| Course | MPH 590 Public Health and Health Education Capstone |
|---|---|
| Module | Module 2 |
| Paper type | Capstone literature review |
| Length | About 1,046 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Master of Public Health |
| Updated | September 2026 |
Free sample paper for MPH 590 Module 2
What the Evidence Says About Preventing Falls in Community-Dwelling Older Adults
Student Name
Master of Public Health Program, Aspen University
MPH 590: Public Health and Health Education Capstone
Instructor Name
Month Day, Year
What the Evidence Says About Preventing Falls in Community-Dwelling Older Adults
A capstone project rests on evidence. This literature review summarizes what is known about falls among older adults living in the community, the interventions that prevent them and how clinical and community services can be linked. It explains why the project chose a therapeutic tai ji quan balance program and identifies the gaps the project was designed to address.
Search Approach
The review drew on searches of PubMed and the Cochrane Library using terms for older adults, falls, exercise, tai chi, balance and community programs, supplemented by federal surveillance reports and program materials. Priority went to systematic reviews and randomized trials published in the past fifteen years. Reference lists of key reviews were checked for additional studies, and program developers' published materials were reviewed for delivery requirements.
How Common Falls Are
The 2018 national behavioral risk survey found that over one in four Americans 65 or older had fallen in the prior year, and about one in ten reported an injury from a fall. The share reporting falls rose between 2012 and 2016 before dipping slightly, and fall deaths continue to increase, particularly among the oldest adults (Moreland et al., 2020).
Risk Factors
Risk factors include muscle weakness, gait and balance problems, a history of falls, fear of falling, certain medications such as sedatives, vision problems, foot problems and home hazards. Many are modifiable, which is why clinical assessment and targeted interventions can reduce risk. Because several risks often occur together, multifactorial approaches that combine exercise with medication review and home safety can add benefit for the highest-risk adults.
Exercise as Prevention
Pooling 108 randomized trials of older people living at home, a Cochrane review found exercise lowered the rate of falls by roughly 23%. Programs that primarily involve balance and functional exercises reduce falls, and programs combining several types of exercise probably do too; tai chi may also prevent falls, while evidence for walking alone or resistance training alone is uncertain (Sherrington et al., 2019).
Tai Chi and Tai Ji Quan
Tai chi emphasizes slow, controlled movements that train balance, weight shifting and body awareness. One randomized trial enrolled 670 older people judged at high fall risk and compared a therapeutically tailored tai ji quan program, a multimodal exercise program and stretching over 24 weeks. The tai ji quan group had far fewer falls than the stretching group and 31% fewer than the multimodal exercise group (Li et al., 2018).
Key Studies
The table summarizes the central evidence.
| Study | Design and population | Main finding | Relevance |
|---|---|---|---|
| Moreland et al., 2020 | National survey, adults 65+ | 27.5% fell in past year; 10.2% injured | Establishes burden |
| Sherrington et al., 2019 | Review of 108 trials | Exercise cut fall rate about 23%; balance training most supported | Supports exercise approach |
| Li et al., 2018 | Trial of 670 high-risk adults | Tai ji quan reduced falls more than other exercise | Supports program choice |
| Stevens & Phelan, 2013 | Development of clinical toolkit | Framework for screening and referral | Supports clinic link |
Clinical Screening and Referral
CDC's STEADI initiative equips primary care teams to spot older patients at risk, check the factors that can be changed and respond with medication review, referral to physical therapy or community exercise and other strategies (Stevens & Phelan, 2013). Referral depends on the availability of community programs, which many areas lack.
Community Translation
Trials show what works under controlled conditions; community delivery raises questions of reach, attendance, instructor quality and sustainability. Community programs must recruit participants, train and retain instructors, find accessible sites and secure funding. Evidence on these implementation factors is thinner than evidence on efficacy. Reports from community programs suggest attendance and instructor retention are the most common challenges.
Gaps the Project Addresses
The review identified three gaps relevant to the county: no evidence-based fall prevention classes were available, clinicians lacked referral options and little was known about how well such programs reach older adults in mixed urban and rural counties. The project addresses the first two directly and contributes local evidence on the third.
Limitations of the Evidence
Many trials enrolled mostly white, relatively healthy volunteers, limiting generalization to diverse and frailer populations. Falls are often self-reported, which may introduce recall error. Long-term effects beyond a year are less studied. These limitations inform how the project's results should be interpreted.
Fear of Falling
Fear of falling is common among older adults, including many who have never fallen. It leads to activity restriction, which weakens muscles and balance and increases actual fall risk. Programs that build confidence as well as physical capacity address this cycle, a theme that shaped the project's theoretical framework.
Costs of Falls
Falls impose large costs through emergency visits, hospitalizations for fractures and head injuries, rehabilitation and long-term care. Preventing even a modest share of falls could save health systems substantial sums, which is relevant to arguments for sustainable funding of community programs.
Program Delivery Features
Reviews and trials suggest that effective programs involve at least moderate amounts of practice, often two or more hours per week over several months, with progressive balance challenges. Group formats add social support and are less costly than individual sessions, supporting their use in community settings.
Screening Tools
A few quick questions about recent falls, unsteadiness and worry about falling pick out many at-risk adults in minutes. Clinicians can follow positive screens with brief tests of gait, strength and balance, then choose interventions matched to the person's risks.
Adherence
Benefits depend on regular attendance. Trials report better results among participants who attend more sessions, and community programs often struggle with dropout. Strategies such as convenient locations, social connection and reminder calls can improve adherence, and the project built these into its design.
