Environmental Scan

F I N A L R E P O R T :

How selected organizations and agencies are addressing falls

prevention and older adults

F A L L S F R E E :

Promoting a National Falls Prevention Action Plan

About The National Council on the Aging

Who We Are Founded in 1950, The National Council on theAging (NCOA) is the nation's first charitable or-ganization dedicated to promoting the health, in-dependence, and continuing contributions of olderAmericans. NCOA is a 3,200 member nationalnetwork of organizations and individuals includingsenior centers, adult day service centers, area agen-cies on aging, faith congregations, senior housingfacilities, employment services, and other con-sumer organizations.

What We DoTo accomplish organizational objectives, the fol-lowing core competencies guide our activities:

n NCOA is a national voice and powerful ad-vocate for public policies, societal attitudes, andbusiness practices that promote vital aging. Afounding member of the Leadership Council ofAging Organizations, NCOA often leads cam-paigns to preserve funding for the OlderAmericans Act. We currently chair and lead theAccess to Benefits Coalition to help lowerincome Medicare beneficiaries find prescriptionsavings. We regularly do public awareness stud-ies such as the Myths and Realities of Aging™that have helped shape the attitudes of millions.

n NCOA is an innovator, developing newknowledge, testing creative ideas, and translat-ing research into effective programs and servic-es that help community service organizations

serve seniors in hundreds of communities.NCOA is the leader in identifying and dissemi-nating best practices and evidence-based pro-gramming in community-based physical activi-ty, chronic disease management and health pro-motion activities. In its long history, NCOA hasalso shaped many innovative aging programs,including Meals on Wheels and FosterGrandparents.

n NCOA is an activator, turning creative ideasinto programs and services that help communi-ty services organizations organize and deliveressential services to seniors. This includesFamily Friends and its Center for HealthyAging. NCOA also administers two federal Pro-grams (Senior Community Service Employ-ment Service and Senior Environmental Pro-gram) and the Maturity Works partnership toprovide employment and training opportunitiesfor mature adults through offices nationwide.

n NCOA develops decision support tools suchas BenefitsCheckUp® and the Long-term CareCounselor™, enabling consumers to make opti-mal decisions and maximize all availableresources and opportunities, whether they arelooking for prescription savings or understand-ing their risk of needing long-term care.

n NCOA creates partnerships that bring togeth-er a wide variety of voluntary, philanthropic,and public organizations to spark innovativesolutions and achieve specific results. Each year,for example, NCOA and the American Societyon Aging partner to bring a joint annual confer-ence to 4,000 professionals in the field.

The Archstone Foundation The Archstone Foundation is a philanthropic leader committed to addressing the issues of Older Americans. About the Archstone Foundation The Archstone Foundation is a private non-profit grantmaking organization founded in 1985, whose mission is to contribute toward the preparation of society in meeting the needs of an aging population. It has awarded more than $50 million in grants since its inception. The Archstone Foundation is currently focusing the majority of its resources to address the following four issue areas, with an emphasis on funding California-based initiatives:

• Elder Abuse Prevention • Fall Prevention • End-of-Life Issues • Responsive grantmaking to address emerging needs within society’s aging population.

The Archstone Foundation and Fall Prevention Fall prevention is an exceptionally important issue for the Archstone Foundation because falls are an enormous threat to the health and well-being of older adults. It is estimated that one in three adults age 65 and older fall each year. While most falls result in minimal injury, more than 20 to 30 percent of adults age 65 and older suffer serious injury from falls, particularly hip fractures and head injury. Of those hospitalized for a hip fracture 40% never return home or live independently again, and 25% will die within one year. The loss of independence that follows a serious fall may lead to institutionalization, contributing to escalating health care costs and an incalculable human cost. Yet many falls can be prevented. The Archstone Foundation is a major supporter of the Falls Free Summit as part of its work to help prevent falls among older adults. The Archstone Foundation strives for lasting change and working in partnership with others. To learn more about the Archstone Foundation and the work of its grantees visit www.archstone.org.

Home Safety Council

Our Mission

The Home Safety Council (HSC) is a 501(c)(3) nonprofit organization dedicated to helping prevent the nearly 21 million medical visits that result on average each year from unintentional injuries in the home. Through national programs and partners across America, the Home Safety Council works to educate and empower families to take actions that help keep them safer in and around their homes.

About the Home Safety Council

Established in 1993, the Home Safety Council serves as a national resource for home safety education and information. We believe that a safe home is in your hands and that’s why our daily commitment is to provide families with the knowledge to implement safety practices in their home. Through relationships with educators, policy makers, safety communities, researchers and media, the Home Safety Council delivers timely information and recommendations for the public. This valuable information could spare them and their loved ones from a serious home-related injury. To learn more about the Council's programs, partnerships and resources, visit the Home Safety Council at www.homesafetycouncil.org.

Why Home Safety?

Unintentional home injury is a major public health problem in the United States. According to the Council’s The State of Home Safety in America™ research report, each year on average preventable injuries in the home:

• Result in nearly 20,000 deaths • Cause nearly 21 million medical visits • Are the fifth leading cause of death overall • Are 2.5 times more likely to cause injury than car crashes • Cost our nation $380 billion • Are largely preventable when home safety practices are put into action at home

How We Promote Our Mission

We work hard to share information through our programs, partners, and resources to keep families safe at home. Our body of work includes:

School and community outreach to educate kids and their parents from coast-to-coast

Research and data collection on unintentional injuries in the home to help target educational programs

Online safety resources to provide the public with easy access to free information and comprehensive tools designed to improve understanding of unintentional home injuries and offer effective ways families/households can safeguard their loved ones

Corporate outreach to assist companies of all sizes in developing effective methods to share home injury prevention information with their employees, families and customers

Grassroots outreach teaming HSC with partner organizations to extend safety messages into local communities

Seasonal consumer awareness campaigns that deliver timely and “calendar relevant” safety tips to the public through media and web-based outreach

Risk group outreach to target groups with the highest incidence of home injury and develop customized educational programs tailored to their needs

Children’s educational programs to teach home safety lessons to elementary age kids in the classroom and on the Internet through specially-designed lesson plans, activities and games

Advocacy and public affairs initiatives to support home safety research, and promote healthy and safer communities

Awards and recognition for corporations and individuals who champion the cause

The Home Safety Council believes that education is the first step to a safer home and that’s why our mission of education and empowerment is so important to the health and well-being of families everywhere.

Falls Free: Promoting a National Falls Prevention Action Plan Table of Contents Page

The problem 2

Response to the problem -- Falls Free: Promoting a National Falls Prevention Action Plan 3

Environmental scan 3

What did organizations tell us? 6

What did we learn from the environmental scan? 11

What next? 13

Appendices

Appendix A: Organization-specific summaries from the environmental scan

Appendix B: National Council on the Aging Falls Free Environmental Scan

Appendix C: Steering Committee Members

14

98

104

2

The problem Falls are a significant health problem for older adults, with serious public health implications. Falls can have devastating outcomes, including decreased mobility, function, and independence, and in some cases, death. Health care for fall-related injuries is expensive. The growth in the senior population, the desire to remain independent, and the rising costs of health care and long-term care make finding ways to prevent and reduce falls of paramount importance in promoting healthy aging (Centers for Medicare and Medicaid Services, http://www.cms.hhs.gov/healthyaging/fallsPI.asp). The National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC) tracks falls-related death rates for older adults. The center notes that from 1988 to 2000, the unintentional fall death rates for both men and women increased significantly. In 2000, falls rates for men were 20 percent higher than rates for women.

Data: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 2002.

According to the CDC’s National Center for Injury Prevention and Control fact sheet (http://www.cdc.gov/ncipc/factsheets/fallcost.htm):

· More than one third of adults age 65 and older fall each year.

· Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes.

· Of those who fall, 20 to 30 percent suffer moderate to severe injuries that reduce mobility and independence, and increase the risk of premature death.

· By 2020, the estimated cost for fall injuries for people age 65 and older is expected to reach $32.4 billion.

3

Response to the problem

Falls Free: Promoting a National Falls Prevention Action Plan In direct response to growing concerns related to falls among the aging population, The National Council on the Aging (NCOA), with funding from the Archstone Foundation and the Home Safety Council, is spearheading an initiative entitled Falls Free: Promoting a National Falls Prevention Action Plan (the National Action Plan). The project addresses the issues surrounding older adult injury rates, loss of independence and attendant medical costs related to older adult falls. NCOA plans an exciting two-day summit, to bring together a diverse group of leaders to tackle the issues and achieve consensus on the National Action Plan. The National Center for Injury Prevention and Control has provided some additional funding support for the publication of the National Action Plan. To help plan and organize the summit, the NCOA convened a Steering Committee of nationally known experts (see Appendix C), who developed the following vision and goal statements for the initiative :

Vision: Older adults will have fewer falls and falls related injuries, maximizing their independence and quality of life. Goal: To launch a national action plan with specific goals, objectives, and strategies to effect sustained initiatives that reduce falls among the elderly.

Environmental scan To better understand national level efforts currently devoted to falls prevention, the Steering Committee commissioned a National Environmental Scan conducted during the summer of 2004. Objectives of the environmental scan The scan had the following objectives:

1. Identify national organizations/agencies/foundations that currently address falls prevention among the elderly.

2. Identify major falls prevention programs, products, resources and services currently in place.

3. Identify significant gaps in programs, products, resources and services that can be addressed by research, new program development and evaluation.

4. Inform the Summit Steering Committee to assist in agenda development.

5. Identify organizations interested in participating in the development of a national plan aimed at reducing falls among the elderly.

6. Provide background to the participants of the Falls Free Summit.

7. Provide the substance for a) an independent report for interested organizations, policy makers, funding organizations and others, and b) a supplemental publication for the National Action Plan.

4

Design of the environmental scan Internet research and Steering Committee recommendations identified the initial list of national organizations and key individuals to be included in the environmental scan. The potential pool was enlarged by asking organizations that completed the scan to identify other relevant contacts. The Steering Committee limited the scan to national level organizations and agencies. The scan did not include state and local agencies, although a limited number of organizations not originally solicited did return completed surveys, including a university, two local community organizations, and two hospitals. Charts 2, 3 and 4 do not include data from these groups, but the supplemental overview (Appendix A) of individual respondents in the second section of this document includes them. Sanner & Company designed the electronic survey instrument, based on a previously successful scan of physical activity programming conducted in 2001. The Steering Committee provided feedback to the design and assisted in constructing the final instrument. Appendix B contains the final instrument. An initial electronic request to organizational leaders presented the issue and asked them to participate in the survey. Unless they declined, all organizations then received the electronic survey to complete. Who contributed to the scan? In total, 98 organizations were contacted. Representatives of the Steering Committee made follow-up contacts via e-mail and/or telephone calls, as appropriate, to encourage response to the survey. In total, 71 national organizations completed and returned the survey (72.4% of those contacted). Chart 1 describes the types of organizations identified by the Steering Committee. Chart 2 (page 5) provides the distribution of the responding national organizations across types of organizations. Fifty-eight (81.6%) of the 71 national organizations that responded indicated an interest, or potential interest, in providing input into the development of a national action plan. Chart 3 (page 5) describes these organizations , which constitute the core of summit invitees.

27

20 17

11 105 4 4

0

5

10

15

20

25

30

Chart 1: Organizations Contacted (N = 98)

Community service/program (27)

Medical professional (20)

Government (17)

Funding (11)

Industry (10)

Medical services (5)

Faith based (4)

Research (4)

5

25

1411

96 4 20

5

10

15

20

25

Chart 2: National Organization Respondents (N = 71)

Community service/program (25)

Medical professional (14)

Government (11)

Funding (9)

Industry (6)

Research (4)

Faith based (2)

21

13 11

3 5 3 20

5

10

15

20

25

Chart 3: National Organizations Interested in Providing Inputinto the National Action Plan (N = 58)

Community service/program (21)

Medical professional (13)

Government (11)

Funding (3)

Industry (5)

Research (3)

Faith based (2)

6

What did organizations tell us? Of the 58 national organizations interested in providing input into the National Falls Prevention Action Plan, 43 currently have initiatives in place that address issues related to falls prevention (see Chart 4). Table 1 (page 7) lists all (63) organizations that responded to the survey (with acronyms in parentheses) and provides an overview of their responses.

Chart 4: Summary of the Mix of Current Programs

Consumer education materials (20)

Professional education materials (20)

Professional education programs (15)

Consumer education programs (16)

Institutional research (10)

Other (17)

Research funding (7)

Services (4)

Health care services (2)

Notes. Chart excludes product manufacturing because respondents do not engage in manufacturing. Scan did not include commercial home building, home design or product developers. Organizations could have multiple programs.

7

Table 1: Responding Organizations and Programs

Organization Current Programs 1. AARP § None reported 2. Administration on Aging (AoA) § Community/consumer education programs

§ Professional education programs § Consumer education materials § Professional education materials § Research funding

3. Agency for Healthcare Research and Quality (AHRQ)

§ Research funding § Institutional research

4. Alliance for Aging Research (AAR) § None reported 5. American Academy of Audiology (AAA) § Professional education programs

§ Professional education materials 6. American Academy of Family Physicians (AAFP) § Consumer education materials

§ Professional education materials 7. American Academy of Orthopaedic Surgeons

(AAOS) § Professional education programs § Consumer education materials § Professional education materials

8. American Association for Active Lifestyles and Fitness (AAALF)

§ Community/consumer education programs § Consumer education materials § Professional education materials

9. American Association of Homes and Services for the Aging (AAHSA)

§ Community/consumer education programs

10. American Board of Internal Medicine (ABIM) § Professional education programs 11. American Geriatrics Society (AGS) and AGS

Foundation for Health In Aging (FHA) § Consumer education materials § Professional education materials

12. American Medical Association (AMA) § None reported 13. American Medical Directors Association (AMDA) § Professional education materials 14. American Nurses Association (ANA) § Professional education programs

§ Professional education materials § Institutional research

15. American Occupational Therapy Association (AOTA)

§ Community/consumer education programs § Professional education programs § Consumer education materials § Professional education materials § Institutional research § Services § Other

16. American Physical Therapy Association (APTA) § Community/consumer education programs § Consumer education materials § Professional education programs § Professional education materials § Research funding

17. American Podiatric Medical Association (APMA) § None reported 18. American Society on Aging (ASA) § Professional education programs

§ Professional education materials 19. American Society of Consulting Pharmacists

Research & Education Foundation (ASCP) § None reported

20. Archstone Foundation § Research funding 21. Assisted Living Federation of America (ALFA) § Professional education materials

8

22. Association of Jewish Aging Services (AJAS) § None reported 23. Association of State & Territorial Chronic Disease

Program Directors (CDD) § Community/consumer education programs § Other

24. Center for Successful Aging (CSA) § Community/consumer education programs § Professional education programs § Consumer education materials § Professional education materials § Institutional research § Health care services

25. Centers for Disease Control & Prevention Division of Nutrition and Physical Activity (CDC/DNPA)

§ Consumer education materials § Other

26. Centers for Disease Control & Prevention National Center for Injury Prevention and Control (CDC/NCIPC)

§ Community/consumer education programs § Professional education programs § Consumer education materials § Professional education materials § Research funding § Institutional research § Other

27. Centers for Medicare & Medicaid Services (CMS) § Other 28. Emergency Nurses Association (ENA) § None reported 29. Fannie Mae § Other: Funding to assist elders age in place 30. Generation Care, Inc. § Services 31. Grantmakers in Health (GIH) § None reported 32. Growing Well, Inc. § Consumer education materials

§ Services 33. Habitat for Humanity (Habitat) § Community/consumer education programs

§ Consumer education materials 34. Home Safety Council (HSC) § Community/consumer education programs

§ Consumer education materials § Institutional research § Other

35. International City County Management Association (ICMA)

§ None reported

36. International Code Council (ICC) § Community/consumer education programs § Professional education programs § Consumer education materials § Professional education materials § Services § Other

37. Lighthouse International (Lighthouse) § Community/consumer education programs § Professional education programs § Consumer education materials § Health care services § Institutional research § Services § Other

38. Meals on Wheels Association of America (MOWAA)

§ None reported

39. Memorial Hermann SW Hospital (Memorial Hermann)

§ Professional education programs § Other

40. Merck Institute of Aging & Health (MIAH) § Professional education materials

9

41. National Association of Area Agencies on Aging (N4A)

§ None reported

42. National Association for Continence (NAFC) § Professional education programs § Consumer education materials

43. National Association for Home Care & Hospice (NAHCH)

§ Professional education materials

44. National Association of Home Builders Research Center, National Center for Seniors’ Housing Research (NAHB)

§ Community/consumer education programs § Professional education programs § Consumer education materials § Research funding § Institutional research § Other

45. National Association of State Units on Aging (NASUA)

§ Other

46. National Council on the Aging (NCOA) § Institutional research § Other

47. National Fire Protection Association (NFPA) § Community/consumer education programs § Consumer education materials

48. National Governors Association (NGA) § Other 49. National Indian Council on Aging (NICA) § Community/consumer education programs

§ Consumer education materials 50. National Osteoporosis Foundation (NOF) § Consumer education materials

§ Professional education materials 51. National Recreation and Parks Association

(NRPA) § None reported

52. National Safety Council (NSC) § None reported 53. Partnership for Prevention (Prevent) § None reported 54. Rebuilding Together, Inc. (RT) § Professional education programs

§ Consumer education materials § Community/consumer education programs § Professional education materials § Services § Other

55. Research!America (R!A) § None reported 56. Retirement Research Foundation (RRF) § Research funding 57. State and Territorial Injury Prevention Directors

Association (STIPDA) § Professional education materials § Other

58. United Government Services (UGS) § Other 59. United Jewish Communities (UJC) § Other 60. U.S. Department of Health and Human Services -

Assistant Secretary of Planning and Evaluation (HHS-ASPE)

§ Institutional research

61. University of Chicago Hospitals (UCH) § Institutional research 62. University of Rochester Department of Emergency

Medicine (URDEM) § Institutional research § Health care services

63. Virginia G. Piper Charitable Trust (Piper Trust) § None reported

10

Table 2 lists the organizations that provide each type of program or initiative: consumer and professional education materials, consumer and professional education programs, institutional research, research funding, health care services, other services, product manufacturing, and other. See Table 1 for full names of the organizations represented by acronyms in this table .

