1. Health Board’s strategic plan includes:  “Work collaboratively with other agencies to develop an initiative involving multiple organizations to address one or more health issues of or more health issues of older adults in Missoula older adults in Missoula County.” County.”

2. More than one third of adults 65 and older fall each year in the United States (Hornbrook et al. 1994; Hausdorff et al. 2001).  Of those who fall, 20%-30% suffer moderate to severe injuries  People 75 and older who fall are four to five times more likely to be admitted to LTC for a year or longer.  Men are more likely to die from a fall.  Women are 67% more likely than men to have a nonfatal fall injury.

3. Missoula Fall Prevention Project  Key partners so far –Missoula Aging Services, MCCHD, UM (Pharmacy, Public Health, PT, Social Work, HHP), CMC, St. Patrick Hospital, some SOS orgs.

4. Recent progress  Convening and Leadership – Greg Oliver (MCCHD)  Survey of providers- Lorena Hillis (MCCHD) & Silvia Puliti (UM PH)  Stepping On- CMC & DPPHS  Assessment of physical activity programs offered to seniors- Thomas Julian (UM HHP)  Fall Risk Assessment Tool (FRAT)- Mindy Renfro (UM PH) & Diana Reetz-Stacey (UM SW)

5. Falls are a multifactorial problem Requiring multifactorial solutions Contributing Factors Have Been Shown to Include:  Age: Risk increases with advancing age  Fall History  Balance & Physical Activity  Medications  Home Environment  Fear of Falling, Depression, Risk-taking Behavior  Use of assistive devices to walk  Vision: Use of multifocal glasses/contacts  Hearing & Vestibular Issues: Dizziness  Social support system 5

6.  Multifactorial: 14 risk factors  Very simple to administer: appropriate for use by minimally- trained medical office staff  Quick: Four self-administered questionnaires for the patient to complete in the waiting room with one quick test of balance & mobility requiring office staff time.  Intervention Plan: Includes targeted, evidence-based interventions for the PCP to consider

7. Stepping On- Community Medical Center has stepped up.

8.  WHO:65 year olds and up living in the community (Missoula County has 11,000)  How:  Improve balance and strength  Environmental and Behavioral Safety  Encourage visual and medical screenings and pharmaceutical management

9.  11,000 Missoula County residents are 65 and over.  Stepping On serves 12-15 people at a time  Getting the most out of our resources for public health objectives

10. New Logo & Web Site 