Implications for the Project
The literature shaped several design choices: selecting a program with randomized evidence, targeting adults at higher risk through screening, delivering classes twice weekly for three months, training instructors to a standard and measuring balance, confidence and falls.
Conclusion
The literature shows that falls are common and harmful, that exercise, especially balance-focused programs, reduces falls, and that a therapeutic tai ji quan program outperformed other exercise in a rigorous trial. Clinical screening can identify at-risk adults, but only if community programs exist. The project fills that gap and adds evidence on community delivery.
References
Li, F., Harmer, P., Fitzgerald, K., Eckstrom, E., Akers, L., Chou, L.-S., Pidgeon, D., Voit, J., & Winters-Stone, K. (2018). Effectiveness of a therapeutic Tai Ji Quan intervention vs a multimodal exercise intervention to prevent falls among older adults at high risk of falling: A randomized clinical trial. JAMA Internal Medicine, 178(10), 1301-1310. https://doi.org/10.1001/jamainternmed.2018.3915
Moreland, B., Kakara, R., & Henry, A. (2020). Trends in nonfatal falls and fall-related injuries among adults aged 65 years and older: United States, 2012-2018. MMWR. Morbidity and Mortality Weekly Report, 69(27), 875-881. https://doi.org/10.15585/mmwr.mm6927a5
Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2019(1), Article CD012424. https://doi.org/10.1002/14651858.CD012424.pub2
Stevens, J. A., & Phelan, E. A. (2013). Development of STEADI: A fall prevention resource for health care providers. Health Promotion Practice, 14(5), 706-714. https://doi.org/10.1177/1524839912463576
What the MPH 590 Module 2 instructions ask for
The MPH 590 catalog entry emphasizes incorporating research findings, and with the second module's prompt held for enrolled students, this sample presents the capstone's literature review. Review chapters usually describe the search approach, summarize evidence on the problem and on interventions, identify gaps and explain how the project responds to them. Say where and how you searched. Organize by theme rather than study by study. Give numbers from key studies. Include a summary table. Point out limits in the evidence, such as who was studied. Connect each theme back to a design decision in your project. Keep a running evidence table as you read so the review writes itself later.
Inside the MPH 590 Module 2 example
The review spans about 1,050 words and sixteen headings, including a four-column summary of four key studies with their designs, findings and relevance. The review covers search approach, burden, risk factors, exercise evidence and tai ji quan before the table, then screening and referral, community translation, gaps and limitations. Fear of falling, costs, delivery features, screening tools, adherence and implications for design complete the body. A margin comment explains that describing the search shows the review was systematic. The conclusion ties evidence directly to the project's choices. Every study in the table is also discussed in the text, so the table and narrative support each other.
Where the marks sit in the MPH 590 Module 2 rubric
Literature reviews for a capstone are judged on a clear search, accurate summaries, synthesis across studies, honest limits and a tight link to the project. This review cites national fall surveillance, a Cochrane review, a randomized trial and the clinical toolkit development paper in APA style. The summary table shows relevance as well as findings. Gaps are specific to the county. Limitations such as unrepresentative trial samples are noted. Graders reward reviews that explain why the evidence led to one intervention rather than another. Clear statements of effect sizes, such as the 23% reduction in fall rate, and careful wording about what each study design can show earn credit. Tying gaps to the county setting shows the review was written for this project.
MPH 590 Module 2 help: mistakes that cost marks
Common problems include summarizing studies one after another without synthesis, citing only studies that support the chosen program and forgetting to connect evidence to the project. Group studies by theme. Report effect sizes. Discuss weaknesses in the evidence. If your review runs long, a tutor can help you trim it to the studies that matter most for your project. Finish by stating the gap your project fills. Include at least one systematic review, one key trial and one source on implementation. Note when evidence comes mainly from populations unlike yours. Finish each thematic section with a sentence on what it means for your project. Keep quotations to a minimum; paraphrase and cite.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More MPH 590 and Master of Public Health sample papers
- MPH 590 Module 1: Capstone Introduction
- MPH 590 Module 3: Theory and Planning Framework
- MPH 590 Module 4: Capstone Project Methods
- MPH 590 Module 5: Capstone Project Results
- MPH 590 Module 6: Capstone Discussion
- MPH 590 Module 7: Recommendations and Implications
- MPH 590 Module 8: Capstone Conclusion and Defense
- MPH 503 Module 8: Public Health Policy Brief
- MPH 510 Module 2: Cohort Studies and Relative Risk
- MPH 570 Module 6: Evidence Review for the Issue
- MPH 520 Module 6: Medical Surge and Crisis Standards
MPH 590 Module 2 questions, answered
What does MPH 590 Module 2 usually ask for?
Aspen's MPH 590 emphasizes incorporating research findings into the capstone, so a literature review supporting the project is a typical assignment. Check your classroom prompt.
Does exercise prevent falls in older adults?
A large Cochrane review found that exercise reduces the rate of falls by about a quarter, with balance and functional exercises best supported.
What should a capstone literature review include?
The search approach, evidence on the problem and interventions, a summary of key studies, gaps the project addresses and limitations of the evidence.
Where can I find a free MPH 590 Module 2 sample paper?
This page holds the capstone literature review, including a table of the four studies that shaped the project.
How is a capstone literature review organized in MPH 590 Module 2?
By theme, from the problem's burden and causes to evidence on interventions, implementation and gaps, ending with how the project responds.