# Expanding the Reach of a Fall Prevention Intervention for Older Adult Emergency Department Patients through Telehealth

> **NIH NIH P20** · RHODE ISLAND HOSPITAL · 2024 · $34,701

## Abstract

PROJECT SUMMARY 
 The Geriatric Acute and Post-Acute Fall Prevention Intervention (GAPcare) is a promising emergency 
department (ED) initiated intervention for reducing falls and healthcare visits in older adults; GAPcare reduced 
6-month ED visits for falls by 66%, all-cause ED visits by 53%, and hospitalizations by 43%. Because GAPcare 
begins immediately after a fall occurs, motivation to change behavior is high. However, GAPcare requires in- 
person pharmacists and physical therapists (PTs), which limits scalability to large EDs, which account for only 
43.8% of all ED visits. If we fail to scale this intervention, valuable prevention opportunities will be missed for the 
2.8 Million older adults who seek care for falls in EDs each year. Our over-arching goal is to expand the reach 
of GAPcare by testing a video telehealth GAPcare (e-GAPcare) intervention in a community ED without existing 
pharmacy and PT services. The rationale for this research is that telehealth for specialist evaluations have 
already been successfully implemented in EDs, suggesting that GAPcare could be adapted for patients with falls 
who would benefit from pharmacy and PT consultation, but cannot receive them due to staffing limitations in 
rural or smaller community EDs. Our long-term goal is to prevent falls in older adults and healthcare visits. The 
overall objective of this application is to develop and test a telehealth intervention for falls based on our 
successful GAPcare model. Our central hypothesis is that e-GAPcare will help ED clinicians identify fall risk 
factors, such as gait, balance, and cognitive impairment and could ameliorate these risk factors through action 
plans co-created with patients preventing the next fall. 
 GAPcare’s specific aims are to: (1) conduct semi-structured interviews (n=18-24) with content experts in 
telehealth stratified by practice setting (metro/suburban/rural) to gain insights about the practical considerations; 
(2) refine the GAPcare intervention and study protocol based on feedback from ED staff, patient and caregivers; 
and (3) conduct a single arm feasibility study with older adult ED patients (n=40) with a recent fall to determine 
if they can complete the fall risk assessment and intervention to assess the feasibility and acceptability of e- 
GAPcare. Dr. Goldberg will obtain initial estimates of efficacy for a larger, multi-center GAPcare III trial. Using 
phone calls and the electronic health record we will measure subsequent falls, and healthcare visits at 6 months, 
to inform initial efficacy for our subsequent larger, multi-center GAPcare III trial. 
 Dr. Goldberg’s e-GAPcare overarching aims are to develop and test an ED-based telehealth intervention that 
reduces recurrent falls and healthcare visits and to launch her physician-scientist career at the intersection of 
emergency medicine and geriatrics. To achieve this goal, Dr. Goldberg will work with her mentors Drs. Resnik 
and Ranney to improve her expe...

## Key facts

- **NIH application ID:** 10766226
- **Project number:** 5P20GM139664-03
- **Recipient organization:** RHODE ISLAND HOSPITAL
- **Principal Investigator:** Elizabeth Goldberg
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $34,701
- **Award type:** 5
- **Project period:** 2022-04-01 → 2027-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10766226

## Citation

> US National Institutes of Health, RePORTER application 10766226, Expanding the Reach of a Fall Prevention Intervention for Older Adult Emergency Department Patients through Telehealth (5P20GM139664-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10766226. Licensed CC0.

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