Table 2: Organizations That Provide Each Type of Program and Initiative

Consumer education materials

Pro-fessional education materials.

Pro-fessional education programs

Consumer education programs

Institu-tional

research Other Research

funding Services Health care services

AAALF AoA AoA AAALF AHRQ AOTA AoA AOTA CSA AAFP AAA AAA AAHSA ANA CDC/DNPA AHRQ ICC Lighthouse AAOS AAFP AAOS AoA AOTA CDC/NCIPC APTA Lighthouse AGS AAOS ABIM AOTA CSA CMS Arch-

stone RT

AoA AAALF ANA APTA CDC/ NCIPC

CDD CDC/ NCIPC

AOTA ALFA AOTA CDC/NCIPC HHS/ ASPE

Fannie Mae

NAHB

APTA AMDA APTA CSA HSC HSC RRF CSA AGS ASA CDD Lighthouse ICC CDC/ NCIPC

ANA CSA Habitat NAHB Lighthouse

CDC/ DNPA

AOTA CDC/ NCIPC

HSC NCOA NAHB

Habitat APTA ICC ICC NASUA HSC ASA Lighthouse Lighthouse NCOA ICC CSA NAC NAHB NGA Lighthouse CDC/

NCIPC NAHB NFPA RT

NAC ICC RT NICA STIPDA NAHB MIAH RT UGS NFPA NAHCH UJC NICA NOF NOF RT RT STIPDA

11

What did we learn from the environmental scan? Community/consumer education programs and consumer education materials § The majority of community/consumer education initiatives (both programs and materials) appear to

use traditional approaches such as health education and physical activity classes, Internet-based information, health fair outreach, speakers’ bureaus, brochure distribution, videos and fact sheets. Two initiatives use more robust methods by delivering specific awareness and/or behavior change models that include outcomes-based evaluation. These model programs are the Center for Successful Aging FallProof Balance and Mobility Program (Page 50) and Remembering When® , an initiative of the National Fire Protection Association (Page 79) that the Centers for Disease Control and Prevention National Center for Injury Prevention and Control (CDC/NCIPC) (Page 52) currently is evaluating.

§ Few programs or materials have been developed specifically to target minority populations or adults with low income or low education. Some Spanish language materials on falls prevention exist, generally produced by federal or state-based agencies.

§ Some excellent consumer focused information appears on Web sites. Some of the many examples include:

o the Centers for Disease Control and Prevention (CDC) toolkit (http://www.cdc.gov/ncipc/pub-res/toolkit/toolkit.htm)

o the American Geriatrics Society Foundation for Health in Aging (Page 34) consumer brochure (http://www.healthinaging.org/public_education/falls_index.php)

o the American Academy of Family Physicians’ (Page 27) Falls: How to Lower Your Risk (http://familydoctor.org/x1885.xml.)

§ The National Council on the Aging (NCOA), with funding from the U.S. Administration on Aging

(AoA), is involved in the design and implementation of a National Resource Center to support AoA evidence-based health promotion/disease prevention initiatives (Page 17). NCOA is acquiring and processing resources and information on prevention programs for service providers. This Center for Healthy Aging Web site (www.healthyagingprograms.org) will report on the Falls Free Summit and help to disseminate the National Action Plan.

Professional education programs and materials § Professional education initiatives fell into two broad categories: those that target medical

professionals and those that target professionals in the fields of building design, construction and remodeling.

§ Medical professional education initiatives tend to follow traditional avenues of delivery: seminars, conferences, symposia, journals, newsletters and information available via the Internet.

§ The CDC has funded the San Diego State University Foundation to establish a National Resource Center for Safe Aging (www.safeaging.org) (Page 53). This includes collecting, organizing and disseminating science-based information on injury prevention.

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§ Clinical practice guidelines that address falls/fall prevention have been developed by the American Geriatrics Society (Page 34), Clinical Practice Guidelines in Preventing Falls in Older Adults, and by the American Medical Directors Association (Page 37), Clinical Practice Guidelines: Fall and Fall Risk in Long Term Care Settings.

§ The National Association of Home Builders National Center for Seniors’ Housing Research (Page 74), Rebuilding Together (Page 86) and the CDC (as part of the U.S. Falls Prevention Program for Seniors) have developed initiatives related to home assessment and modification, including workshops, toolkits and support materials

§ The International Code Council (Page 64) provides professional education to the building industry on codes and standards. They also offer building plan reviews as well as assessment and evaluation of building products.

Research § The Agency for Health Care Research and Quality is funding translation research related to falls.

The Administration on Aging has funded the National Association of Home Builders National Center for Seniors’ Housing Research to administer grants on assistive technology and aging in place (Page 74).

§ The U.S. Department of Health and Human Services/Assistant Secretary for Planning and Evaluation (HHS-ASPE) (Page 94) plans to release a report on falls prevention interventions and methodology in the near future. The HHS-ASPE research report likely will contain a detailed description of proposed interventions and a methodology for selecting the sample, collecting data and measuring outcomes to determine the effectiveness of interventions. Subsequent HHS-ASPE research will include a feasibility study on which to base a larger scale effort.

§ Lighthouse International is currently collecting data on programs, products and services that deal with adaptive age-related vision loss and falls, fear of falls and falls risk (Page 66).

Other initiatives of note § The Centers for Disease Control and Prevention, National Center for Injury Prevention and Control

is estimating the healthcare costs of older adult falls-related injuries.

§ Fannie Mae provides funding for home modifications to enable older adults to age in place.

§ National Association of Home Builders/National Center for Seniors’ Housing Research conducts extensive product testing on surfaces used throughout the home and durability/serviceability of bathroom fixtures and materials. In addition they test flooring materials, grab bars, and other products that can both directly and indirectly relate to accident prevention in the home.

§ Rebuilding Together provides home modification assessment and construction services to low income seniors in select geographic areas of the United States.

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What next? § No strategic and comprehensive approach appears to exist to communicate falls prevention

information to either professional or consumer audiences. While a number of organizations disseminate information, the issue of falls prevention lacks a champion for a focused and strategic national marketing, public and professional awareness and education campaign. Support for this type of initiative would benefit from market research of key stakeholder audiences to better understand awareness, issues, beliefs and barriers related to falls and falls prevention.

§ A number of medical professional organizations address the issue of falls prevention within their association membership through journal articles, seminars, conferences, etc. Opportunities may exist for collaborative professional education initiatives and collaborative development and dissemination of clinical guidelines.

§ The scan included primarily not-for-profit organizations, trade groups, government agencies and

medical associations that address the needs of the aging population. While it may prove more challenging to obtain input from commercial organizations because they need to protect proprietary information and because they may not place a high priority on older consumers, opportunities may exist to engage home improvement, home decorating, hardware, and household product manufactures and distributors. Partnerships may provide promising avenues for consumer education and information dissemination and result in marketing initia tives.

§ Opportunities exist to reach out to key construction and manufacturing industries in the areas of

lighting, floor covering/floor surface and design.

§ Results of the scan suggest that businesses and funding organizations may not perceive that falls in the elderly have critical and costly consequences. A comprehensive effort to provide education about falls prevention, one that engages organizations in the importance of falls prevention initiatives, could prove useful in securing funding from granting organizations; promoting public/private partnership initiatives; and engaging policy makers at the local, state and federal levels

§ As noted earlier, some organizations provide Falls Prevention materials for older adults on their Web sites. Although adults 50 and older increasingly use the Internet, differences in comfort with the technology exist between those age 50 to 65 and those older than 65, which may reduce the effectiveness of online tools for communicating with some older adults. It may be appropriate to explore other communication venues and to identify a stronger intermediary role for community-based organizations serving older adults.

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APPENDIX A: ORGANIZATION-SPECIFIC SUMMARIES FROM THE ENVIRONMENTAL SCAN

Page

AARP 16

Administration on Aging 17

Agency for Healthcare Research & Quality 21

Alliance for Aging Research 25

American Academy of Audiology 26

American Academy of Family Physicians 27

American Academy of Orthopaedic Surgeons 29

American Association for Active Lifestyles & Fitness 30

American Association for Homes & Services for the Aging 32

American Board of Internal Medicine 33

American Geriatrics Society & AGS Foundation for Health in Aging 34

American Medical Association 36

American Medical Directors Association 37

American Nurses Association 38

American Occupational Therapy Association 39

American Physical Therapy Association 42

American Podiatric Medical Association 43

American Society on Aging 44

American Society of Consulting Pharmacists Research & Education Foundation 45

Archstone Foundation 46

Assisted Living Federation of America 47

Association of Jewish Aging Services 48

Association of State & Territorial Chronic Disease Program Directors 49

Center for Successful Aging 50

Centers for Disease Control & Prevention Division of Nutrition and Physical Activity 52

Centers for Disease Control & Prevention National Center for Injury Prevention and

Control

53

Centers for Medicare & Medicaid Services 55

Emergency Nurses Association 56

Fannie Mae 57

Generation Care, Inc. 58

15

Grantmakers in Health 59

Growing Well, Inc. 60

Habitat for Humanity 61

Home Safety Council 62

International City/County Management Association 63

International Code Council 64

Lighthouse International 66

Meals on Wheels Association of America 68

Memorial Hermann SW Hospital 69

Merck Institute of Aging and Health 70

National Association of Area Agencies on Aging 71

National Association for Continence 72

National Association for Home Care and Hospice 73

National Association of Home Builders Research Center 74

National Association of State Units on Aging 77

National Council on the Aging 78

National Fire Protection Association 79

National Governors Association 80

National Indian Council on Aging 81

National Osteoporosis Foundation 82

National Recreation & Parks Association 83

National Safely Council 84

Partnership for Prevention 85

Rebuilding Together, Inc. 86

Research!America 89

Retirement Research Foundation 90

State and Territorial Injury Prevention Directors Association 91

United Government Services 92

United Jewish Communities 93

U.S. Department of Health and Human Services -Assistant Secretary of Planning and

Evaluation

94

University of Chicago Hospitals 95

University of Rochester Department of Emergency Medicine 96

Virginia G. Piper Charitable Trust 97

16

AARP 601 E St., NW Washington, DC 20049 Web site: www.aarp.org Contact: Elizabeth Clemmer, Public Policy Institute Phone: 202-434-3911 Fax: 202-434-6402 E-mail: eclemmer@aarp.org Organization Mission AARP is a nonprofit, nonpartisan membership organization for people age 50 and over. AARP is dedicated to enhancing quality of life for all as we age. AARP leads positive social change and delivers value to members through information, advocacy and service. AARP also provides a wide range of unique benefits, special products, and services for our members. These benefits include AARP Web site at www.aarp.org, AARP The Magazine, the monthly AARP Bulletin , and a Spanish-language newspaper, Segunda Juventud. Active in every state, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, AARP celebrates the attitude that age is just a number and life is what you make it. Falls prevention-related programs or services AARP does not currently report any falls-prevention programs or initiatives.

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Administration on Aging (AoA) One Massachusetts Ave., NW Washington, DC 20001 Web site: www.aoa.gov Contact: Diana Lawry Phone: 202-357-3435 Fax: 202-357-3469 E-mail: Diana.lawry@aoa.gov Organization Mission The mission of the US Administration on Aging (AoA) is to promote the dignity and independence of older people, and to help society prepare for an aging population. AoA carries out its mission with and through a national network of public and private organizations at national, state and local levels. It is charged, under the Older Americans Act, with the responsibility to serve as the advocate for older people and to oversee the development of a comprehensive and coordinated system of care that will enable older individuals to remain at home and participate fully in the community life. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): As an example, the goal of a program in the greater Hartford area is to embed a sustainable evidence-based fall prevention program within senior centers by enhancing fall prevention-related knowledge and behavior, while also building or enhancing relationships between senior centers and relevant community and health care organizations. Objectives are to develop, implement, evaluate, and disseminate a fall-prevention program that is based on research targeting the following risk factors:

ü Balance, gait, and vision impairments ü Postural hypotension ü Multiple medication use ü Home hazards

This intervention includes an initial falls assessment in which participants report the number of falls in the past year. Those with fewer than two falls participate in a balance maintenance program at the center. Those with two or more falls have a risk factor assessment and may participate in management strategies related to their identified risk factor at the senior centers. Some examples of these strategies include:

ü Gait and/or balance training (maintenance or progressive) ü Medication grid, regular review, or reduction ü Appropriate footwear ü Environmental intervention/home safety evaluation ü Adequate fluid intake

This is a three year grant program funded by AoA to an Area Agency on Aging in Connecticut being carried out in local senior centers. Project coordinators also plan to make the intervention adaptable in other community settings such as senior housing and adult day centers.

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The program targets older persons living in the area serviced by the North Central Connecticut AAA. Senior centers were chosen to capture a socio-economically, ethnically, and functionally diverse population. During the first year, three senior centers will be targeted with culturally tailored fall-prevention programs (660 seniors served). During the second and third years, eight additional centers will be included (4,000 seniors exposed). An additional 5,500 older adults will be reached through an additional 30 senior centers. At-risk seniors who do not usually participate in senior services will also be targeted.

Evaluation:

An impact evaluation will help determine the intervention’s effect on participating seniors and center personnel. It includes developing interview-based questionnaires for use with participants and staff, continuous recruiting and interviewing of staff and seniors, as well as matching and randomizing participating centers beginning in year two or three. Additionally, databases are being developed on all collected data to allow for statistical analyses. Primary outcomes for seniors are being measured as self-reported falls. Primary outcomes for professional staff and volunteers are being measured as change in fall prevention-related knowledge and behaviors in staff. Secondary outcomes for seniors are being measured as change in fall prevention-related knowledge and behaviors, change in confidence in performing activities without falling, and self-reported fall injuries. A process evaluation allows ongoing monitoring of program activity and determines where increased efforts might be needed. The evaluation includes summarizing the number of center personnel and seniors participating in the fall prevention program. It also generates tables and graphs to illustrate both trends in fall prevention program participation and gender, ethnic and racial information to illustrate the diversity of participating seniors. Summary tables are also being developed each year documenting the specific number of fall prevention activities and educational materials at each center. The Center on Aging at the University of Connecticut Health Center is acting as the research organization for the project and is responsible for collecting and analyzing data, as well as evaluating the program.

§ Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations, health fairs, physical activity programs): A Matter of Balance (MOB) provides classes to reduce risk of falling, stop fear of falling and improve activity levels; it addresses physical, social and cognitive factors associated with falling. It was developed by Roybal Center for Research in Applied Gerontology, Boston University/New England Research Institutes, with NIA funding. This three year AoA funded grant was made to an Area Agency on Aging. It is being led by trained lay leaders and carried out in a community setting. A variety of classes and activities are held which address the physical, social and cognitive factors associated with falling, and incorporate an introduction to exercise. Strategies include:

ü Promoting the view of falls and fear of falling as controllable ü Setting realistic goals for increasing activity ü Changing the environment to reduce fall risk factors ü Promoting exercise to increase strength and balance

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The target population is low-income seniors in Maine in the geographic areas of York and Cumberland Counties (particularly the City of Portland) during year one, expanding statewide during years two and three. Franco Americans and Native Americans tribes are also targeted as part of this program.

Evaluation:

The process evaluation tracks all design and implementation activities in order to assess problems encountered and successful completion of activities. Data is being collected concerning the procedures, problem identification, and problem solving. An analysis of this data will be presented to the Advisory Committee at regular meetings. The impact evaluation compares outcomes for participants of the MOB/VLL (volunteer lay leaders) to outcomes for participants of MOB that used professional leaders. Measures that were used to evaluate the original MOB evidence-based program are being used for the VLL program as well. These measures include the Howland-Pearson Scale, the Sickness Impact Scale, and Pearlin & Schoolers Mastery Scale. To evaluate specific improvements for MOB/VLL participants, baseline data is being compared with outcomes at six months and one year. The University of Southern Maine School of Social Work serves as an academic partner and is designing and conducting the evaluation of the intervention.

§ Professional education programs (e.g., seminars, training, conferences): AoA staff support professional education programs by leading and participating in seminars and workshops at aging and health national and regional conferences. Recently, AoA facilitated a pre-conference intensive workshop on “Implementing Evidence-Based Health Promotion and Disease Prevention Model Programs” for the National Association for Area Agencies on Aging Conference. This session included a presentation by a representative from the AoA Falls Prevention Grant Program in Connecticut. The Assistant Secretary for Aging also presents at major conferences, and in the spring of 2004 included information on the AoA evidence-based grants (including falls prevention) at the HHS Steps to A HealthierUS Summit. AoA has also funded the National Council on the Aging (NCOA) to design and implement a National Resource Center to support AoA health promotion/disease prevention grantees and to inform and engage the aging services network and others in evidence-based programs, including those focused on falls prevention. Presentations and materials are provided at national and regional aging and health conferences, e.g., ASA-NCOA, N4A, NASUA, GSA, APHA, CDD. Target audiences include professionals in aging, public health, community aging service providers, the aging network, other health and human service providers.

Evaluation: AoA has funded NCOA to work with the evidence-based grantees (including two falls prevention programs) on the evaluation tasks and data collection.

