Alison Berglund, SPT
As most of my classmates know, I am very passionate about working with older adults. This interest has been longstanding, as I had many opportunities throughout high school and college to work with individuals in the geriatric population. Working as a caretaker for a sweet woman with dementia during her last few months of life and helping my grandmother during her battle with dementia were difficult experiences, but immensely rewarding and eye-opening. I quickly realized that our older adult population is all too often overlooked and vastly underappreciated. My passion for working with the geriatric population deepened throughout PT school as I had several opportunities to continue working with older adults in the community through volunteer experiences and during my clinical rotations.
One experience that I particularly enjoyed was volunteering for CHAMP (Community Health and Mobility Partnership), which is a community-based falls prevention program that began in 2009.1 The mission of this program is to reduce falls risk in older adults through prescription of a personalized home exercise program which includes muscle strength, balance, and mobility exercises.1 I was excited to have the opportunity to become more involved with this program during my third year through an independent study in the fall semester and my capstone project in the spring semester.
PROJECT OVERVIEW & PURPOSE:
As the population in the United States ages, falls are becoming a growing problem. It is estimated that every year 30% of older adults fall, resulting in injury and costly hospital admissions.2 Therefore, as our population ages, implementing effective community-based programs to decrease falls risk of older adults should be a mission and priority of clinicians working with this population. CHAMP is one program that addresses the needs of this population, with the incorporation of the evidence-based Otago exercise program to prescribe participants home exercises.3 During the initial visit, participants are provided with a calendar to record their exercises and falls each day of the month. However, many participants report that they often forget to utilize these calendars. Therefore, the focus of my capstone project was to increase the utility of these calendars.
STATEMENT OF NEED:
The falls and exercise calendars are an important part of CHAMP, as they help participants stay on track with their exercise programs and serve as a reminder to perform exercises and walk daily. At the start of the fall semester, I had the opportunity to volunteer at a CHAMP event at Pennybyrn Retirement Facility and interviewed each participant. I spoke with the returning participants about their satisfaction with CHAMP, adherence with their exercise programs, and their perceptions of the utility of the falls/exercise calendars. The vast majority of participants reported that the number one barrier to filling out the exercise calendar was forgetfulness. After discussion with Dr. Vicki Mercer and CHAMP site coordinators, it was decided that participants should receive a check-in phone call one week after their initial CHAMP visit. The aim of the follow-up phone call policy is to help participants remember to fill out these calendars, ensure they do not have questions about exercises, and hopefully improve their adherence to the home program.
The first product I created for this project was a follow-up phone call script that DPT students will utilize when conducting calls. I also created a PowerPoint presentation and conducted a training session for students who will be performing the follow-up phone calls. The presentation included an overview of CHAMP, the purpose of the follow-up phone calls, and case scenarios designed to engage the audience and encourage critical thinking about challenges that may arise during the calls. I also created a post-training quiz to assess comprehension of the audience members. Finally, I created an annotated bibliography that describes the facilitators and barriers to exercise in the older adult population. When conducting follow-up phone calls for CHAMP, it will be important to understand barriers that may affect a participant’s willingness or ability to exercise. I was able to share some of these barriers and possible strategies to help participants overcome them during the training session.
During the process of creating the products for my capstone, I was able to utilize feedback from my advisor and committee members to improve my materials. I also gained feedback about the phone call script from current and future CHAMP coordinators at a meeting held in February.
To assess the effectiveness of my presentation and quality of my PowerPoint, I created a post-presentation evaluation form for audience members to complete. The form includes questions about the overall quality of my work, how prepared audience members feel to conduct follow-up calls after participating in the training, and suggestions to improve the effectiveness of the presentation. Overall, the trainees reported that they felt the presentation was effective and that they are confident in their abilities to perform the phone calls.
Overall, I am satisfied with the products I created for the implementation of a follow-up phone call policy for CHAMP. I enjoyed starting this project by interviewing CHAMP participants, which allowed me to identify their needs and change my project accordingly. I also had the opportunity to collaborate with CHAMP site coordinators and peers during the course of this project. I found this to be a valuable learning experience and appreciated the feedback I received in order to improve my materials and ensure that they most appropriately addressed the needs of CHAMP participants.
I feel that my training session was successful as well. Since I had completed follow-up phone calls myself prior to holding the training, I felt prepared to provide the audience with information about strategies to improve effectiveness of the calls as well as challenges they may encounter. I am hopeful that this new policy will help CHAMP participants stay on track with their programs and increase their use of the falls/exercise calendars. I am thankful for the opportunities I have had to volunteer with CHAMP and help to implement a new policy.
I would like to thank my advisor, Vicki Mercer PT, PhD for her feedback and support throughout the process of creating this project. Her assistance in the development of the project initially as well as in the improvement of my materials throughout the semester is much appreciated. I would also like to thank her for all of the time and energy she has invested in the development and coordination of CHAMP. I have witnessed first-hand how valuable CHAMP has been for so many older adults who would not have access to such a program without Dr. Mercer’s hard work and devotion. I would also like to thank Gabrielle Scronce, PT, DPT and Kayla McBane for serving as my committee members and providing me with feedback about the project. Finally, thank you to my classmate, Anna Speer, for your help and support during the last year. I had fun collaborating and volunteering with you!
- Vicki Mercer. CHAMP Policies and Procedures Manual. CHAMP Policies and Procedures Manual. 2018. https://ncchamp.org/materials. Accessed March 17, 2019.
- Florence CS, Bergen G, Atherly A, Burns E, Stevens J, Drake C. Medical costs of fatal and nonfatal falls in older adults. J Am Geriatr Soc 2018;66(4):693-698. doi:10.1111/jgs.15304.
- Campbell AJ, Robertson MC. Otago exercise programme to prevent falls in older adults. New Zealand: Otago Medical School, University of Otago; 2003.
- Image: https://www.google.com/search?q=otago+exercise+program+elderly&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiT9Ni9psjhAhUChOAKHejcDGsQ_AUIDygC&biw=1194&bih=699#imgrc=Rek72IeMgcp5dM: