What factors influence community-dwelling older people's intent to undertake multifactorial fall prevention programs?

Abstract

Purpose: To investigate previous, current, or planned participation in, and perceptions toward, multifactorial fall prevention programs such as those delivered through a falls clinic in the community setting, and to identify factors influencing older people's intent to undertake these interventions.

Design and methods: Community-dwelling people aged >70 years completed a telephone survey. Participants were randomly selected from an electronic residential telephone listing, but purposeful sampling was used to include equal numbers with and without common chronic health conditions associated with fall-related hospitalization. The survey included scenarios for fall prevention interventions, including assessment/multifactorial interventions, such as those delivered through a falls clinic. Participants were asked about previous exposure to, or intent to participate in, the interventions. A path model analysis was used to identify factors associated with intent to participate in assessment/multifactorial interventions.

Results: Thirty of 376 participants (8.0%) reported exposure to a multifactorial falls clinic-type intervention in the past 5 years, and 16.0% expressed intention to undertake this intervention. Of the 132 participants who reported one or more falls in the past 12 months, over one-third were undecided or disagreed that a falls clinic type of intervention would be of benefit to them. Four elements from the theoretical model positively influenced intention to participate in the intervention: personal perception of intervention effectiveness, self-perceived risk of falls, self-perceived risk of injury, and inability to walk up/down steps without a handrail (P<0.05).

Conclusion: Multifactorial falls clinic-type interventions are not commonly accessed or considered as intended fall prevention approaches among community-dwelling older people, even among those with falls in the past 12 months. Factors identified as influencing intention to undertake these interventions may be useful in promoting or targeting these interventions.

Keywords: falls clinics; falls prevention; motivation; older adults.

Figure 1

Participant flow through the study. Note: *394 participants commenced participation in the overall survey, but 4.6% (n=18) ceased participation prior to reaching the component relating to the multifactorial intervention, leaving 376 commencing the multifactorial component of the survey.

Figure 2

Responses to questions on initial survey regarding perceptions and intent to participate in a multifactorial fall prevention program. Note: *Decision-making aid is the person/s who are most involved in how an individual makes decisions about their health (may be self or others).

Figure 3

Number of participants who reported they did not consider the falls clinic type of intervention would be of personal benefit, among those who 1) fell in the past 12 months and 2) thought they were likely to fall in the next 12 months. Notes: Percentages reported are for the proportion of participants at increased risk of falls due to 1) reporting that they thought they would fall in the next 12 months and 2) having had one or more falls in the past 12 months (n=132). The figure does not include 1) the participants who did not think they would fall in the next 12 months and 2) the participants who did not fall in the past 12 months.