§ Consumer education materials (e.g., brochures, web-based information, videos, books): Through the AoA funding for the National Resource Center, NCOA is acquiring and processing

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resources and information on prevention (including falls prevention); this includes making materials easy to access and use by various audiences, including consumers. Dissemination is primarily through the AoA web and the National Resource Center web; relevant materials are distributed at national and regional conferences concerning aging and health. When appropriate, materials are targeted to older persons and their caregivers. There is no cost for materials.

§ Professional education materials (e.g., journals, conferences, training) : The AoA Web site includes information about its evidence-based programs, including falls prevention, and links to other health promotion, disease/disability prevention resources. Through the AoA funding for the National Resource Center, NCOA is acquiring and processing resources and information on prevention (including falls prevention) and healthy aging to expand a searchable data-base for use by professionals. This includes making materials easy to access and use by various audiences (including falls prevention program grantees). Materials are disseminated primarily on the AoA web and the National Resource Center web. Relevant materials are distributed at national and regional conferences concerning aging and health. The target audiences are professionals in aging, public health, community aging service providers, the aging network, and other health service providers. There is no cost for materials.

§ Research funding: While AoA does not conduct research concerning falls-prevention, it is currently supporting the translation of evidence-based research (including two concerning falls prevention) into disability and disease prevention programs by community aging service providers.

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Agency for Healthcare Research and Quality (AHRQ) 540 Gaither Road Rockville, MD 20850 Web site: www.ahrq.gov Contacts: William Spector, PhD or D.E.B. Potter Phone: 301-427-1446 (Spector) 427-1564 (Potter) Fax: 301-4271430 (Spector) 427-1276 (Potter) E-mail: WSpector@ahrq.gov; DPotter@ahrq.gov Organization Mission To improve the quality, safety, efficiency, and effectiveness of health care for all Americans. The mission is driven by the needs of users of our research—patients, clinicians, health system leaders, and policymakers. The primary focus of our mission is to ensure that the research we support is translated into practice so it can improve people's lives. The products of the Agency include the scientific evidence that supports decision making to improve health care, as well as tools that assist in efforts to improve quality and reduce costs. Our focus is on getting research results in the hands of those who can put it to practical use as rapidly as possible. Falls prevention-related programs or services § Research funding to other organizations :

AHRQ sponsors and conducts research that provides evidence-based information on health care outcomes; quality; and cost, use, and access. The information helps health care decision makers—patients and clinicians, health system leaders, purchasers, and policymakers—make more informed decisions and improve the quality of health care services. A recent area of focus has been on nursing home resident safety and falls prevention. Decisions related to grants and contracts are made in compliance with federal law. See www.ahrq.gov/fund/funding.htm for details. Funding decisions are peer reviewed. Funding is allocated three times annually. AHRQ-Funded Ongoing Research

Project: Developmental Center for Evaluation and Research in Patient Safety in Long-Term

Care – Reducing Falls (1P20HS011588-01) Project Focus: Falls in nursing homes PI: Ouslander Institution: Emory University Project Dates: 9/30/2001 – 9/29/2004

Project: Suncoast Developmental Center for Patient Safety Evaluation and Research (P20

HS11557) Project Focus: Falls in community PI: Wolfson Institution: University of South Florida Project Dates: 9/30/2001 – 9/29/2004

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Project: Using Prospective MDS Data to Enhance Resident Safety (R18 HS11869) Project Focus: Using a computerized information system to prevent adverse events in long-term

care settings PI: Teigland Institution: Foundation for Long Term Care Project Dates: 9/30/2001 – 3/31/2005

Project: Improving the Management of Falls in Long-Term Care Facilities (TO 290-00-

011-3) Project Focus: Fall prevention demonstration in nursing homes, transfer of program from

academia to nursing home chain PI: Ouslander Institution: Emory University Project Dates: 1/1/2004 – 12/31/2005

Project: California Nursing Outcomes Coalition (CalNOC) Partners to Reduce Patient Falls

Project (1U18HS013704-01) Project Focus: Falls in hospitals PI: Donaldson Institution: Association of California Nurse Leaders Project Dates: 9/30/2002 – 9/29/2006 Project: Testing a Restorative Care Nursing Program (R01 HS13372-01) Project Focus: Improve functional status, quality of life, and prevent falls in nursing homes PI: Resnick Institution: University of Maryland Baltimore County Project Dates: 9/27/2003 – 8/31/2007

Project: Propoxyphene Use in the Aged: Predictors and Outcomes (R03 HS13551-01) Project Focus: Medication use and effects upon falls among the elderly PI: Kamal-Bahl Institution: University of Maryland Baltimore County Project Dates: 4/15/2003 – 7/14/2004

Project: Unit Level Nurse Workload Impacts on Patient Safety (R01 HS11954) Project Focus: Nurse staffing and patient outcomes and safety in hospitals PI: Donaldson Institution: University of California San Francisco Project Dates: 9/30/2001 – 9/29/2004

Project: Pharmacist Technology for Nursing Home Resident Safety? (R18 HS11835) Project Focus: Electronic medication monitoring and effect on adverse events in nursing homes PI: Lapane Institution: Brown University Project Dates: 9/30/2001 – 9/29/2004

§ Institutiona l research:

The products of AHRQ include the scientific evidence that supports decision making to improve health care, as well as tools that assist in efforts to improve quality and reduce costs. AHRQ

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focuses on getting research results in the hands of those who can put it to practical use as rapidly as possible.

§ Dissemination of information: Research is disseminated through multiple avenues, including media, web, professional meetings, peer reviewed and popular press, interviews, electronic newsletters and journals, workshops and conferences. Of particular relevance is the recent AHRQ conference, “Translating Research into Practice: Advancing Excellence from Discovery to Delivery,” July 12-14, 2004, at the new Washington DC Convention Center. AHRQ-funded published research, 1995-present

Andrade, S.E., S.R. Majumdar, K.A. Chan, D.S. Buist, A.S. Go, M. Goodman, D.H. Smith, R.

Platt, and J.H. Gurwitz, 2003. Low frequency of treatment of osteoporosis among postmenopausal women following a fracture. Arch Intern Med, 2003; 163(17):2052-7.

Bates, D.W., R.S. Evans, H. Murff, P.D. Stetson, L. Pizziferri, and G. Hripcsak, 2003. Detecting

adverse events using information technology. J Am Med Inform Assoc, 2003; 10(2):115-28.

Bates, D.W., K. Pruess, P. Souney, and R. Platt, 1995. Serious falls in hospitalized patients: correlates and resource utilization. Am J Med, 1995; 99(2):137-43.

Col, N.F., M.H. Eckman, R.H. Karas, S.G. Pauker, R.J. Goldberg, E.M. Ross, R.K. Orr, and J.B.

Wong, 1997. Patient-specific decisions about hormone replacement therapy in postmenopausal women. JAMA, 1997; 277(14):1140-7

Col, N.F., M.H. Eckman, R.H. Karas, S.G. Pauker, R.J. Goldberg, E.M. Ross, R.K. Orr, and J.B.

Wong, 1997. Patient-specific decisions about hormone replacement therapy in postmenopausal women. JAMA, 1997; 277(14):1140-7.

Corser, W.D., 2004. Postdischarge outcome rates influenced by comorbidity and interdisciplinary

collaboration. Outcomes Manag, 2004; 8(1):45-51. Feldstein, A.C., G.A. Nichols, P.J. Elmer, D.H. Smith, M. Aickin, and M. Herson, 2003. Older

women with fractures: patients falling through the cracks of guideline-recommended osteoporosis screening and treatment. J Bone Joint Surg Am, 2003; 85-A(12):2294-302.

Goldberg, W., C. Mueller, E. Panacek, S. Tigges, J.R. Hoffman, and W.R. Mower, 2001.

Distribution and patterns of blunt traumatic cervical spine injury. Ann Emerg Med, 2001; 38(1):17-21.

Karagas, M.R., G.L. Lu-Yao, J.A. Barrett, M.L. Beach, and J.A. Baron, 1996. Heterogeneity of hip

fracture: age, race, sex, and geographic patterns of femoral neck and trochanteric fractures among the US elderly. Am J Epidemiol, 1996; 143(7):677-82.

Ray, W.A., J.R. Daugherty, and M.R. Griffin, 2002. Lipid-lowering agents and the risk of hip

fracture in a Medicaid population. Inj Prev, 2002; 8(4):276-9. Ray, W.A., P.B. Thapa, and P. Gideon, 2002. Misclassification of current benzodiazepine exposure

by use of a single baseline measurement and its effects upon studies of injuries. Pharmacoepidemiol Drug Saf, 2002; 11(8) :663-9.

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White, S.V., 2002. Effective Practices Improve Patient Safety Summit 2001. Journal for Healthcare

Quality, 2002; 24(1):34-6.

AHRQ intramural research Erlichman, M. and T.V. Holohan, 1996. Bone densitometry: patients receiving prolonged steroid

therapy. Health Technology Assessment (Rockville , MD), 1996(9):i-vi, 1-31. Erlichman, M. and T.V. Holohan, 1996. Bone densitometry: patients with end-stage renal disease.

Health Technology Assessment (Rockville , MD), 1996(8):1-27. Romano, P.S., A. Elixhauser, K.M. McDonald, and M.R. Miller, 2002. HIM's [Health Information

Management] role in monitoring patient safety. Journal of AHIMA, 2002; 73(3):72-4. Shaffer, T., R. Correa, W. Spector, and D. Potter, 2004. Risk Factors for Development of Nursing

Home Fractures: Evidence from the MEPS Nursing Home Survey, 1996. (Draft)

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Alliance for Aging Research (AAR) 2021 K Street, NW, Suite 305 Washington, DC 20006 Web site: www.agingresearch.org Contact: Katie McFadden Phone: 202-293-2856 Fax: 202-785-8574 E-mail: kmcfadden@agingresearch.org Organization Mission The Alliance for Aging Research promotes greater scientific and medical discovery to improve the quality of life of a growing population of older people and to ensure the benefits of a long and healthy life to every aging man and woman. Falls prevention-related programs or services The Alliance for Aging Research does not currently report any falls prevention programs or initiatives.

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American Academy of Audiology (AAA) 11730 Plaza America Drive, Suite 300 Reston, VA 20190 Web site: www.audiology.org Contact: Richard E. Gans, PhD, President Phone: 703-790-8466 Fax: 703-790-8631 E-mail: rgans@dizzy.com Organization Mission The American Academy of Audiology promotes quality hearing and balance care by advancing the profession of audiology through leadership, advocacy, education, public awareness and support of research. Falls prevention-related programs or services § Professional education programs (e.g., seminars, training, conferences):

The Academy includes featured sessions and instructional courses in balance topics at the annual convention. These programs are delivered as CEU opportunities. The target audience is audiologists who attend the convention and the special workshops and programs offered by the private sector. The Academy also approves CEU programs for manufacturers of balance equipment as well as programs conducted by institutions

§ Professional education materials (e.g., journals, conferences, training): The materials are prepared and disseminated by the individual presenters and manufacturers providing the education and or presentations.

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American Academy of Family Physicians (AAFP) 11400 Tomahawk Creek Parkway Leawood, KS 66211 Web site: www.aafp.org Contact: LeAnn Carl Phone: 800-274-2237 ext. 6538 Fax: 913-906-6092 E-mail: lcarl@aafp.org Organization Mission § To provide responsible advocacy and education to patients and the public in all health-related

matters § To preserve and promote quality cost-effective health care § To promote the science and art of family medicine and to ensure an optimal supply of well-trained

family physicians § To promote and maintain high standards among physicians who practice family medicine § To preserve the right of family physicians to engage in medical and surgical procedures for which

they are qualified by training and experience § To provide advocacy, representation and leadership for the specialty of family practice § To maintain and provide an organization with high standards to fulfill the above purposes and to

represent the needs of its members

Falls prevention-related programs or services § Consumer education materials (e.g., brochures, web-based information, videos, books):

Patient education materials are available at www.familydoctor.org. These free web-based materials target consumers.

§ Professional education materials (e.g., journals, conferences, training) : CME video monograph program (evidence-based) Aging and Health Issues: A Family Physician’s Role. The program includes a section on injury prevention and a 20-page monograph and a 20-minute video with physician patient vignettes. American Family Physician monograph Caring for the Aging Patient: A Case-Based Approach includes a section on advice to patients and caregivers and measures to help prevent falls. The materials are available as CD-ROM products. They have been used as part of AAFP’s 2004 Annual Clinical Focus on Caring for America’s Aging Popula tion. The materials are disseminated via mail and the Internet. The target audience is AAFP’s 94,000

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members. Most materials are free. There is a cost for the video programs.

§ Other programs: AAFP has launched a new initiative called Americans in Motion (AIM). The goal of this initiative is to improve the health of all Americans (including the elderly) by implementing a multifaceted fitness program addressing physical activity, nutrition, and emotional well-being in the individual, family and community. The AIM initiative is conceptualized to be readily available resource to family physicians who wish to promote fitness as a path to health.

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American Academy of Orthopaedic Surgeons (AAOS) 6300 N. River Road Rosemont, IL 60018 Web site: www.aaos.org Contact: Donna Siwek, Manager, CME Administration-staff liaison, Committee on Aging Phone: 847-823-7186 Fax: 847-823-8027 E-mail: Siwek@aaos.org Organization Mission Through education, health services research, advocacy, support of academic orthopaedics and communication, the mutual mission of the American Academy of Orthopaedic Surgeons and American Association of Orthopaedic Surgeons (collectively, “AAOS”) is to promote the highest quality musculoskeletal health, the interests of all patients, the profession of orthopaedics, and unity and collaboration among all orthopaedic organizations. Falls prevention-related programs or services § Professional education programs (e.g., seminars, training, conferences):

AAOS conducts a number of courses that cover a variety of musculoskeletal conditions in the older patient, including falls. Programs are delivered live and via the Internet. Target audiences: Orthopaedic surgeons and other musculoskeletal healthcare providers. Evaluation: Courses are evaluated to determine whether or not the course objectives were met.

§ Consumer education materials (e.g., brochures, web-based information, videos, books): AAOS produces a number of fact sheets and brochures that address musculoskeletal conditions that affect older patients including falls, arthritis, osteoporosis, etc. Materials are available online and via mail when requested Target audiences: General public and physician’s offices. Materials are free to consumers.

§ Professional education materials (e.g., journals, conferences, training) : Articles addressing various musculoskeletal conditions affecting the older patient, fall prevention and communication with and treatment of older patients appear frequently in the organization’s bi-monthly journal which is distributed to members and also available online. The journal is provided as a membership benefit and is available to non-members for an annual subscription rate of $99. Target audiences: Orthopaedic surgeons and other musculoskeletal healthcare providers.

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American Association for Active Lifestyles and Fitness (AAALF) 1900 Association Drive Reston, VA 20191 Web site: www.aahperd.org/aaalf Contact: Vicki Clary Phone: 800-213-7193 ext. 432 Fax: 703-476-9527 E-mail: vclary@aahperd.org Organization Mission A member driven organization that promotes active lifestyles for all individuals through knowledge expansion, information dissemination and collaborative efforts. Falls prevention-related programs or services § Community/consumer education program(s) (classes, workshops, seminars, demonstrations, health

fairs, physical activity programs, etc.): AAALF is currently funded by the Centers for Disease Control and Prevention to provide Training and Encouraging Senior Activity Project (TESA) programs. The association also provides leadership training workshops (Fitness Programs for Older Adults [FPOA]) on falls-prevention to physical therapists, program administrators, and related health and wellness professionals. Workshops on falls prevention are also offered to certify nursing assistants, physical therapy assistants, and volunteer activity leaders. The TESA program is offered as a one or two day workshop targeting older adults. FPOA are offered as half-day, one or two day workshops providers of activity programs for older adults. The programs are based on lectures, demonstrations and participation. TESA is evaluated through follow-up telephone interviews with older adults to see if they are continuing to be active. FPOA is evaluated via a written evaluation of the program related to content and relevance.

§ Consumer education materials (e.g., brochures, web-based information, videos, books): AAALF offers publications on exercise programs and needs of senior, elderly and frail populations. Developing Fitness Programs for Frail & Well Elderly Adults: A resource for activity professionals to develop fitness programs for residents/participants regardless of their current level of function. This book looks at the key aspects of fitness that need to be addressed when working with older adults, teaches how to measure improvement, and offers strategies to increase participation among residents/participants. It discusses staff training issues and provides recommendations for equipment. Strength Programs for Frail & Well Elderly: Focused on strength training for older adults, the text explains muscular strength and its importance for the older adults, discusses use of health and fitness assessments for participants, and includes illustrated exercised and training logs.

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Cardiovascular Programs for the Frail and Well Elderly: Provides basic cardiovascular exercise programs for the older adult. It provides basic knowledge of the biological and physiological changes that occur in the aging population. Addresses physical conditions that can affect the safety of exercise, including specific diseases. Exercises included. Flexibility Programs for Frail and Well Elderly : Defines flexibility and shows its importance in maintaining a quality of life for the older adult. Discusses health and fitness assessments as a foundation for exercise program design and provides general guidelines for training and specific guidelines for the frail and well elderly. It discusses staff training issues and provides recommendations for equipment. Quick Series Guide ~ Exercise for Seniors: Pocket size guide designed with finger tabs, full color, and laminated pages for durability provides information seniors need to begin a safe and easy exercise program at home. Care giving: Leisure and Aging: Outlines the costs and benefits of leisure and recreation intervention for caregivers and their families. Functional Fitness Assessment for Adults Over 60 Years: This test uses field-based measurement techniques and is designed for use by persons who are not necessarily trained for clinical responsibilities. (Accompanying video available.) Who? Me?! Exercise? Safe Exercise for People Over 50: Handbook for senior exercise classes designed to nudge students out of a sedentary lifestyle into a functional healthy, and active one. Exercise and the Older Adult: Textbook has the latest information on physical activity for the older adult. Biomechanics, exercise physiology, health issues, sensory-motor function and measurement are covered by leading experts in the field. The book also includes leisure activities, instructions for sitting and standing, and aquatic exercise and dance. Chapters reflect current trends and address low impact aerobics, strength development, and exercise and activities for the frail elderly. Materials are disseminated through professional association Web site and AAHPERD publishing company. Target audiences are health and fitness professionals offering the programs and the general public who are interested in information about safe exercise. Costs of materials vary.

