Evaluation of a Fall Prevention Program to Reduce Fall Risk and Fear of Falling Among Community-Dwelling Older Adults and Adults with Disabilities

IF 3.6 3区医学

Clinical Interventions in Aging Pub Date : 2024-03-06 DOI:10.2147/cia.s448196

Melissa Hawkins, Tori Goldhammer, Robin McClave, Edwinta Jenkins-Smith

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Abstract

Purpose: The overarching goal of the program evaluation was to determine the reach and impact of the District-funded Safe At Home (SAH) modification program in reducing falls, fall injuries, and fear of falls among community-dwelling older adults and adults with disabilities. The SAH program has served over 6000 adults since 2016, the majority of whom are women (79%) and over age 60 (92%).
Materials and Methods: Letters were mailed in September 2022 to clients (n=492) who had home modifications completed between October 2021-March 2022 inviting them to participate in a brief phone survey about program satisfaction, falls, fall location, and severity. The validated Fall Efficacy Scale (FES) was administered pre (at first visit), post (at last visit), and during the phone survey (within 6 months to 1 year of program completion) to assess fear of falling. The response rate was 55% (n=241).
Results: Older adults (n=219) and adults with disabilities (n=22) reported high program satisfaction. Most clients, 79%, did not report a fall since the completion of the home modifications. The majority of falls reported, 76%, occurred inside the home. The average evaluation FES score was 32.5 (SD=22.6, range 10– 100), indicating relatively low fear of falling. Higher FES scores were associated with a greater likelihood of reporting a fall (r=0.44, p < 0.001, n=51) and older age (r = 0.17, p < 0.01). FES scores were not related to gender. Evaluation FES scores were significantly lower than the pre-FES scores, indicating a reduction in fear of falling and positive impact of the home modifications (T(107) = 5.14, p < 0.001).
Conclusion: The client-centered SAH program demonstrates significant reductions in falls, fear of falling, and high satisfaction among clients. Recommendations include program expansion to offer other evidence-based components to reduce falls and support safe aging in place.

Keywords: program evaluation, home modification, fall efficacy scale, FES, injury, prevention, independent living

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评估旨在降低社区老年人和残疾成年人跌倒风险和跌倒恐惧的预防跌倒计划

目的：项目评估的总体目标是确定地区资助的 "安全在家"（SAH）改造项目在减少社区老年人和残障成年人跌倒、跌倒伤害和跌倒恐惧方面的覆盖范围和影响。自 2016 年以来，SAH 计划已为 6000 多名成年人提供了服务，其中大部分是女性（79%）和 60 岁以上的老年人（92%）：2022 年 9 月向 2021 年 10 月至 2022 年 3 月期间完成家庭改造的客户（n=492）邮寄了信件，邀请他们参加关于项目满意度、跌倒、跌倒地点和严重程度的简短电话调查。在项目前（首次就诊时）、项目后（最后一次就诊时）和电话调查期间（项目完成后 6 个月至 1 年内），分别进行了经验证的跌倒效能量表 (FES) 测试，以评估对跌倒的恐惧感。回复率为 55%（n=241）：结果：老年人（人数=219）和残疾成年人（人数=22）对项目的满意度很高。大多数客户（79%）在家庭改造完成后没有报告过跌倒。所报告的跌倒大多发生在家中，占 76%。平均评估 FES 得分为 32.5（SD=22.6，范围为 10-100），表明跌倒恐惧感相对较低。FES 分数越高，报告跌倒的可能性越大（r=0.44，p <0.001，n=51），年龄越大（r=0.17，p <0.01）。FES 分数与性别无关。评估时的 FES 分数明显低于 FES 前的分数，这表明对跌倒的恐惧有所减轻，并且家庭改造产生了积极影响（T（107）= 5.14，p < 0.001）：以客户为中心的 SAH 项目显著减少了跌倒和跌倒恐惧，客户满意度很高。结论：以客户为中心的 SAH 计划明显降低了客户的跌倒恐惧，客户的满意度也很高。建议扩展该计划，提供其他循证内容，以减少跌倒并支持安全的居家养老。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.20

自引率

2.80%

发文量

193

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.