Programmatic influences on outcomes of an evidence-based fall prevention program for older adults: a translational assessment

Abstract

Investigating the implementation and dissemination of evidence-based health-promotion programs to reach large numbers of diverse older adults is needed. The purpose of this study is to examine relationships between class size and session attendance and assess differences in intervention outcomes based on these community-based fall prevention program characteristics. Pre-post data were analyzed from 2,056 falls prevention program participants. PROC MIXED for repeated measures and ordinary least squares regressions were employed. Approximately 32% of participants enrolled in recommended class sizes (eight to 12 participants) and 76.4% of enrolled seniors attended more than five of eight sessions. Enrolling in smaller class sizes was associated with higher class attendance (X 2 =43.43, p<0.001). Recommended class sizes and those with 13-20 participants reported significant improvements in falls efficacy and physical activity. Perfect attendance was associated with improvements in falls efficacy (t=2.52, p<0.05) and activity limitation (t=−2.66, p<0.01). Findings can inform fall prevention program developers and lay leader deliverers about ideal class sizes relative to maximum intervention benefits and cost efficiency.

Falls Efficacy Among Older Adults Enrolled in an Evidence-Based Program to Reduce Fall-Related Risk

“…As indicated in previous shorter-term studies of AMOB program, [18][19][20][21][22] falls efficacy increased as a result of the enrollment in this evidence-based program and maintained for at least 6 months. Although consistent with other behavioral intervention research showing intervention delay over time, [31][32][33] the falls efficacy effects in this study remained significant at 6 months compared with baseline, thus showing sustained efficacy-related improvements over time.…”

“…[19][20][21][22] The program goal is to reduce fall-related disability by instilling greater confidence in one's abilities to prevent or manage falls while increasing physical activity to counter balance and gait deficits.…”

Effect of a Matter of Balance programme on avoidance behaviour due to fear of falling in older adults

“…However, the authors stated that mean change scores were so small that they probably did not represent a clinically meaningful change . Similarly, Smith et al used Q2 and Q4 of the CDC HRQOL‐4 to measure HRQOL and found no significant change in scores from baseline to post‐AMOB …”

“…A Matter of Balance: Managing Concerns about Falls (AMOB) is an evidence‐based programme for older adults that focuses on teaching cognitive behavioural strategies for managing fear related to falling and subsequent activity restrictions . Several studies have reported participant outcomes associated with implementation of the AMOB programme . Results indicated a positive impact on FOF, activity avoidance/restriction, falls self‐efficacy, balance confidence, and functional measures .…”

Functional and Biomechanical Assessments of A Matter of Balance/Volunteer Lay Leader Model

“…The prevalence of falls in elderly individuals is approximately 40% (Rossat et al, 2010) and alarmingly, two-thirds of the deaths from unintentional injuries are related to a fall event in this population (AGS, 2001;Smith, Hochhalter, Chen, Wang, & Ory, 2011). Agerelated changes in both motor and cognitive abilities have been linked to increased falls risk in the elderly.…”