§ Professional education materials (e.g., journals, conferences, training): FPOA and TESA manuals and workshop manuals are provided to health/fitness/wellness professionals. Newsletters are sent two to three times annually to members whose area of interest/expertise is aging. The target audience for professional materials are members of the Council for Aging and Adult Development (CAAD).

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American Association of Homes and Services for the Aging (AAHSA) 2519 Connecticut Ave. NW. Washington, DC 20008 Web site: www.aahsa.org Contacts: Deborah Cloud Katie Sloan Phone: 202-783-2242 Fax: 202-783-2255 E-mail: dcloud@aahsa.org Organization Mission To create the future of aging services and increase the value of membership. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): AAHSA’s Rhode Island affiliate has a falls prevention program. AAHSA’s East Center for Aging Services Technology is working with technology companies to develop sensors to gauge changes in gait that might lead to falls.

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American Board of Internal Medicine (ABIM) 510 Walnut Street, Suite 1700 Philadelphia, PA 19106 Web site: www.abim.org Contact: F. Daniel Duffy, MD Phone: 215-446-3507 Fax: E-mail: dduffy@abim.org Organization Mission To promote excellence in health care through leadership in evaluation and standard setting for internal medicine and its subspecialties. Falls prevention-related programs or services § Professional education programs (e.g., seminars, training, conferences):

A self-evaluation-of-practice program contains links to other educational programs. It is delivered to internists and geriatricians recertifying in internal medicine and geriatrics, via the Internet or on CD. In addition, a practice improvement module for the evaluation of the care of the vulnerable elderly in office practice of physicians is being developed. It will be available to internists and geriatricians recertifying in internal medicine and geriatrics who will be recertifying in an ABIM certificate. Delivery will be via the Internet or on CD. There is currently no evaluation mechanism associated with these programs.

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American Geriatrics Society (AGS) & AGS Foundation for Health in Aging (FHA) 350 Fifth Avenue, Suite 801 New York, NY 10010 Web site: www.americangeriatrics.org Contact: Elvy Ickowicz Phone: 212-308-1414 Fax: 212-832-8646 E-mail: eickowicz@americangeriatrics.org Organization Mission The American Geriatrics Society (AGS) is a nationwide, not-for-profit association of geriatrics health care professionals, research scientists, and other concerned individuals dedicated to improving the health, independence and quality of life of all older people. The AGS promotes high quality, comprehensive and accessible care for America's older population, including those who are chronically ill and disabled. The organization provides leadership to health care professionals, policy makers and the public by developing, implementing and advocating programs in patient care, research, professional and public education, and public policy. The AGS Foundation for Health in Aging (FHA) aims to build a bridge between the research and practice of geriatrics health care professionals and the public, and to advocate on behalf of older adults and their special needs: wellness and preventive care, self-responsibility and independence, and connections to the family and community. Falls prevention-related programs or services § Consumer education materials (e.g., brochures, web-based information, videos, books):

Consumer pamphlet on preventing falls in older person includes information on what a person can do to prevent falls as well as what a doctor can do to help. This pamphlet also includes a medication diary, which persons can use to keep track and report on the medications they take. Also available are 15 patient handouts designed from the Practicing Physician Education (PPE) project. These educational materials, for patient/family education, discuss critical falls management concepts. They can be found, downloaded and photocopied as needed from the FHA Web site. Printed brochures are available for purchase in bulk, by either calling the AGS Foundation for Health in Aging or ordering online. All consumer education materials are available online for free through the FHA Web site (www.healthinaging.org). They can be read and used online, or printed and photocopied as needed (they are available online in a printer friendly format). Eldercare at Home, a step-by-step manual for those caring for an older person at home is available for purchase for $19.95. The plain text of the workbook is also available online at no cost. The target audiences are older persons and their caregivers.

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§ Professional education materials (e.g., journals, conferences, training):

In 2001, the AGS released a new clinical practice guideline on the prevention of falls in older persons. These guidelines will help physicians and other health care professionals identify those patients at risk for falls, and once evaluated, to take the appropriate steps to help prevent future falls. Update of the Guideline is underway. Through the Practicing Physician Education Project, supported by the John A. Hartford Foundation, the AGS developed a Toolkit on the Prevention of Falls in Older Persons. The toolkit is intended to help physicians better understand falls and contain educational materials, suggested guidelines, forms and tools for evaluation, diagnosis and treatment. The toolkit is available online through the Merck Institute for Aging and Health Web site (www.miahonline.org). Falls is one of the many topics covered in both the Geriatrics Review Syllabus -5th Edition (GRS5), The Geriatrics Nursing Review Syllabus and in Geriatrics At Your Fingertips. Falls are also covered in depth in the AGS GEMS course, a national continuing education curriculum designed for pre-hospital providers. Geriatric Education for Emergency Medical Systems (GEMS) was created to help EMS providers better assess and manage ill, injured, or disabled older patients. The AGS/BGS/AAOS Guideline for the Prevention of Falls in Older Persons was published in May 2001 in the Journal of the American Geriatrics Society . The guideline is also available through the AGS Web site (www.americangeriatrics.org). The target audiences are health care professionals and EMS providers. The Guideline is available for free on the AGS Web site (www.americangeriatrics.org). GRS5, the Geriatrics Nursing Review Syllabus, and GEMS are available for purchase. Geriatrics At Your Fingertips is available in print for purchase, or free on-line at (www.geriatricsatyourfingertips.org).

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American Medical Association (AMA), Program on Aging and Community Health 515 N. State Street Chicago, IL 60610 Web site: www.ama-assn.org/ama/pub/category/4642.html Contact: Joanne Schwartzberg Phone: 312-464-5355 Fax: E-mail: joanne_schwartzberg@ama-assn.org Organization Mission As the national professional organization for all physicians, the American Medical Association (AMA) serves as the steward of medicine and leader of the medical profession. The AMA’s envisioned future is to be an essential part of the professional life of every physician and an essential force for progress in improving the nation’s health. Only the AMA has the national voice, the reputation and the stature to be a strong advocate for physicians and their patients. Through active advocacy at all levels of the private and public sectors, the AMA works to protect the patient-physician relationship, which is at the heart of medicine. Advocacy takes many forms, including public health initiatives, legislation, marketplace interventions and strengthening physician leverage in negotiations. As an activist physician organization, the AMA is dedicated to ensuring that the patient-physician bond is kept vital and that physicians retain the freedom to practice the science and art of medicine in its purest form. The association’s agenda for the future is ambitious, encompassing a broad scope of activities. The AMA believes that placing a more disciplined focus on our core mission is the right path for the AMA. The landscape of American health care continues to change dramatically and the AMA is positioned to fight for physicians and their patients. One of the top priorities for 2004 is professional liability reform. Patients are losing access to care because physicians are being forced to retire early, reduce their scope of practice or close their practice and move to another state. Falls prevention-related programs or services The American Medical Association does not currently report any programs or services related to falls prevention in the elderly.

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American Medical Directors Association (AMDA) 10480 Little Patuxent Parkway, Suite 760 Columbia, MD 21044 Web site: www.amda.com Contact: Jacqueline Vance Phone: 410-992-3105 Fax: 410-740-4572 E-mail: jacquelinevance@amda.com Organization Mission The American Medical Directors Association is the professional association of medical directors and physicians practicing in the long term care continuum, dedicated to excellence in patient care by providing education, advocacy, information, and professional development. Falls prevention-related programs or services § Professional education materials

The American Medical Directors Association has developed clinical practice guidelines exclusively for the frail elder in the long-term care setting for the interdisciplinary team. AMDA has also recently revises “Fall and Fall Risk in the Long Term Care Setting” clinical practice guidelines.

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American Nurses Association (ANA) 600 Maryland Avenue, SW, Suite 100W Washington, DC 20024-2571 Web site: www.nursingworld.org Contact: Mary Jean Schumann, MSN, RN, MBA, CPNP, Director, Nursing Practice and Policy Phone: 202-651-7043 Fax: 202-651-7349 E-mail: mschuma@ana.org Organization Mission The American Nurses Association is a full-service professional organization representing the nation's 2.6 million Registered Nurses through 54 constituent state associations and ten organizational affiliate members. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public. Falls prevention-related programs or services § Professional education programs (e.g., seminars, training, conferences):

Through its Nursing Advocacy Program Constituent Member Programs, ANA provides continuing education sessions, including Using Evidence to Reduce Falls & Injuries at the ANA 2004 Biennial Convention. Sessions are also available on the ANA Web site. The five-year grant-funded Nurse Competence in Aging (NCA) program is designed to maximize the sustainability of geriatric competence-enhancing activities within national specialty nursing associations and to assure that association members deliver improved care for older adults. The program targets the geriatric competence - the knowledge, skills and attitudes of the 400,000 nurses who are professionally identified as members of 60 national specialty nursing associations. Programs are delivered in person and through the NCA Web site, www.geronurseonline.org. Information is also disseminated via the NCA booth at annual meetings of specialty nursing associations, and addressed via topic -specific conference calls. Target audiences are ANA members and members of specialty nursing associations. Session attendees evaluate speakers as well as the objectives, content and method of teaching.

§ Professional education materials (e.g., journals, conferences, training) : The NCA program Web site, www.geronurseonline.org, provides information about falls. The target audience for this information is specialty nursing association members. Materials are available to professionals at no cost.

§ Institutional research: NCA collects national nursing measure data from hospitals about the patients who fall and the relationship to nurse staffing. This data is provided back to the individual institution with benchmarking parameters comparing like hospitals and types of nursing units.

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American Occupational Therapy Association (AOTA) 4720 Montgomery Lane, PO Box 31220 Bethesda, MD 20824-1220 Web site: www.aota.org Contact: Janie B. Scott, MA, OTR/L, FAOTA, Director Practice Department Phone: 301-652-6611, ext. 2903 Fax: 301-652-1417 E-mail: jscott@aota.org Organization Mission The American Occupational Therapy Association advances the quality, availability, use, and support of occupational therapy through standardizing-settings, advocacy, education, and research on behalf of its members and the public. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): AOTA staff are involved in national (Rebuilding Together) and local organizations (Homes for Life Coalition of Howard County, Maryland), providing community education that may have an impact on falls prevention. AOTA members deliver a wide variety of community awareness activities on the local level. Activity delivery is varied, including senior expos, health fairs, and workshops. The audience varies according to the specific topic and presenter. Activities discussed here are geared to older adults, caregivers, individuals with disabilities, and service providers. Outreach typically includes cultural sensitivity. Rebuilding Together and other collaborative efforts do address the needs of individuals from diverse backgrounds and with low incomes. Since the activities are varied as are the people delivering the services, evaluation efforts vary from none to structured questionnaires and follow-up.

§ Professional education programs (e.g., seminars, training, conferences): AOTA hosts an annual conference geared to occupational therapy clinicians, educators, students, researchers and scientists. A wide number of tracks exist that include gerontology, home modifications, older drivers/community mobility, and physical disabilities. Course content may specifically focus on fall prevention, or this subject area may be imbedded in presentations. The AOTA Annual Conference offers institutes, workshops, papers, panels, posters and plenary sessions. Individual sessions may have specific evaluations distributed by the presenter(s). AOTA conducts a conference evaluation directed to attendees. AOTA also currently has self-paced courses that include fall prevention material, specifically Low Vision: Occupational Therapy Intervention With the Older Adult and ROTE (The Role of Occupational Therapy With the Elderly .) The self-paced clinical courses are individual study programs, containing individually-bound lessons delivered to the home and completed according to the individual’s schedule. The target audiences are occupational therapists, occupational therapy assistants, students. Students complete an examination at the end of the course. AOTA’s

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Continuing Education Department surveys course participants for assessment of the course, conference, etc. AOTA’s online courses provide quality continuing education from experienced content experts on topics of professional concern, including falls prevention. Topics include Fundamentals of Occupational Therapy for Individuals with Dementia, Advanced Occupational Therapy for Individuals with Dementia, and Occupational Therapy for Family, Professionals and Paraprofessional Caregivers of Individuals with Dementia . These online courses include strategies for increasing safety within living environments (falls prevention.) The target audiences are occupational therapists, occupational therapy assistants and students. Students complete an examination at the end of the courses. AOTA’s continuing education department surveys course participants for assessment of the materials. AOTA’s Approved Provider Program (APP) is designed to promote the quality and relevance of continuing education activities offered to occupational therapy practitioners. Current programs include Treating Falls and Balance Problems; A Clinical Approach to Balance and Falls in the Neurologic and Geriatric Population; Assessing Balance and Falls; Geriatric Balance & Falls: Functional Scale Measurement & Intervention; and Evaluation & Treatment of Balance Dysfunction in the Elderly: Predicting & Preventing Falls. The majority of courses are offered live over a one or two-day period. One course was delivered online. The target audiences are occupational therapists, occupational therapy assistants, students and others. All of the AOTA’s APPs must have a clear and concise written statement of intended learning outcomes that are observable and/or measurable, are based on identified needs for each continuing education activity, and are communicated to learners before and during each activity.

§ Consumer education materials (e.g., brochures, web-based information, videos, books): Fact sheet: Occupational Therapy and the Prevention of Falls Tip sheets: Maintaining Quality of Life with Low Vision

Fall Prevention for People with Disabilities and Older Adults Modifying Your Home for Independence Living with Alzheimer’s Disease Aging in Place

Materials are available to the public via AOTA’s Web site and at AOTA and other professional conferences. Members often download and distribute materials at local events. These materials are targeted to consumers, health care professionals, individuals interested in occupational therapy as a career. Materials are available at no cost.

§ Professional education materials (e.g., journals, conferences, training): The majority of AOTA publications have articles on fall prevention. American Journal of Occupational Therapy (AJOT): a monthly, juried professional journal. An example of an AJOT journal article title, “The Development of an Assessment to Evaluate Behavioral Factors Associated with Falling.” OT Practice: a bimonthly practice magazine. The magazine contains feature articles, news briefs, research and employment opportunities, and monthly continuing education articles. A recent continuing education article in this publication that included fall prevention, “Aging in Place: Implications for Occupational Therapy.”

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Special Interest Section Quarterly: AOTA has eleven special interest sections (SIS). Each one publishes a quarterly newsletter. Example of Quarterly topic: “Home and Community SIS: Fear of Falling, Part 1: Prevalence, Intensity, and Implications.” AJOT and the SIS Quarterlies are mailed to members and subscribers and are available online at AOTA’s Web site (members only section). OT Practice is mailed to members and selected articles are available on AOTA’s Web site. Target audiences are occupational therapists, occupational therapy assistants, and students. The publications are provided to AOTA members as a member benefit. Subscriptions are also available .

§ Institutional research: Although AOTA is not currently involved in falls-prevention research, individual members have been and are now. A list of those individuals is available upon request. AOTA’s communication vehicles disseminate evidenced based research and its application to practice. The organization also uses its Web site and a 1-Minute Update distributed to members electronically. AOTA is currently exploring with the American Occupational Therapy Foundation the development of a research database/directory.

§ Services (e.g., emergency alert systems, home assessments, home or facility design) : AOTA’s Home and Community Health SIS’s Home Modifications Network provides written materials and presentations regarding all phases of home assessment and modifications. A Home Modifications Practice Guideline will be published by AOTA shortly as will a companion piece on design features. Individual members are involved in the delivery of home assessments, modification and design recommendations, and fall prevention consultations locally and nationally. Services are distributed via AOTA Annual Conference, OT Practice, AOTA’s Web site and through local venues.

§ Other: Approximately 25 percent of AOTA’s 35,000 members provide services to older adults. Fall prevention services are delivered in skilled nursing and assisted living facilities, through individual screening, evaluation and intervention and through area agencies on aging. A growing number of members are involved in environmental assessments for accessibility and modifications. Some members are involved in fall prevention research studies. Researchers are involved in evidence based reviews (Cochrane Musculoskeletal Injuries Group, Marian Arbesman) and clinical research. AOTA and AOTF are hosting an International Conference on Evidence Based Occupational Therapy funded by a grant from American Healthcare Research Quality. AOTA is also currently developing board certification in gerontology and specialty certifications in driver rehabilitation and community mobility, environmental modification, and low vision. These certification programs are expected to have components of fall prevention imbedded in them. Also under development are workshops on home/environmental modifications.

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American Physical Therapy Association (APTA) 1111 N Fairfax Street Alexandria, VA 22314 Web site: www.apta.org Contact: Kenneth Harwood, PT, PhD, CIE Phone: 703-706-3170 Fax: 703-838-8910 E-mail: kenharwood@apta.org Organization Mission The mission of the American Physical Therapy Association (APTA), the principal membership organization representing and promoting the profession of physical therapy, is to further the profession's role in the prevention, diagnosis, and treatment of movement dysfunctions and the enhancement of the physical health and functional abilities of members of the public. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): Members of the organization present classes and develop individual programs for older individuals at risk for falling. The target audience for these classes is older adults at risk for falls.

§ Professional education programs (e.g., seminars, training, conferences): Professional education programs are presented on state-wide, national and international levels. Presentations are usually face-to-face, although there are some Internet programs available. The target audiences are physical therapists and related health professionals. The courses are evaluated by the participants.

