic Disease Prevention Program, Seniors and People with Disabilities Program and the Injury and Violence Prevention Program act as conveners and facilitators

Coalition committees:
Ad hoc committees are formed as needed and disbanded as projects conclude
Fall prevention grant management workgroup

Regional/county/local coalitions or workgroups you support/provide technical assistance:

2-3 challenges encountered:
Due to chronic state budget shortfalls legislative concepts to develop and support older adult health promotion programs have failed to move forward.

Lack of resources to support a dedicated staff person to build and maintain a fall coalition and lack of resources to support coalition activities limit the feasibility of maintaining a stand along fall prevention effort.

In 2010, the Governor’s proclamation request on fall prevention didn’t move through the approval process and the department public information office has concerns about and resists publicizing fall prevention.

2-3 successes to share:
State agencies and partners have agreed to include fall prevention as part of Healthy Aging.

Oregon communities received funds to implement three Tai Chi Moving for Better Balance projects since 2007.

Public Health Week activities in Oregon focused a week of activities and lectures on injury and violence prevention topics that included a plenary session presentation by NCOA staff Nancy Whitelaw and a group exercise demonstration and practice by Tai Chi Moving for Better Balance instructors.

For information about Oregon’s falls prevention initiatives and Healthy Aging Network, please contact:

Lisa M. Millet
Injury Prevention & Epidemiology Section Manager
Office of Disease Prevention & Epidemiology
Public Health Division
Oregon Health Authority
800 NE Oregon St. Suite 772
Portland, OR  97232
503-572-8585 cell

Jennifer Mead
Healthy Aging
DHS - Seniors & People with Disabilities, State Unit on Aging
800 NE Oregon St., Suite 730
Portland, OR  97232

Oregon Injury Prevention Plan:  http://public.health.oregon.gov/DiseasesConditions/InjuryFatalityData/Documents/OregonInjuryPreventionPlan.pdf


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