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By Mark Rudi
Pueblo Partnership
UNM Health Sciences Team Helping to Develop a Fall-Prevention Program for Zuni Elders
New Mexico has about 1½ times the falls-related death rate of other states – and at Zuni Pueblo, it may be about double the national rate.
University of New Mexico Health Sciences researchers Vallabh “Raj” Shah, PhD, and Carla Herman, MD, conducted a pilot study of 50 seniors age 65 and up at Zuni that found 75 percent felt they were at risk for a fall.
Now, Shah a Distinguished and Regents’ professor in the Departments of Biochemistry & Molecular Biology and Internal Medicine, and Herman, professor in the Division of Geriatrics, have received a five-year, $2.5 million grant from the National Institutes of Health (NIH) to study falls risk in the pueblo.
The pilot study we have done identified more than 52 percent of Zuni elders reporting falls in the past year, which is significantly higher than the U.S. national average
“The pilot study we have done identified more than 52 percent of Zuni elders reporting falls in the past year, which is significantly higher than the U.S. national average of 28 percent,” said Shah, who has worked with Native Americans for more than 25 years.
“In partnership with Zuni Pueblo leadership and community stakeholders, we seek to study the feasibility of implementing community health representative-led fall-risk screening and an evidence-based exercise program to address lack of access to home-delivered physical therapy and heath disparities.”
People with weakness in the lower extremities and balance problems are at a higher risk for falls. Those patients generally work with a physical therapist in exercise programs to reduce their risk. However, Zuni Pueblo’s senior center does not have any physical therapists on staff, Shah said.
The UNM team, working with Zuni’s senior center and wellness program, will have UNM physical therapists train community health representatives in falls prevention. The study will evaluate whether a community health representative can be trained in physical therapy and falls prevention education to decrease the risk of falls.
“They really didn’t have a lot of community programs to prevent falls – things like tai-chi,” Herman said. “Since Dr. Shah and his team have been working out in that community for decades, it seemed like a perfect fit for the program.”
Working with Zuni’s senior center and wellness program, the UNM team will identify 200 people at risk for falls. One hundred will be in a randomized control trial receiving education and home modification, while the other 100 will receive an at-home prescribed exercise program, as well as the home modification and education.
Home modifications will be a part of the study. The team will look at whether a home has adequate indoor lighting and whether there are bars to hold onto in the bathtub and in the bathroom. The grant will cover any modifications that might be needed for the home.
If everything goes as planned, Shah and Herman hope to start the study in December.
“This is a very unique model,” Shah said. “If it works in this rural, isolated community, then it can be used by many across the country, because physical therapy is a specialty that is not available in rural areas, and not in our pueblos – and we have many of them to think about in New Mexico.”
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