§ Consumer education materials (e.g., brochures web-based information, videos, books): PowerPoint materials are being developed for use by physical therapy professionals. The target audience for these presentations is older persons at risk for falls.

§ Professional education materials (e.g., journals, conferences, training) : PowerPoint presentations and Internet-based courses are available to physical therapists and related health care professionals. These materials are offered free or for minimal cost.

§ Research funding: APTA provides research funding to support university research. Applications for funding are peer reviewed. Funding is awarded annually.

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American Podiatric Medical Association (APMA) 9312 Old Georgetown Road Bethesda, MD 20814 Web site: www.apma.org Contact: George Tzamaras Phone: 301-581-9200 Fax: 301-530-2752 E-mail: gptzamaras@apma.org Organization Mission The American Podiatric Medical Association, Inc. is committed to advancing the profession of podiatric medicine for the benefit of its members and the public, by ensuring the highest quality foot and ankle care. Falls prevention-related programs or services The American Podiatric Medical Association does not currently report any falls prevention programs.

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American Society on Aging (ASA) 833 Market St., Suite 511 San Francisco, CA 94131 Web site: www.asaging.org Contact: Chaya Gordon, MPH Phone: 415-974-9604 Fax: 415-974-0300 E-mail: chayag@asaging.org Organization Mission Enhancing the knowledge and skills of people working with older adults and their families. Falls prevention-related programs or services § Professional education programs (e.g., seminars, training, conferences):

One day special program at ASA/NCOA third annual joint conference (April 2004) on Fall Prevention: A National, State and Local Perspective. Nationally and regionally known experts in fall prevention used a variety of formats including lectures, panel discussions, and workshops. The target audiences included public - and private-sector service providers and researchers, educators and advocates, health and social service professionals, administrators and policymakers in the field of aging and aging-related fields. A post-program web-based evaluation was conducted to determine how useful the program was to attendees. Sessions on different aspects of fall prevention by various regional and national experts have been a part of many ASA annual conferences and summer series.

§ Professional education materials (e.g., journals, conferences, training) : The winter 2002-03 issue of Generations was on “Falls and Fall-Related Injuries” and included articles on many aspects of fall prevention such as risk factors, fear of falling, prevention, intervention, research and resources. ASA’s bimonthly newspaper Aging Today featured an article on fall prevention in the Sept-Oct 2002 Healthy Aging 2010 “In Focus” section that was based on a media background paper on fall prevention prepared by ASA Editor Paul Kleyman in conjunction with the CDC. Generations and Aging Today are available by subscription at no cost to ASA’s members. The original falls prevention media background paper was distributed to the media at ASA’s 2002 joint conference. The target audiences are public - and private-sector service providers and researchers, educators and advocates, health and social service professionals, administrators and policymakers in the field of aging and aging-related fields. The fall prevention issue of Generations is available to members and non-members as a single -copy back issue for $12 each.

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American Society of Consulting Pharmacists Research and Education Foundation (ASCP) 1321 Duke Street Alexandria, VA 22314 Web site: www.ascpfoundation.org Contact: Kathleen A. Cameron, RPh, MPH Phone: 703-739-1316, ext. 107 Fax: 703-739-1500 E-mail: kcameron@ascp.com Organization Mission The mission of the American Society of Consultant Pharmacists Research and Education Foundation is to improve the health and well-being of older persons through appropriate, effective, and safe medication use. The ASCP Foundation provides leadership, innovation, and expertise in medicines and aging to seniors and those who care for them. The unique focus of the ASCP Foundation is the development, integration, and application of knowledge regarding medication use in the senior population and the practice of senior care pharmacy to optimize health care outcomes. Falls prevention-related programs or services The ASCP is not currently engaged in falls prevention programs. However several of its member associations implement programs at the community level.

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Archstone Foundation 401 E. Ocean Blvd, Suite 1000 Long Beach, CA 90802 Web site: www.archstone.org Contact: Mary Ellen Kullman Courtright, MPH Phone: 562-590-8655 Fax: 562- 495-0317 E-mail: mecourtright@archstone.org Organization Mission Research, program development, direct service delivery and professional education funding to other organizations. Falls prevention-related programs or services § Research funding to other organizations :

Funding decisions are made by a panel or committee. Funding is allocated quarterly. Archstone Foundation has provided funding support to the development of the Fall Proof Balance and Mobility Training program (California State University, Fullerson); the National Center for Supportive Housing and Home Modifications (environmental factors); fall prevention pilots in adult day care settings with early stage dementia and another with advanced dementia; a fall prevention pilot through a senior center with low income seniors living in mobile home parks; and both a California and national blueprint planning processes.

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Assisted Living Federation of America (ALFA) 11200 Waples Mill Road Fairfax, VA 22039 Web site: www.alfa.org Contact: Ann McDermott Phone: 703-691-8100 Fax: 703-691-8106 E-mail: amcdermott@alfa.org Organization Mission ALFA is a trade association dedicated exclusively to the assisted living industry and the population it serves. It represents over 5000 for and non for profit homes, as well as a diverse range of organizations involved in the assisted living industry. ALFA has 40 state affiliates nationwide, and it seeks to promote the philosophy of consumer choice and quality of life for seniors. Falls prevention-related programs or services § Professional education materials (e.g., journals, conferences, training):

Assisted Living University has a video on falls as part of its series on risk reduction. The video is about nine minutes in length, intended for general in-service training or CEU education. The video addresses topics such as internal/external factors involved in resident falls, how to deal with resident falls once they occur, and how to safeguard the facility.

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Association of Jewish Aging Services (AJAS) 316 Pennsylvania Ave., SE, Suite 402 Washington, DC 20003 Web site: www.ajas.org Contact: Harvey Tillipman Phone: 202-543-7500 Fax: 202-543-4090 E-mail: harvey@ajas.org Organization Mission The Association of Jewish Aging Services is a unique forum that promotes and supports elder services in the context of Jewish values through education, professional development, advocacy and community relationships. Falls prevention-related programs or services The Association of Jewish Aging Services does not implement falls-prevention programs or services from a national perspective, but many of its member organizations address the issue at the community level.

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Association of State & Territorial Chronic Disease Program Directors (CDD) 8201 Greensboro Drive, Suite 300 McLean, VA 22101 Web site: www.chronicdisease.org Contact: Ryan Dryden, Executive Director Phone: 703-610-0203 Fax: 703-610-9005 E-mail: RDryden@chronicDisease.org Organization Mission CDD provides state-based leadership and expertise for chronic disease prevention and control at the state and national level. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): A grants program to state health department/state unit on aging collaborations has included fall-reduction efforts through physical activity programs. This continuing project has joint funding from the National Association of State Units on Aging and CDD through the support of AoA and CDC. Grantees employ a range of interventions and delivery mechanisms, primarily reaching community-dwelling elders 60 years of age and older although some include adults beginning at age 50. The grantees are required to evaluate for impact and fidelity. Other: CDD produced a catalog of promising practices that includes fall prevention strategies and distributed it to state health departments. The Osteoporosis Council (Chaired by Nancy Libby Fisher) considers fall prevention to be among its top strategic priorities.

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Center for Successful Aging (CSA) California State University, Fullerton 800 North State College Blvd., KHS 241 Fullerton, CA 92834-6850 Web site: http://hdcs.fullerton.edu/csa Contacts: Debra J. Rose PhD and C. Jessie Jones, PhD Phone: 714-278-7317 Fax: 714-278-5317 E-mail: successaging@fullerton.edu Organization Mission The Center for Successful Aging, through its educational, research, and service activities, has as its mission the promotion of health and vitality, and the reduction of frailty and disability in later years. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): The FallProof Balance and Mobility Program operates on the campus of California State University, Fullerton; in more than 20 community-based facilities in California; and in residential care settings in Southern California. The targeted exercise and education program is delivered by certified instructors trained through the Center for Successful Aging at California State University, Fullerton. Instructors are hired by community college districts, hospitals, and other organizations to implement the program in community-based or residential care settings. The target audience is older adults at moderate to high risk for falls. The community outreach programs are free, and every effort is made to target low socioeconomic groups. Facilities are also situated in communities with large minority populations (e.g. Hispanic and Asian elders.) Regular outcome measures are obtained for all community-based programs, and two large funded research grants have tested short and long-term efficacy of the program in reducing disability and falls in community and residential care settings. Program satisfaction surveys have also been disseminated to current and former clients of the program.

§ Professional education programs (e.g., seminars, training, conferences): Undergraduate and graduate students in gerokinesiology complete course work and internship experiences in the Center for Successful Aging senior fitness and balance and mobility programs. A balance and mobility instructor specialist certification program is also offered through the Center for Successful Aging. The Center also hosts conferences, seminars, and forums addressing issues related to fall risk reduction and wellness throughout the year. On-campus programs are operated through the Center for Successful Aging and are available to the Community. Faculty in the Division of Kinesiology and Health Science teach coursework and internships in gerokinesiology. The instructor certification program is delivered via the web and on-site practical training workshops.

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Physical activity instructors of older adults, health professionals, nurses, activity directors, physicians, physical therapists, occupational therapists, and older adult volunteers are the target audiences. All programs are outcome based – course grades, certification grades, attendee surveys are all used to evaluate the efficacy of programs operated through the Center for Successful Aging.

§ Consumer education materials (e.g., brochures, web-based information, videos, books): Exercise brochures are available for older adults.

§ Professional education materials (e.g., journals, conferences, training) : Training manuals, professional publications (e.g. Senior Fitness Test Manual: FallProof! A Comprehensive Balance and Mobility Program and Physical Activity Instruction of Older Adults); web-based coursework and videos related to fall risk reduction programming and assessment. Instructional videos, DVDs and CDs. Materials are published by Human Kinetics, and distributed via the Center for Successful Aging Web site and at conferences. The target audiences are physical activity instructors of older adults, health care professionals and older adults. Cost of materials range from free to approximately $60 for published books. The Center staff also serve as co-editors for the Journal of Aging and Physical Activity. The journal is available via subscription ($65 annually). The target audiences are gerontologists, health care professionals, and researchers.

§ Health care services (e.g., family medicine, internal medicine, gerontology, orthopedic, podiatric, vision) : A monthly fall risk screening and assessment clinic is offered free to the community. The service specifically targets older adults with diabetes and at high risk for falls. Most services are delivered free of charge to participants. A small fee for service program operates on the Cal State Fullerton campus throughout the year.

§ Institutional research: Predictors of successful rehabilitation outcome Factors influencing risk for falls Short and long term efficacy of fall risk reduction intervention strategies Cost effectiveness of fall risk reduction programming Information is disseminated through peer-review journals, grant reports, professional journals, Web sites and conference presentations.

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Centers for Disease Control & Prevention, Division of Nutrition and Physical Activity (CDC/DNPA) 4770 Buford Hwy NE Atlanta, GA 30341 Web site: www.cdc.gov/nccdphp/dnpa Contact: David Buchner, MD, MPH Phone: 770-488-5692 Fax: 770-488-5473 E-mail: ZDG4@CDC.GOV Organization Mission To prevent death and disability from chronic diseases. To promote maternal, infant, and adolescent health. To promote healthy personal behaviors. To accomplish these goals in partnership with health and education agencies, major voluntary associations, the private sector, and other federal agencies. Falls prevention-related programs or services CDC has two main units concerned with fall prevention. The National Center for Injury Prevention has a non-intentional injury prevention program that has projects in fall prevention. There are materials on the CDC Web site, CDC has funded a fall prevention clearing house, and has funded some research. The other unit interested in fall prevention is the Physical Activity and Health Branch in the Division of Nutrition and Physical Activity . It has a variety of projects that promote physical activity in older adults. These projects are regarded as preventing falls because of the evidence that physical activity prevents falls in older adults. None of the projects are labeled a “fall prevention program” however. Of particular interest to the Falls Blueprint is the fact that CDC is part of a group working with NCQA to develop a HEDIS measure on falls. A third unit is the Aging and Health Studies Branch in the Division of Adult and Community Health. This unit does not have any fall prevention activities per se, but has programs in arthritis and provides general coordination of aging activities at CDC.

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Centers for Disease Control & Prevention, National Center for Injury Prevention and Control (CDC/NCIPC) 4771 Buford Hwy, MS-K63 Atlanta, GA 30341 Web site: www.cdc.gov/ncipc Contacts: Sarah Olson, MS, CHES Judy Stevens, PhD Phone: 770-488-1302 (Ms. Olson); 770-488-4649 (Dr. Stevens) Fax: 770-488-1317 E-mail: sco3@cdc.gov; jas2@cdc.gov Organization Mission The mission of the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention is to prevent premature death and disability and to reduce the human suffering and medical costs caused by injuries. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): Remembering When: A Fire & Falls Prevention Program for Older Adults. This program, which can be implemented in either a group or home setting, focuses on 16 key messages related to fire and fall prevention. In addition to the education component, there is also a smoke alarm installation and fall intervention program which allows for environmental modifications to be made to the home (e.g., smoke alarms, night lights, hand rails). Health Departments in Arkansas, Maryland, Minnesota, North Carolina and Virginia have been funded to conduct the program. The program is delivered in either a group or one-on-one in the home setting. It is targeted to older consumers. Georgia State University is conducting an evaluation of the Virginia Health Department's Remembering When Program. The purpose of the evaluation is to document both knowledge and behavioral change as a result of the program. The evaluation centers around two different models of program delivery: group presentations and individual presentations for homebound seniors.

§ Professional education programs (e.g., seminars, training, conferences): National Resource Center on Safe Aging. In 1998, the CDC funded the San Diego State University Foundation to establish a national resource center. The National Resource Center for Safe Aging (formerly the National Resource Center on Aging and Injury) is a joint effort between the University Center on Aging, San Diego State University, and the American Society on Aging, San Francisco. The goal of the National Resource Center is to collect, organize, and disseminate science-based information about preventing injuries among older adults. The Resource Center has developed a Web site to provide information about preventing unintentional injuries among older adults and elder abuse to public health professionals, senior service providers, and others. www.safeaging.org. The primary audiences are public health and health care practitioners and senior service providers.

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§ Consumer education materials (e.g., brochures, web-based information, videos, books): What You Can Do to Prevent Senior Falls - This brochure provides specific steps older persons can take to prevent injuries related to falls. Check for Safety - This checklist provides older adults concerned about falls and fall-related injuries with simple with concise information (based on current research) about steps they can take to reduce their chances of falling at home. These materials may be downloaded from the Injury Center’s Web site. The target audience is older consumers. Materials are available at no cost.

§ Professional education materials (e.g., journals, conferences, training): U.S. Fall Prevention Programs for Seniors. Published in the fall of 2000, U.S. Fall Prevention Programs for Seniors: Selected Programs Using Home Assessment and Modification describes 18 fall prevention programs in12 states that use comprehensive education and fall-risk reduction strategies that include home assessment and home modification. The publication also includes examples of materials that programs can use as models as well as contact information for 22 additional programs. The Tool Kit to Prevent Senior Falls. This is a comprehensive collection of health education materials, including a home safety checklist, which is designed to reduce falls and fall-related injuries among older adults. It was developed by the Injury Center to provide health professionals with current technical information and materials that can be incorporated into new or existing fall prevention activities. Over 6,000 copies have been distributed. Materials produced by the Injury Center can be downloaded from the Web site. The target audiences are health professionals and senior service providers. There is no charge for materials.

§ Research funding to other organizations : The Injury Center funds cooperative agreements to state health departments, universities, and other qualified organizations to conduct fall prevention research. Research applications are peer reviewed. There is not a specific funding cycle.

§ Institutional research: The injury center funds randomized controlled studies in four states to assess the effectiveness of different comprehensive approaches to preventing falls among adults aged 65 and older. Scientists in the Injury Center at CDC regularly publish articles in the peer reviewed journals on fall risk factors and prevention strategies

§ Other: Estimating the Healthcare Costs of Older Adult Fall-Related Injuries: The primary goal of this project is to estimate the direct medical costs of fall-related injuries among adults age 65 and older in the United States in 2000. This project will use two sets of data to estimate the medical costs of falls. It will include the costs for fatal falls, falls treated in emergency departments, hospitalizations, nursing home costs and physician visits.

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Centers for Medicare and Medicaid Services (CMS) 7500 Security Blvd. Mailstop S3-02-01 Baltimore, MD 21244 Web site: www.cms.hhs.gov Contact: Pauline Lapin Phone: 410-786-6883 Fax: 410-786-4005 E-mail: plapin@cms.hhs.gov Organization Mission We assure health care security for beneficiaries. In serving beneficiaries, we will open our programs to full partnership with the entire health community to improve quality and efficiency in an evolving health care system. Falls prevention-related programs or services § CMS provides insurance coverage through the Medicare program for services related to the

treatment of falls-related injuries. CMS is currently working on clarifying coverage and payment policy related to the evaluation and management of falls for people at risk of falls who have not yet fallen to make it clear to clinicians that these services would be covered under Medicare.

§ CMS also commissioned an evidence report on falls prevention, collected data on falls in its Medicare Current Beneficiary Survey (these data have not yet been analyzed), and is interested in quality indicators for falls for quality improvement projects.

§ CMS plans to clarify coverage and payment policy related to evaluation and management services for people at high risk for falls that have not experienced an injury requiring healthcare services. CMS is also exploring the creation of new codes to help identify people with a history of falls.

§ The Medicare Current Beneficiary Survey included falls in a recent survey round; these data have

yet to be analyzed. § There is interest in the agency to identify falls quality indicators and conduct quality improvement

and public reporting initiatives around falls.

