By Laura L. Acosta
That is why the College of Health Sciences has engaged faculty from the School of Nursing and the Department of Economics and Finance in the College of Business Administration in an interdisciplinary collaboration to conduct research that improves the lives of older adults. Formed in 2011, the Fall Prevention Research Coalition at UTEP combines perspectives from a wide range of disciplinary experts to analyze fall prevention among elderly Hispanics.
The team involves social workers, occupational therapists, physical therapists, kinesiologists, pharmacists, a certified family nurse practitioner and occasional input from an economist on health care cost implications. They’ve also partnered with several home care agencies and
Ph.D. (Kinesiology); João Batista Ferreira-Pinto, Ph.D. (UTEP’s Center for Interdisciplinary Health Research and Evaluation);
Amanda M. Loya, Pharm.D. (Pharmacy); Donna Cude-Islas, MSSW (Social Work); Guillermina Solis, Ph.D. (Nursing); Katherine
Lawson, Ph.D. (Occupational Therapy); and from the Universidad Autonoma de Ciudad Juárez Angeles Lopez (Psychology) and
Francisco Llera (Urban Planning).
Bob Wood, Ph.D., director of the Falls Lab at New Mexico State University, to enhance their research.
The goal is to identify risk factors for falls from all kinds of perspectives – age, muscle weakness, home hazards and medication use, for example. Serious falls can lead to hospitalizations and intense morbidity in older adults, said Candyce S. Berger, Ph.D., chair and professor of the UTEP Department of Social Work.
“The community is the future of health care,” Berger said. “Since 1985, the push is to do more community-based care and reduce (hospital) readmissions. One of the major sources of hospital readmissions among the elderly is due to falls.”
The Centers for Disease Control and Prevention estimates that each year, one in every three adults age 65 and older falls, and they can suffer moderate to severe injuries, such as hip fractures, lacerations and head traumas. These injuries can make it hard for them to get around or live independently and increase their risk of death.
Berger launched the coalition with Donna Cude-Islas, a clinical instructor in the Department of Social Work, in response to a citywide initiative by the Visiting Nurses Association to reduce the risk of falling among the elderly.
They assembled a team of health professionals, and with support from a $5,000 grant from the National Library of Medicine, the coalition partnered with two home care agencies to conduct comprehensive in-home assessments to evaluate fall risk factors among older adults.
“You can’t approach this from a single discipline,” Berger said. “You really need a multidisciplinary approach to this effort. And our ultimate goal is to design an intervention that can be tested.”
About 50 participants have been evaluated in their homes by a faculty member or graduate student in nursing, social work, pharmacy or occupational therapy. The group members then combine their findings to analyze the problem areas.
While a comprehensive falls risk assessment has been done on Caucasian and African-American populations on the East Coast, Cude-Islas found that not many studies had been done about the Mexican-American population.
According to Cude-Islas, cultural factors play a significant role in the health of Mexican-American older adults who tend to live at home with family, instead of being institutionalized. But she wonders if living at home offers them a more protective environment.
“Do they stay healthy longer because they live in this multi-generational household, or is that a risk factor because there are grandchildren in the house? Or is it better because there are a lot of people around to help take care of them?’’ Cude-Islas said.
These questions and more are being investigated with the support of a $20,000 grant the coalition received last year from the UTEP Office of the Provost and the Office of Research and Sponsored Projects to conduct interdisciplinary research.
The funding has allowed the group to move its research from in-home visits to the UTEP Virtual Reality and Motor Control Research Laboratory, where Rebecca Reed-Jones, Ph.D., assistant professor of kinesiology uses motion analysis equipment to analyze full three-dimensional body movements.
Participants stand on force plates that allow Reed-Jones to measure their balance and gait as they get up from a chair, walk a short distance and sit back down. She captures information about what’s happening at the joint and how much force the joint is using to move.
Test results are then compared to the problems that were identified during the home assessment.
“We are really interested in whether we’re picking up on the problem in the home visit,” Reed-Jones said. “With the motor analysis, we can begin to see if there is something else that we can be doing in the home that will address those issues that we can’t necessarily see with the naked eye during the home visit.”
For Reed-Jones, being part of an interdisciplinary team that involves health sciences has made it possible for her to engage with the elderly population, even though she is not a clinician.
“Health professionals like social workers might look at why this (fall) is happening from a social perspective, whereas I’m looking at it from a very neurological movement-control scenario,” Reed-Jones said. “So if your knee is not moving correctly, that may be an underlying issue. If so, how can a physical therapist help them with that issue and prevent them from falling?”
Berger said the two grants have allowed their research to go one step further. And while the group is committed to working together, the coalition also has been a catalyst for smaller projects.
In December, Guillermina Solis, Ph.D., assistant clinical professor in the School of Nursing, and Katherine Lawson, Ph.D., a lecturer in occupational therapy, received a $2,500 grant from the U.S. Department of Health and Human Services Office on Women’s Health to implement a fall prevention program for women ages 55 and older in El Paso County.
The coalition’s next step is to provide simulation training to health professionals, such as occupational and physical therapists.
“It’s really easy to say, ‘Let’s pull together an interdisciplinary group,’ but you’ve got to really put time and effort into building that group to get a sense of direction,” Berger said. “Each of us came with our own ideas, but together we collaborated to identify a mutual agenda to provide the elderly a safe and healthy environment.”