Primary prevention of falls: effectiveness of a statewide program

Abstract

Objectives: We examined a population-wide program, Pennsylvania's Healthy Steps for Older Adults (HSOA), designed to reduce the incidence of falls among older adults. Older adults completing HSOA are screened and educated regarding fall risk, and those identified as being at high risk are referred to primary care providers and home safety resources.

Methods: From 2010 to 2011, older adults who completed HSOA at various senior center sites (n = 814) and a comparison group of older adults from the same sites who did not complete the program (n = 1019) were recruited and followed monthly. Although participants were not randomly allocated to study conditions, the 2 groups did not differ in fall risk at baseline or attrition. We used a telephone interactive voice response system to ascertain the number of falls that occurred each month.

Results: In multivariate models, adjusted fall incidence rate ratios (IRRs) were lower in the HSOA group than in the comparison group for both total (IRR = 0.83; 95% confidence interval [CI] = 0.72, 0.96) and activity-adjusted (IRR = 0.81; 95% CI = 0.70, 0.93) months of follow-up.

Conclusions: Use of existing aging services in primary prevention of falls is feasible, resulting in a 17% reduction in our sample in the rate of falls over the follow-up period.

FIGURE 1—

Consolidated Standards of Reporting Trials study diagram: Healthy Steps for Older Adults (HSOA) program evaluation, Pennsylvania, 2010–2011.

FIGURE 2—

Comparison of the incidence of falls, by incidence rate ratios, in the program and comparison groups for self-reported balance categories (a) good, very good, or excellent, and (b) fair or poor: Healthy Steps for Older Adults Program (HSOA), Pennsylvania, 2010–2011. Note. The median was 7.5 months of follow-up. *P = .015.