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Emergency Nurses Association (ENA) 915 Lee Street Des Plaines, IL 60016-6569 Web site: www.ena.org Contact: Pierre Désy Phone: 847-460-4082 Fax: 847-460-4005 E-mail: pdesy@ena.org Organization Mission ENA's mission is to provide visionary leadership for emergency nursing and emergency care. Whatever it is that makes emergency nurses and other emergency care professionals work smarter, information, education, networking, or representation, they get it by joining ENA. ENA is an international, action-oriented organization ready to support the profession through access to important scientific information and the latest research; networking opportunities with key governmental, academic, and professional contacts; and monitoring of government activities affecting the profession. Members are staff nurses; emergency department nurse managers; administrators; clinical nurse specialists; pediatric, trauma, or flight nurses; pre-hospital coordinators; nurse practitioners; educators; and student nurses. ENA's mission encompasses the following values

1. All individuals have a right to quality emergency care delivered with compassion. 2. Respect for diversity of patients and colleagues is inherent to emergency nursing practice and

emergency care. 3. Prevention of illness and injury and promotion of wellness are essential components of

emergency nursing practice and emergency care. 4. The discipline of emergency nursing includes a defined and evolving body of knowledge based

on research. 5. Continuing education and professional development are fundamental to emergency nursing

practice and emergency care. 6. Emergency nursing practice is both independent and collaborative.

Falls prevention-related programs or services: ENA does not currently report any falls prevention programs or initiatives.

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Fannie Mae 3900 Wisconsin Avenue, NW Washington, DC 20016-2892 Web site: www.fanniemae.com Contact: James Taylor Phone: 202-752-7000 Fax: E-mail: james_taylor@fanniemae.com Organization Mission Our mission, and our ultimate goal, is to help more families achieve homeownership. Falls prevention-related programs or services § Other:

Expanding the American Dream Commitment: The AARP and Fannie Mae Collaborative: Affordable Housing for Older Americans and Livable Communities AARP and Fannie Mae are collaborating on a program that will focus on supporting affordable housing for older Americans and building livable communities. The collaborative will support Fannie Mae’s Expanding the American Dream Commitment plan by focusing on those items in the plan that affect the housing and livable community needs of older Americans. The two organizations have agreed to work together to develop strategies and approaches to address the unique housing needs of citizens as they age. Under the collaborative, Fannie Mae business managers and AARP staff will conduct roundtable sessions twice a year to mark the company’s progress toward the American Dream Commitment® goals that affect mid-life and older citizens, and allow AARP to advise Fannie Mae regarding strategies to address housing challenges facing older Americans and identify opportunities. The five-year collaborative will focus on: Rental housing production and preservation Mortgage products for homeowners Policy and consumer information issues Livable communities

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Generation Care, Inc. 945 E. Sherman Blvd. Muskegon, MI 49444 Web site: www.generationcareinc.com Contact: Holly Lookabaugh-Deur, PT, DSc Phone: 231-737-4374 Fax: 231-830-9196 E-mail: hollyld@generationcare.com Organization mission Generation Care exists to promote functional freedoms and independence across the lifespan. Falls prevention-related programs or services Generation Care Inc. provides innovative intervention programs such as advanced balance treatment, home assessments (TEACH - Technology Enhanced Assessment of Client Homes), aquatic and land exercises.

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Grantmakers in Health (GIH) 1100 Connecticut Ave., NW, Suite 1200 Washington, DC 20036 Web site: www.gih.org Contact: Anne L. Schwartz, PhD, Vice President Phone: 202-452-8331 Fax: 202-452-8340 E-mail: aschwartz@gih.org Organization mission To help grantmakers improve the nation’s health. Falls prevention-related programs or services At this time Grantmakers in Health does not have any specific falls-related programs or initiatives.

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Growing Well, Inc. 6651 S. CR 1000 E Cloverdale, IN 46120 Web site: Contact: Lisa Hettich, PharmD, CGP Phone: 765-720-2775 Fax: 765-526-8066 E-mail: hettich@ccrtc.co Organization Mission Identify and manage multiple risk factors (including falls) in the community-dwelling senior population. Falls prevention-related programs or services § Services:

Fall risk assessments are done in the home and then recommendations are made to the senior, family and physicians to minimize their risk. The primary audiences are community dwelling seniors.

§ Consumer education materials (e.g., brochures, web-based information, videos, books): Basic written information is provided on environmental fall risk, medications that may contribute to falls, and specific recommendations on ways to lower the overall risk for falls (for example, the correct way to change positions while minimizing orthostatic hypotension.) The materials are disseminated in a report format as part of the Growing Well services. The target audiences are community-dwelling seniors.

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Habitat for Humanity 121 Habitat Street Americus, GA 31709 Web site: www.habitat.org Contact: Jennifer Langton Phone: 229-924-6935 Fax: E-mail: Jlangton@hfhi.org Organization Mission Habitat for Humanity International is a nonprofit, ecumenical Christian housing ministry. HFHI seeks to eliminate poverty housing and homelessness from the world, and to make decent shelter a matter of conscience and action. Habitat invites people of all backgrounds, races and religions to build houses together in partnership with families in need. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): Habitat for Humanity offers a workshop called “Construction Site Safety” (or a variation on these words). Usually an internal construction manager of one of Habitat’s local affiliates delivers the workshop to a wider, regional audience as part of a conference. Sometimes a professional will deliver a workshop on the same topic. Workshops include hand-outs and occasionally, CD-ROMs. The primary target audiences are construction managers and supervisors who lead construction teams. In some areas, workshops provide materials in Spanish. Mature adults can volunteer, including the construction managers. Each local HFHI affiliate is supposed to train any volunteers, including potential homeowners.

§ Consumer education materials (e.g., brochures, web-based information, videos, books):

OSHA Guidelines Chapter on safety in the official Construction Operations Manual, produced by Habitat. Falls Prevention document. Materials are disseminated through an internal server electronically, through attachments to e-mail, and through hardcopy through a manual and at workshops. Target audiences include Habitat staff and volunteers. They range from young adults to retired adults of diverse backgrounds. Materials are free or available at a nominal cost.

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Home Safety Council (HSC) 1725 Eye Street, NW, Suite 300 Washington, DC 20006 Web site: www.homesafetycouncil.org Contact: Patricia Adkins Phone: 202-349-1100 Fax: 202-349-1101 E-mail: patricia.adkins@homesafetycouncil.org Organization Mission The Home Safety Council is a 501(c)(3) nonprofit organization dedicated to helping prevent more than 21 million medical visits each year from unintentional injuries in the home. Through national programs and partners across America, the Home Safety Council works to educate and empower families to take actions that help keep them safer in and around their homes. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): Through Lowe’s Heroes, a corporate partnership volunteer program with Lowe’s Companies, Inc., the Home Safety Council offers a senior safety project for store volunteer teams. Individual stores’ project descriptions often includes falls prevention and retrofitting safety products in senior homes. The program is delivered at the grassroots level by store volunteer teams. The primary target audiences are older adults living in their own homes. Some of these outreach programs specifically target minority and/or low income elders. The store volunteer teams evaluate their efforts based on the condition of the home prior to enhancements and then after changes are made.

§ Consumer education materials (e.g., brochures, web-based information, videos, books):

Multiple pieces of information concerning older adult falls are available via the organization’s Web site. The information is targeted to the general consumer. The information is available free of charge.

§ Institutional research: Every two-to-three years, HSC with the University of North Carolina-Injury Prevention Research Center (UNC-IPRC) conducts a review of research on key issues regarding home safety. One review topic concerns data on falls within the home. HSC with the help of UNC-IPRC disseminates the information.

§ Other: The HSC is involved in public policy initiatives that address falls prevention in the elderly.

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International City/County Management Association (ICMA) 777 North Capitol Street, NE #500 Washington, DC 20002 Web site: www.icma.org Contact: Nadejda Mishkovsky Phone: 202-962-3582 Fax: 202-962-3500 E-mail: nmishkovsky@icma.org Organization Mission The International City/County Management Association’s mission is to create excellence in local government by developing and fostering professional local government management worldwide. Falls prevention-related programs or services ICMA does not currently report any falls prevention programs or initiatives.

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International Code Council (ICC) 5203 Leesburg Pike, Suite 600 Falls Church, VA 22041 Web site: www.iccsafe.org Contact: Sara Yerkes Phone: 703-931-4533 Fax: 703-379-1546 E-mail: syerkes@iccsafe.org Organization Mission To promulgate a comprehensive and compatible regulatory system for the built environment, through consistent performance-based regulations that are effective, efficient and meet government, industry and public needs. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): The ICC does not have any programs specific to the elderly. The ICC does have programs that are intended to provide building safety-related information to the public. Foremost of those programs is National Building Safety Week , held one week each year in April. Through a series of ads, consumer information, and other activities, state and local governments participate with ICC to implement community-wide building safety programs. Certainly the needs of the elderly could be included in this activity in the future. State and local government agencies throughout the U.S. implement Building Safety Week. The primary target audiences are all elected officials, the building industry and the public at large.

§ Professional education programs (e.g., seminars, training, conferences): The ICC provides numerous educational and training programs via seminars, an online campus, and audio conferencing. The focus of these programs is on the provisions of building codes and standards. While not directly addressing falls, the provisions as noted above do have an impact on building design, construction and operation, which in turn impact the prevention of falls. These programs cover issues such as means of egress, stair geometry, handrails, guardrails, and lighting. The programs are delivered face-to-face, online and through audio means. Target audiences include federal, state and local government, building designers and others associated with the built environment.

§ Consumer education materials (e.g., brochures, web-based information, videos, books): The ICC provides some consumer-related information that is available on the web and disseminated through Federal, state and local government and through Building Safety Week. Materials include items such as deck safety but to date have not included a focus on falls and the elderly. They are available free.

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§ Professional education materials (e.g., journals, conferences, training) : All educational programs developed and delivered by the ICC have manuals, workbooks or some other support materials. The materials address falls and the elderly only to the degree that a presentation on the provisions of the codes and standards for egress, stairs, handrails, etc. would have an impact on reduction in falls. Cost of materials varies by the course.

§ Product manufacturing or development (assistance devices, foot wear, lifestyle management products, and home maintenance products such as grab bars and floor coverings): The ICC does not manufacture products but does, through the ICC Evaluation Service, an assessment and evaluation of building products for compliance with building codes and standards is provided. Such evaluations foster the application and use of new and innovative products.

§ Services (e.g., emergency alert systems, home assessments, home or facility design) : The ICC conducts building plan review services that, while not specific to the issue of falls-prevention, do evaluate building design for compliance with building codes and standards.

§ Other: The ICC fosters a process by which codes and standards covering public health, safety and welfare are developed for adoption by Federal, state and local government. Those codes and standards address building design, construction and operation with respect to, among others, paths of travel, visibility, etc. such that the safety of building users (including the elderly) is addressed. The ICC also provides a number of support services and products intended to facilitate the implementation of and conformance to those codes and standards. Through development and adoption of these documents a foundation for falls prevention is created. Through their implementation, using the support services such as education provided by the ICC to the building industry, public safety is enhanced. These documents and programs apply to the public, including the elderly, and can certainly be enhanced in the future to increase their focus on the special needs of the elderly. Of interest, the ICC has contacted the Administration on Aging with the intent to exploring how the ICC can foster success with their programs.

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Lighthouse International 111 East 59th Street New York, NY 10022 Web site: www.lighthouse.org Contact: Martin Yablonski Phone: 212-821-9115 Fax: 212-821-9712 E-mail: MYABLONSKI@lighthouse.org Organization Mission To overcome vision impairment for people of all ages through worldwide leadership in rehabilitation services, education, research, prevention and advocacy. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): Individual assessments in the home by certified vision rehabilitation professionals. Counseling to individuals through Lighthouse’s low vision assessment process. Lighthouse has identified falls as an indicator for a formal orientation and mobility assessment in a newly developed triage process. The assessment is delivered by professional vision rehabilitation professionals in a consumer’s home. Service is provided once need is identified via a triage process. The need for intervention may also be identified through a low vision assessment. The primary target audience is individuals with vision impairment. The majority of Lighthouse consumers are older than age 65, and have recent and varying amounts of functional vision loss. The goal is restoration of function through the teaching of safe alternative strategies. Some consumers provide follow up information via a survey.

§ Professional education programs (e.g., seminars, training, conferences): Lighthouse International targets ophthalmologists in an effort to extend their service to their visually impaired patients. This is done through high level management meetings (Director to Doctor), use of Lighthouse developed prescription pads, and a series of “Living Better with…” brochures for patients as well as “Ask your Doctor…” for the Doctor’s office. All this is in an effort to increase early identification of patients with vision loss that may cause a fall.

§ Consumer education materials (e.g., brochures, web-based information, videos, books): Lighthouse has developed a series of Living Well with (an eye disease) brochures for patients of ophthalmologists, as well as Tips for Confident Living which are periodically sent to newspapers. The organization also periodically addresses the issue of falls and fall prevention in consumer publications including Sharing Solutions and to professionals through Aging & Vision New).

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§ Professional education materials (e.g., journals, conferences, training) : Falls are often addressed during the annual scientific symposium.

§ Health care services (e.g., family medicine, internal medicine, gerontology, orthopedic, podiatric, vision) : Outreach to ophthalmologist – primarily retinal specialists on the losses and safety issues attributed to reduced vision. Publication of Living Better with Vision Loss brochures. Note: Through a low vision service, Lighthouse International identifies many individuals who are legally blind, qualifying them for state sponsored services. Lighthouse International provides services to any individual who has a functional vision impairment affecting their daily life and/or work skills.

§ Institutional research: Lighthouse has a research program on adaptation to age-related vision loss that collects data on falls and fears of falling & fall risk. Findings are disseminated in journals and at conferences.

§ Product manufacturing or development (assistance devices, foot wear, lifestyle management products, home maintenance products such as grab bars and floor coverings): While Lighthouse International does not manufacture the type of assistive devices as mentioned above, it provides recommendations following home assessment. It should also be noted that Lighthouse International’s professional products divis ion is one of the largest distributor of low vision devices in this country.

§ Other: The prevention of falls through the vision rehabilitation interventions.

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Meals on Wheels Association of America (MOWAA) 203 South Union Street Alexandria, VA 22314 Web site: www.mowaa.org Contact: Linda Netterville Phone: 703-548-5558 Fax: 703-548-8024 E-mail: Linda@mowaa.org Organization Mission The mission of MOWAA is to provide visionary leadership and professional training, and to develop partnerships that will ensure the provision of quality nutrition services. Falls prevention-related programs or services Meals on Wheels Association of America does not currently report any falls prevention programs or initiatives.

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Memorial Hermann SW Hospital 7600 Beechnut St. Houston, TX 77074 Web site: Contact: Lisa Miller Phone: 713-456-5880 Fax: 713-456-5214 E-mail: lisa_miller@mhhs.org Organization Mission Falls prevention-related programs or services § Professional education programs (e.g., seminars, training, conferences):

CEU programs for nurses on falls prevention. Memorial Hermann SW Hospital also has an active “Falls Team” made up of multidisciplinary members from PT, nursing and pharmacy. Programs are delivered through speakers.

§ Other: The clinical pharmacist identifies if the fall may have been related to a medication. The hospital hopes to identify a fall “trigger” so that the pharmacist can identify patients who are taking more than nine medications and recognize the falls risk of that patient.

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Merck Institute of Aging and Health (MIAH) 1100 New York Avenue NW, Suite 350W Washington, DC 20005 Web site: www.miahonline.org Contact: Patricia Barry, MD, MPH Phone: 202-842-0525 Fax: 202-354-6599 E-mail: patricia_barry@merck.com Organization Mission MIAH is a non-profit organization dedicated to improving the health and independence of older people around the world by communicating health information, educating the public and health professionals and encouraging research on health in the aging field. Falls prevention-related programs or services The Merck Institute of Aging and Health provides professional education materials through conferences, journals and training.

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National Association of Area Agencies on Aging (N4A) 1730 Rhode Island Ave. NW, Suite 1200 Washington, DC 20036 Web site: www.n4a.org Contact: Adrienne Dern Phone: 202-872-0888 Fax: 202-872-0057 E-mail: Adern@n4a.org Organization Mission N4A's primary mission is to build the capacity of its members to help older persons and persons with disabilities live with dignity and choices in their homes and communities for as long as possible. Falls prevention-related programs or services The National Association of Area Agencies on Aging (N4A) does not currently report any falls prevention programs or initiatives.

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National Association for Continence (NAFC) P.O. Box 1019 Charleston, SC 29402 Web site: www.nafc.org Contact: Nancy Muller, Executive Director Phone: 843-377-0900 Fax: 843-377-0905 E-mail: memberservices@nafc.org Organization Mission NAFC's mission continues to be one of consumer advocacy, education of the public, and information dissemination through collaboration and networking for the benefit of those with urinary incontinence. Falls prevention-related programs or services § Professional education programs (e.g., seminars, training, conferences):

”Toolkit” for health care providers and administrators in eldercare. Information is also provided through seminars and via the Web site.

§ Consumer education materials (e.g., brochures, web-based information, books): Your personal guide booklet Newsletter Telephone and mail contact with consumers, caregivers and families.

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National Association for Home Care and Hospice (NAHCH) 228 7th St, SE Washington, DC 20003 Web site: www.nahc.org Contact: Mary St.Pierre Phone: 202-547-7424 Fax: 202 547-7382 E-mail: mts@nahc.org Organization Mission NAHC believes that Americans should receive health care and social services in their own homes, so far as this is possible. Senior citizens and other vulnerable groups should be able to live in independence through the assistance of home care services, making institutionalization a last resort. NAHC seeks to reverse the current bias that places hundreds of thousands, possibly millions, of fragile children and chronically ill seniors in nursing homes or retained in hospitals when they could receive equal or better care at home. NAHC believes that home care keeps families together and is devoted to doing all in its power to preserve the sanctity of the American family, the bedrock of American democracy. Falls prevention-related programs or services § Professional education materials (e.g., journals, conferences, training) :

Tools are shared by home care providers, for example through Web sites: http://www.nahc.org/NAHC/LegReg/mbrs_only/ListservContrib/Clinical/Protocol-Fall-Prevention.doc and http://www.nahc.org/NAHC/LegReg/mbrs_only/ListservContrib/Clinical/Risk-Assesment-Falls.doc An article appeared in CARING Magazine, April 2004 Watch Your Step! Preventing Falls in the Home 2003 Annual Meeting Program: Preventing Falls and Other Injuries: The US Experience The target audiences are home care and hospice providers.

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National Association of Home Builders Research Center (NAHB) National Center for Seniors’ Housing Research 400 Prince George’s Blvd. Upper Marlboro, MD 20774 Web site: www.nahbrc.org Contact: Charlotte Wade, Director, NCSHR Phone: 301-430-6213 or toll free: (800) 638-8556 Fax: 301- 430- 6184 E-mail: cwade@nahbrc.org Organization Mission The mission of the NAHB Research Center is to promote innovation in housing technology to improve the quality, durability, affordability, and environmental performance of homes and home building products. The National Center for Seniors’ Housing Research is a joint effort between the U.S. Administration on Aging and the NAHB Research Center. Our goal is to offer the most current information on older adults’ housing issues and options so that all Americans can continue to live comfortably, safely, and independently in their own homes as they age, regardless of income or ability level. Falls prevention programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): The NAHB Research Center maintains a demonstration home in Bowie, Maryland. The LifeWise Home was built to show how a typical tract home can be built to accommodate the changing needs of a resident as they age in place with emphasis on safety and maintaining independence. In addition, NAHB Research Center provides panelists and other speakers at conferences, trainings, or special events. The organization sponsors booths at trade shows and conferences where information on seniors housing is provided. Public tours of the LifeWise Home are provided on the second Tuesday of each month. Special tours are provided upon request. Speakers are also available by request. The primary target audiences are consumers, representatives of the housing industry and the aging network, policy makers, government officials.

§ Professional education programs (e.g., seminars, training, conferences): Staff provides trainings at seminars and other events on designing and building homes that will be accessible for persons as they age in place. Staff developed the training materials for the Certified Aging in Place Specialist (CAPS) program which is offered by the NAHB University of Housing and the Remodeler’s Council to train remodelers in working with older persons. The first day of the training relates to the changing physical condition of seniors and how that relates to safety and maintaining independence in the home. The second day of the training is on the proper design and

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installation of accessibility features, such as ramps, roll in showers, non-slip floor surfaces, preventing glare, etc. A third day relates to business and ethics. Participants must pass an exam at the end of each day to receive the certification. Persons taking the CAPS program are required to pay registration fees which vary by the location where the trainings are provided. There are also some set fees that go to NAHB, but the Research Center does not bear any responsibility in this part of the training Staff developed a similar program with more technical detail for use by Rebuilding Together (RT) to train skilled volunteers in installing home modifications. Research Center staff trained the trainers for CAPS and the RT programs, and the programs are being taught by both groups throughout the country. Speakers are also provided at seminars. Programs contain varying amounts of information about falls prevention. The target audience for CAPS is primarily targeted to remodelers, but people from many different professions have been taking the class. RT targets volunteers who will be building and/or installing home modifications, such as ramps, wider doorways, and grab bars. There is no specific evaluation effort other than class evaluation forms.

§ Consumer education materials (e.g., brochures, web-based information, videos, books): The NAHB Research Center Web site has a tremendous amount of information on seniors housing, including resource materials for students who participated in our annual design competition, and other events. A virtual tour of the winning entries from the student design competition can also be viewed on line. There are several books on seniors’ housing that are available for purchase through the online bookstore or by contacting the Research Center. The target audience for these materials is the general public. The cost of material varies by item. Many reports or other information can be downloaded from the Web site for free.

§ Research funding to other organizations : The Administration on Aging has contracted with the Research Center to manage a grants program, Assistive Technology and Aging in Place. This program provides limited funding for research/educational programs to help seniors and/or their caregivers access assistive technology. The NAHB is currently in the midst of the cycle with this project which includes nine projects from different areas of the United States. It has not been determined if a second round of funding will be available. Funding decisions are made by a panel or committee.

§ Institutional research: NAHB does not conduct specific testing/research on the elimination of falls; however, they do administer questionnaires to gather data on consumer/senior preferences with regard to their homes and amenities. Some of this data is revealing. A recent survey found that an adequate number of grab bars were not being installed in assistive living facilities where they are certainly needed, nor were the facilities being built with wider doorways to accommodate wheelchairs.

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Findings are available for purchase through the Research Center bookstore, or directly from the Market Research department under special circumstances. Some information is available online through our Web site. In addition, NAHB provides an extensive number of interviews to newspapers, magazines, and trade publications with wide readership.

§ Other: Through its lab, the Research Center conducts extensive product testing on surfaces used throughout the home, and durability/serviceability of bathroom fixtures and materials. In addition, NAHB tests flooring materials, grab bars, and other products such as windows and evaluates how they operate, a concern that can both directly and indirectly relate to accident prevention in the home. Products are sold or distributed through printed reports available from the NAHB bookstore, and through presentations to consumer and industry groups. Some information is proprietary, going only to the client. NAHB also has the capacity to conduct focus groups on this topic with industry reps and consumers for clients. Products that are tested by the Research Center and pass the test earn a certification that is often used in their marketing. NAHB tests the products by having auditors throughout the country randomly purchase or pull them from shelves in the marketplace to insure that manufacturers are maintaining the integrity of the design. Product testing in the NAHB laboratory must be under contract with an R/D or manufacturing company.

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National Association of State Units on Aging (NASUA) 1201 15th Street, NW, Suite 350 Washington, DC 20005 Web site: www.nasua.org Contact: Theresa Lambert Phone: 202-898-2578 Fax: 202-898-2583 E-mail: tlambert@nasua.org Organization Mission The mission of the National Association of State Units on Aging is to advance social, health and economic policies responsive to the needs of a diverse aging population and to enhance the capacity of the membership to promote the rights, dignity and independence of, and to expand opportunities and resources for, current and future generations of older persons, adults with disabilities and their families. Falls prevention-related programs or services § Tracking developments in state aging service systems.

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National Council on the Aging (NCOA) 300 D Street, SW, Suite 801 Washington, DC 20024 Web site: www.ncoa.org Contact: Bonita Lynn Beattie, PT Phone: 202-479-6698 Fax: 202-479-0735 E-mail: bonita.beattie@ncoa.org Organization Mission The National Council on the Aging is a national network of organizations and individuals dedicated to improving the health and independence of older persons; increasing their continuing contributions to communities, society and future generations; and building caring communities. Falls prevention-related programs or services § Institutional research:

Building on the information acquired through the environmental scan described in this document, the National Council on the Aging (NCOA) is planning a December 2004 summit called Falls Free: Promoting a National Falls Prevention Action Plan. The Council is working with a steering committee of key informants in the field of falls prevention that includes Mary Tenetti, Debbie Rose, John Pynoos, Sarah Olson (CDC) and others. The summit, modeled on the National Blueprint to Increase Physical Activity in Adults Age 50 and Older initiative (two members of that steering committee working on the Falls Free Summit Planning committee), will convene small working groups to address issues related to falls prevention and identify practical solutions/strategies across an array of topics. The topics will primarily include medications, physical activity and mobility, home safety and environmental safety. More than 90 individuals and organizations (stakeholders) have been identified for input into the process. These include health care providers, funders, national organizations, government organizations , researchers and academics, consumers, communications experts, and key political leaders. Input from this environmental scan (which was commissioned by NCOA) as well as existing research and a number of white papers will help inform the summit steering committee and, eventually , the attendees about what is taking place nationally around the topic of falls prevention. The scan also will identify and provide information about organizations that play key roles in this field and who should be at the summit. The outcome of the summit will be a National Action Plan on Falls Prevention that NCOA will disseminate in various formats to national partners in order to extend the reach of concern and intervention from only the aging services network to a broader audience.

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National Fire Protection Association (NFPA), Center for High-Risk Outreach 1 Battery March Park Quincy, MA 02169 Web site: www.nfpa.org Contact: Sharon Gamache Phone: 617-984-7286 Fax: 617-770-0200 E-mail: sgamache@nfpa.org Organization Mission To reduce the world-wide burden of fire and other hazards on the quality of life by providing and advocating scientifically-based consensus codes and standards, research, training and education. NFPA’s Center for High-Risk Outreach: To reduce deaths and injuries from fires and burns among those at highest risk: young children, older adults, and people in low-income communities. Falls prevention-related services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): Remembering When®: A Fire and Fall Prevention for Older Adults is a comprehensive program developed in partnership with the Centers for Disease Control and Prevention. The program focuses on 16 key behaviors/messages, eight on falls. The program is delivered by fire fighters, public health workers, hospital outreach workers through three main approaches of the program are group presentations, home visits, and smoke alarm installation. The primary target audience is adults 65 and older. The program can be used for all older adults. However, the NFPA Center for High-Risk Outreach and the CDC provide extra resources to outreach to low-income communities. The program also is available in Spanish and has been adapted for Latino older adults. Prior to the development of the program focus groups were conducted in high-risk communities in Mississippi, Arkansas and Alaska and the cities of Cleveland and Atlanta. There was also a formulative evaluation. The CDC has conducted a three-year implementation and evaluation in Arkansas, Maryland, Minnesota, North Carolina, and Virginia. In addition, the Georgia State University is presently conducting an evaluation of the program in communities in Virginia.

§ Consumer education materials (e.g., brochures, web-based information, videos, books): An interactive trivia game supporting Remembering When® is disseminated by fire fighters and other professionals who are either conducting educational programs to groups of older adults, are conducting home visits, or are installing smoke alarms and fall prevention aids for older adults. Nearly 10,000 copies of the entire curriculum have been given away free. Now they are available for sale. All the handouts can be copied by fire departments, public health and others and handed out free.

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National Governors Association (NGA), Center for Best Practices 444 North Capitol Street, Suite 267 Washington, DC 20001 Web site: www.nga.org Contact: Diane Braunstein Phone: 202-624-7854 Fax: 202-624-5313 E-mail: dbraunstein@nga.org Organization Mission To share state best practices among the states. Falls prevention-related programs or services § Other:

The issue is covered in NGA papers and reports.

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National Indian Council on Aging (NICA) 10501 Montgomery Blvd. NE, Suite 210 Albuquerque, NM 87111 Web site: www.nicoa.org Contact: Gary Kodaseet, Executive Director Phone: 505-292-2001 Fax: 505-292-1922 E-mail: gary@nicoa.org Organization Mission Advocacy for American Indian and Alaska Native elder health and social services. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): Falls prevention is addressed as part of speeches on health living. These are presented to state and tribal elders conferences. The primary audience is Indian elders age 55 and older.

§ Consumer education materials (e.g., brochures, web-based information, videos, books): Falls prevention has been featured in the NICA quarterly newsletter which is sent to membership (Indian elders.)

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National Osteoporosis Foundation (NOF) 1232 22nd St., NW Washington, DC 20037 Web site: www.nof.org Contact: Harriet Shapiro Phone: 202-223-2226 Fax: 202-223-2237 E-mail: harriet@nof.org Organization Mission Established in 1984, the National Osteoporosis Foundation is the nation’s leading voluntary health organization solely dedicated to osteoporosis and bone health. NOF remains the nation’s leading resource for healthcare professionals, patients, and organizations seeking up-to-the-minute medically sound information on the causes, prevention, diagnosis and treatment of osteoporosis. NOF’s Vision: To make bone health a reality and a lifelong priority for all individuals. NOF’s Mission: To prevent osteoporosis, to promote lifelong bone health, to help improve the lives of those affected by osteoporosis and related fractures, and to find a cure. NOF achieves its mission through programs of awareness, public and health professional education, advocacy and research. Falls prevention-related programs or services § Consumer education materials (e.g., brochures, web-based information, videos, books):

NOF has a consumer oriented brochure: Falls and Related Fractures. Materials are disseminated via NOF’s web store, as well as in response to e-mail and telephone requests. In addition materials are distributed through support groups. The target audiences are osteoporosis patients, the general public and students. The cost of print materia ls is $25 for a package of 50 brochures.

§ Professional education materials (e.g., journals, conferences, training) : NOF has a health care document on rehabilitation that includes information on falls and fall prevention, The Health Professional’s Guide to Rehabilitation of the Patient with Osteoporosis. It is disseminated in response to e-mail requests, web store orders, at national meetings of medical societies, and in response to telephone requests. The target audiences are health care professionals involved in metabolic bone disease. The cost of materials to professionals is $15 for a package of ten Rehabilitation Guides.

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National Recreation and Parks Association (NRPA) 22377 Belmont Ridge Road Ashburn, VA 20148 Web site: www.nrpa.org Contact: Susan Potts Phone: 703-858-0784 Fax: 703-858-0794 E-mail: programs@nrpa.org Organization Mission The Mission of the National Recreation and Park Association is to advance parks, recreation and environmental conservation efforts that enhance the quality of life for all people. NRPA's Values - We believe that parks and recreation:

§ Enhances the human potential by providing facilities, services and programs that meet the emotional, social and physical needs of communities.

§ Articulates environmental values through ecologically responsible management and environmental education programs.

§ Promotes individual and community wellness that enhances the quality of life for all citizens. § Utilizes holistic approaches to promote cultural understanding, economic development, family

public health and safety, by working in coalitions and partnerships with allied organizations. § Facilitates and promotes the development of grassroots, self-help initiatives in communities across

the country.

The Goals of the National Recreation and Park Association are:

§ To promote public awareness and support for recreation, park and leisure services as they relate to the constructive use of leisure and thereby to the social stability of a community and the physical and mental health of individuals. NRPA strives to promote public awareness of the environmental and natural resource management aspects of recreation and leisure services.

§ To facilitate the development, maintenance, expansion and improvement of socially and environmentally relevant public policy that supports recreation, parks and leisure programs and services.

§ To enhance the development of parks, recreation and tourism professionals and to provide services that contribute to the development of NRPA members.

Falls prevention-related programs or services NRPA does not currently have any falls prevention-related initiatives.

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National Safety Council (NSC) 1121 Spring Lake Drive Itasca, IL 60143 Web site: www.nsc.org Contact: Donna M. Siegfried Phone: 630-775-2099 Fax: 630-285-9594 E-mail: siegfrid@nsc.org Organization Mission The National Safety Council, chartered by an act of Congress, is a non-governmental, not-for-profit, public service organization devoted solely to educating and influencing society to adopt safety, health and environmental policies, practices and procedures that prevent and mitigate human suffering and economic losses arising from preventable causes. Falls prevention-related programs or services The National Safety Council does not currently have any specific programs or services related to falls prevention in the elderly.

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Partnership for Prevention 1015 18th Street, N.W., Suite 200 Washington, DC 20036 Web site: www.prevent.org Contact: Steven H. Woolf, MD, MPH Phone: 202-833-0009 ext. 106 Fax: 202-468-2661 E-mail: swoolf@prevent.org Organization Mission To improve health by preventing illness and injury and by promoting health. Falls prevention-related programs or services Partnership for Prevention is not currently engaged in any falls prevention initiatives.

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Rebuilding Together, Inc. (RT) 1536 16th Street, NW Washington, DC 20036 Web site: www.rebuildingtogether.org Contact: Lee Berkeley Shaw, Program Manager Phone: 202-483-9083 Fax: 202-483-9081 E-mail: Lee_Shaw@rebuildingtogether.org Organization Mission Rebuilding Together, Inc. is the nation’s nonprofit providing home modifications and home repair services to low-income homeowners nationwide. By recruiting over 275,000 volunteers nationwide and soliciting donated and discounted products, Rebuilding Together is able to provide this service free to its recipients, and in so doing, make the home a safer place to age with independence. Falls prevention-related programs or services § Community/consumer education programs (e.g., classes, workshops, seminars, demonstrations,

health fairs, physical activity programs): Rebuilding Together offers two levels of free home modifications training workshops to its network of leaders and volunteers, and the community at large. The Level 1 workshop covers aging trends and identifies hazards in the home, and addresses assistive technology and hardware that can make aging in place easier and more successful. This workshop is taught by an Independent Living Strategist. The Level 2 workshop discusses community partnerships and provides a technical approach to installing grab bars, building ramps, and widening doorways. This class is taught by a CAPS certified remodelor. Depending on funds available, workshops will be held multiple times a year in a variety of pre-arranged geographic locations. Information is made available on Rebuilding Together’s Web site about upcoming workshops and anyone is welcomed to register. There is no registration fee. Primary target audiences are Rebuilding Together leadership and volunteers. Audiences often include occupational therapists, Area Agency on Aging leadership, members of the academic community, local building/plumbing/roofing representatives, and occasionally an Administration on Aging representative. The training workshops are designed for those who are to make the improvements to low-income homes, not the homeowners themselves. However, the workshops are open to all. There is often follow-up to clarify issues raised or provide more information on products and/or partnerships, and evaluation forms are taken at the end of each workshop and used to make the material more relevant to the target audiences.

§ Consumer education materials (e.g., brochures, web-based information, videos, books): Rebuilding Together has a section of its Web site devoted to information about home modifications. The organization plans to update that information to include a quiz and a house walk-thru on its Web site. A Home Safety Awareness Brochure is available, specifically designed to inform about

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aging in place. A Home Safety Checklist, developed in partnership with an occupational therapist and the Administration on Aging is also available . Rebuilding Together has adapted a Home Time episode on accessibility and has a two-tiered curriculum on home modifications awareness-building, and training on installation. Rebuilding Together attends between three and twelve trade shows and conferences annually , distributing between 300 - 500 copies of the brochures and checklists at each. At these shows, there are hands-on demonstrations to educate on some of the assistive technology that is available for consumers and agencies, much of which is at a reasonable cost to the consumer. Between four and ten training workshops are held each year, providing an opportunity to distribute between 25-75 copies of each item. Copies of materials are distributed throughout the aging network on a regular basis, and each of the organization’s 250 offices receives copies of everything available and can order more at no charge. Rebuilding Together’s target audience is three-fold. The primary target is the volunteers who make up the affiliate network. These individuals provide the service delivery. The secondary audiences are the aging and disability networks. Rebuilding Together wishes to partner in communities around the country to provide the service delivery to populations often left out due to economic disparities. By informing national, state, and local agencies about services and emphasis on the low-income senior and disability populations, Rebuilding Together hopes to foster partnerships that will allow services to reach more people. And finally, Rebuilding Together seeks to educate the public at large. As the baby boomers begin to age, it is important that they know the steps they can make to keep them safe in their homes for a longer period of time. All Aging in Place/Safety f or Seniors materials are free, paid for through a grant from the Administration on Aging. At some point in the future, a nominal fee may be placed on the workshops to ensure attendance and cover the cost of cancellations, but at present, they are also free.

§ Professional education materials (e.g., journals, conferences, training) : Rebuilding Together hosts an annual conference for members of its affiliate network and partners. This conference is intended to share best practices on a range of issue areas, everything from board governance to recruiting volunteers. Sessions on home modifications do factor into the agenda. In the past, there are usually two full-day sessions of the Home Modifications Workshops listed above, and two to three sessions which cover topics including working with occupational therapists, partnering with Area Agencies on Aging, and Best Practices in the Network. Materials are given out at these sessions, as well as in conference bags and on the handouts table. There is a conference registration fee (usually around $300) and the full-day workshops are between $25-$75 each. All materials at conference are free to the affiliates.

§ Services: Home assessments as part are provides as part of evaluation of an application for service. If a homeowner is accepted, home repair and home modification services are provided through a network of skilled and unskilled volunteers. Services are free to qualified homeowners. Products are donated or discounted. Fundraising activities are conducted locally and nationally to support these projects.

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§ Other: Rebuilding Together offers training on home modifications to prevent falls in the home, and provides free installation of such modifications to qualified low-income homeowners in selected geographic areas nationwide. Preventative home modification services are provided to low-income seniors and persons with disabilities. This can mean anything from adding grab bars in the bathroom to building a ramp for access to the outside. Homeowners’ needs are often matched with the appropriate assistive technology as well.

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Research!America (R!A) 1101 King Street Alexandria, VA 22314 Web site: www.researchamerica.org Contact: Karen A. Goraleski Phone: 703-739-2577 ext. 21 Fax: 703-739-2372 E-mail: kgoraleski@researchamerica.org Organization Mission To make medical and health research, including research to prevent disease and injury and to promote health, a much higher national priority. Falls prevention-related programs or services As an advocacy organization with efforts underway to raise awareness of the importance of prevention and public health research, Research!America addresses the need for an increased investment in research on injuries in general. The organization has not addressed research in terms of any specific age.

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Retirement Research Foundation (RRF) 8765 West Higgins Road, #430 Chicago, IL 60631 Web site: www.rrf.org Contact: Marilyn Hennessy Phone: 773-714-8080 Fax: E-mail: hennessy@rrf.org Organization Mission To support programs that improve the quality of life for older Americans. Falls prevention-related programs or services § Research funding:

RRF is a funder, so its expertise comes from that perspective. Research funding has generally targeted balance training, strength training, and other factors affecting stability and falling. Funding decisions are made by the Board of Trustees, informed by technical peer review.

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State and Territorial Injury Prevention Directors Association (STIPDA) 2965 Flowers Road South, Suite 105 Atlanta, GA 30341 Web site: www.STIPDA.org Contact: David Scharf, MPH, Executive Director Phone: 770-690-9000 Fax: 770-690-8996 E-mail: d.schart@stipda.cbeyond.com Organization Mission STIPDA's mission is to strengthen the ability of state, territorial, and local health departments to reduce death and disability associated with injury and violence. Falls prevention-related programs or services § Professional education materials (e.g., journals, conferences, training) :

Reports are generated from the STIPDA Injury Surveillance Workgroup (ISW) on falls and on the subject of fall related injury. Materials are made available during STIPDA’s annual meeting and through the STIPDA Web site. The target audiences are injury prevention researchers and practitioners. Reports are free to STIPDA members and available to non-members at a nominal cost (less than $25 each). Meeting materials are also free to STIPDA members.

§ Other: STIPDA’s Injury Surveillance Workgroup (ISW) Initiative is aimed at providing consensus-based recommendations for conducting fall injury surveillance, including data collection, epidemiological issues, data coding, analysis, display, and dissemination. The information from the ISW is developed into a consensus report which is published and available through STIPDA. The primary target is injury prevention practitioners and researchers who are involved in fall surveillance and epidemiology.

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United Government Services (UGS) 401 W. Michigan Ave. Milwaukee, WI 53203 Web site: www.ugsmedicare.com Contact: James Cope, MD Phone: 414-226-6080 Fax: 414-226-5226 E-mail: james.cope@cobalt-corp.com Organization Mission United Government Services is a CMS contractor. As a fiscal intermediary UGS pays Medicare claims for Part A Medicare, i.e. hospitals, home health, hospice, SNF, etc. Falls prevention-related programs or services United Government Services does not currently have specific falls prevention initiatives.

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United Jewish Communities (UJC) 1720 I Street, NW, Suite 800 Washington, DC 20006 Web site: www.ujc.org Contact: Sara Strope Phone: 202-785-5900 Fax: 202-785-4937 E-mail: sara.strope@ujc.org Organization Mission United Jewish Communities (UJC) represents 155 Jewish Federations and 400 independent communities across North America. Through the UJA Federation Campaign, UJC provides life-saving and life-enhancing humanitarian assistance to those in need, and translates Jewish values into social action on behalf of millions of Jews in hundreds of communities in North America, in towns and villages throughout Israel, in the former Soviet Union, and 60 countries around the world. Through the Israel Emergency Campaign, UJC and the Jewish Federations of North America are providing economic, social, human welfare and other types of support to Israelis and victims of terror as they strive to lead normal lives during a period of extreme difficulty. UJC was established to chart a new course for the Jewish community: to improve the quality of Jewish life worldwide, nurture Jewish learning, care for those in need, rescue Jews in danger, and ensure the continuity of our people. UJC is committed to meeting today’s and tomorrow’s challenges with a bold new model of Jewish community and philanthropy, a framework for new opportunities and new partnerships that will challenge the Jewish people to continue the traditions of education, leadership, advocacy, and responsibility that have inspired the world. Falls prevention-related programs or services United Jewish Communities currently has no national falls prevention initiatives. Some programs are conducted by its member federations at the local level.

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U.S. Department of Health and Human Services - Office of the Assistant Secretary for Planning and Evaluation (HHS-ASPE) 200 Independence Ave., SW, Room 424E Washington, DC 20201 Web site: http://aspe.hhs.gov Contact: Gavin Kennedy Phone: 202-690-6443 Fax: 202-401-7733 E-mail: gavin.kennedy@hhs.gov Organization Mission The Assistant Secretary for Planning and Evaluation (ASPE) advises the Secretary of the Department of Health and Human Services on policy development in health, disability, human services, and science, and provides advice and analysis on economic policy. ASPE leads special initia tives, coordinates the Department's evaluation, research and demonstration activities, and manages cross-Department planning activities such as strategic planning, legislative planning and review of regulations. Integral to this role, ASPE conducts research and evaluation studies, develops policy analyses and estimates the cost and benefits of policy alternatives under consideration by the Department or Congress. Falls prevention-related programs or services § Institutional research:

The purpose ASPE’s current ‘falls’ research is two-fold: (1) to develop a strategy or “intervention” to reduce an older person’s risk of falling in her/his home and (2) to develop a methodology for conducting a formal evaluation to determine the effectiveness of the intervention. ASPE anticipates that the evaluation will be based on a controlled-experimental design. For example, a random sample of community-dwelling elders would receive a focused intervention that could include home safety, environmental hazard and health status assessment, and comprehensive and periodic follow up to reduce the risk. A matched control group will receive no intervention. For convenience, the sample will be limited to older persons who are long-term care insurance policy holders. ASPE is anticipating shortly a final report that contains a detailed description of proposed interventions and a methodology for selecting the sample, collecting data, and measuring outcomes to determine the effectiveness of the intervention, i.e., reducing the incidence of falls and associated acute health and long-term care costs. Subsequent research will include a feasibility study on which to base a larger scale effort. Information is disseminated informally via policy research networks and formally via traditional distribution mechanisms (web, mailings, and conferences) and occasionally through news release.

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University of Chicago Hospitals (UCH) 5841 S. Maryland Ave. Chicago IL 60637 Web site: www.uchospitals.edu Contact: Cai Glushak, MD, EMS Director Phone: 773-702-9502 Fax: 773-702-7182 E-mail: cglushak@medicine.bsd.uchicago.edu Organization Mission To provide EMS (pre-hospital care services) for Chicago, including seniors. Falls prevention-related programs or services The University of Chicago is spearheading an elderly at risk program, using paramedics and emergency medical technicians to identify and respond to seniors at risk. A small study showed that paramedics are adept at identifying seniors at risk for falling. (Published in Pre-Hospital Emergency Care).

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University of Rochester Department of Emergency Medicine (URDEM) 601 Elmwood Avenue, Box 655 Rochester, NY 14642 Web site: Contact: Manish N. Shah, MD Phone: 585-273-3849 Fax: 585-275-2092 E-mail: manish.shah@rochester.edu Organization Mission Falls prevention-related programs or services § Institutional research:

The University of Rochester Department of Emergency Medicine is currently evaluating a program using emergency medical technicians to identify at risk older adults. After identification, the patients’ primary care physicians are notified of the identified risk and encouraged to address these fall issues with their patients.

§ Services: The University of Rochester Department of Emergency Medic ine has developed a program to have emergency medical technicians evaluate older adults while caring for them during emergency responses. The results of these evaluations are communicated to each patient’s primary care physician for further follow up.

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Virginia G. Piper Charitable Trust 6720 North Scottsdale Rd., Suite 350 Scottsdale, AZ 85253 Web site: www.pipertrust.org Contact: Carol Krantz, Program Officer Phone: 480-556-7123 Fax: 480-348-1316 E-mail: ckrantz@pipertrust.org Organization Mission The Virginia G. Piper Charitable Trust seeks to enhance and strengthen the quality of life for the people in Maricopa County through its support of health care and medical research, children, older adults, arts and culture, education and religious organizations. Falls prevention-related programs or services The Virginia G. Piper Charitable Trust does not currently have any falls related initiatives.

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APPENDIX B: NATIONAL COUNCIL ON THE AGING FALLS FREE ENVIRONMENTAL SCAN

National Council on the Aging Falls Free Environmental Scan

Please return your response to this survey by <date inserted>

The questionnaire is designed to allow you to respond quickly. If you are responding electronically, prior to completing this form please save it in a “Word Document” file in a location on your computer where you will be able to retrieve it (for example, in your “My Documents” folder). Enter and save your responses, and then send that document as an e-mail attachment to bsanner@comcast.net. You can note your responses using an “X” or by highlighting your response. If possible select a different font color to highlight your electronic response so they can be easily interpreted. If you wish to respond via fax, please print this form. Mark your responses in a dark color ink and fax to Brigid Sanner at 214-553-1262. Please feel free to contact Brigid Sanner at 214-553-0621 if you have questions or need more information.

1. Organization name:

Contact person: Address: City, State, Zip: Phone: Fax: Web site: E-mail: ..

2. Organization Mission:

3. Does your organization address the issue of falls and mature (age 50 or older) adults? ð Yes

ð No

ð We address the issue of falls, but not explicitly related to older adults.

4. If you responded “No” to question 3, do you anticipate addressing the issue of falls and older adults in your programs or services in the next two to four years? ð Yes

ð No

ð Not certain at this time

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5. Are you interested in providing input into the development of a national plan aimed at reducing

falls among the elderly? ð Yes

ð No

ð Not certain at this time 6. The National Council on the Aging, with funding from the Archstone Foundation and the Home

Safety Council, is spearheading a Falls Free Summit to develop a realistic national plan aimed at reducing falls among older adults. Please indicate areas of expertise individuals from your organization might contribute. (Please check all that apply.) ð Advocacy/public policy

ð Communication with older consumers ð Leadership among professional organizations that address health and welfare needs of elderly

ð Products/services targeted to older consumers (assist devices, medical services, home care products, etc.) ð Program development

ð Program evaluation

ð Program implementation (health, wellness, education, etc.)

ð Services or support programs for the elderly (meals, home visits, etc.)

ð Research ð Other: Describe briefly:

If you are not addressing the issue of falls at this time we appreciate your input into this survey.

Please return it to the attention of Brigid Sanner.

Via e-mail bsanner@comcast.net

Or

Fax to 214-553-1262

If you are addressing the issue of falls, please take time to respond to the questions on the following pages.

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7. Indicate the type(s) of falls-prevention programs or services your organization currently engages in. Please check all that apply:

A. ð Community education program(s) (classes, workshops, seminars, demonstrations, health fairs, physical activity programs, etc.)

B. ð Professional education program(s) (seminars, training, conferences, etc.)

C. ð Consumer education materials (brochures, web-based information, videos, books, etc.)

D. ð Professional education materials (journals, conferences, training, etc.)

E. ð Health care services (family medicine, internal medicine, gerontology, orthopedic, podiatric, vision, etc.)

F. ð Research funding to other organizations.

G. ð Institutional research. H. ð Product manufacturing or development (assistance devices, foot wear, lifestyle

management products, home maintenance products (grab bars, floor coverings, etc.) I. ð Services (emergency alert systems, home assessment, home or facility design, etc.)

J. ð Other: Please describe briefly. ___________________________________________.

For each of the falls-prevention programs or services your organization currently engages in (those checked in question #7), please provide the following information: 8. Community education program(s) (classes, workshops, seminars, demonstrations, health

fairs, physical activity programs, etc.): Provide a brief description of this program. How is the program delivered? Who is the primary target audience(s)? Does the program specifically target minority and/or low income elders? If yes, please describe. Describe any evaluation efforts your organization has undertaken related to your falls programs.

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9. Professional Education Programs (seminars, training, conferences, etc.): Please provide a

brief description of this program. How is the program delivered? Target audience(s)? Describe any evaluation efforts your organization has undertaken related to your falls programs.

10. Consumer education materials (brochures, web-based information, videos, books, etc.): Please provide a brief description of these materials. How are the materials disseminated? Target audience(s)? Cost of materials?

11. Professional education materials (journals, conferences, training, etc.): Please provide a brief description of these materials. How are the materials disseminated? Target audience(s)? Cost of materials?

12. Health care services (family medicine, internal medicine, gerontology, orthopedic, podiatric, vision, etc.) Please describe briefly.

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13. Research funding to other organizations. Please describe the research program. How are funding decisions made? ð Panel or committee (not peer reviewed)

ð Peer reviewed

ð Other Is there a specific funding cycle? ð Yes ð No If “Yes” please indicate when awards are made: ð Annually

ð Bi-annually

ð Quarterly

ð Other

14. Institutional research. Please describe the falls-prevention research your organization is engaged in. How do you disseminate research findings?

15. Product manufacturing or development (assistance devices, foot wear, lifestyle management products, home maintenance products (grab bars, floor coverings, etc.). Briefly describe your falls-prevention product(s). How are your products sold or distributed?

16. Service(s) (emergency alert systems, home assessments, home or facility design, etc.) Briefly describe your falls-prevention service(s). How are your services sold or distributed?

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17. If you are involved in other falls-prevention issues not covered in the list in question “6” please

describe briefly.

18. Are there any falls-prevention programs, products or services you are familiar with, that you recommend we look at as good models of effective initiatives? If yes, please indicate the name of the program, product or service, sponsoring organization or company, and contact name if possible.

Thank you for your time and assistance in providing information about your organization’s Falls Prevention programs.

Please return this survey to Brigid Sanner.

bsanner@comcast.net

or fax to

Fax: 214-553-1262

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APPENDIX C: STEERING COMMITTEE

The Summit is being organized and designed under the oversight of the Falls Free Summit Steering Committee, whose membership includes the following: § Patricia Adkins

Home Safety Council

§ Bonita Lynn Beattie The National Council on the Aging

§ Wojtek J. Chodzko-Zajko, PhD University of Illinois at Urbana-Champaign

§ Mary Ellen Kullman Courtright Archstone Foundation

§ Catherine Gordon Centers for Disease Control and Prevention

§ Sarah Olson Centers for Disease Control and Prevention

§ Jon Pynoos, PhD University of Southern California

§ Debra J. Rose, PhD Center for Successful Aging California State University, Fullerton

§ Serena Sanker The National Council on the Aging

§ Brigid McHugh Sanner Sanner & Company

§ Mary E. Tinetti, MD Yale Program on Aging

§ Nancy Whitelaw, PhD The National Council on the Aging

ACKNOWLEDGMENTS

We would like to thank the numerousorganizations and agencies who took thetime to provide thoughtful input to thisproject. It is evident that a great deal of fine work is being done to address this

important issue.

The Environmental Scan and this Final Report were conducted and prepared

by Sanner and Company Marketing andCommunications, 7930 Fair Oaks Avenue,

Dallas, TX 75231-4606.

T H E N A T I O N A L C O U N C I L O N T H E A G I N G300 D Street, SW Suite 801

Washington, DC 20024(202) 479-1200