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. 2018 Dec 13;18(1):311.
doi: 10.1186/s12877-018-1004-z.

The impact of community-based interventions for the older population: a quasi-experimental study of a hip-fracture prevention program in Norway

Henning Øien  1 , Niklas Jakobsson  2   3 , Carl Bonander  4   5
Affiliations

The impact of community-based interventions for the older population: a quasi-experimental study of a hip-fracture prevention program in Norway

Henning Øien et al. BMC Geriatr. .

Abstract

Background: Hip fractures among older adults are a major public health problem in many countries. Hip fractures are associated with expensive health care treatments, and serious adverse effects on patients' health and quality-of-life. In this paper, we estimate the effect of a community-based hip fracture prevention program that was initiated in 16 Norwegian municipalities in 2007. Specifically, the participating municipalities implemented one or more of the following interventions: exercise programs for older adults, information and education campaigns to communicate how to effectively reduce falls to care workers and older adults, and preventive home safety assessment and modification help services.

Methods: We used a difference-in-difference design, and identified control municipalities by matching on pre-intervention trends in the outcome. The outcome measure was the incidence of hip-fractures among older adults (≥65 years).

Results: We found no statistically significant effects of the implemented program on the incidence of hip fractures, on average, in older subgroups (≥80 years) or in municipality-specific analyses.

Conclusions: It is unclear whether the interventions managed to achieve a change in hip fracture rates at the population level.

Keywords: Community interventions; Difference-in-differences; Hip fracture; Matching; Natural experiments.

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Conflict of interest statement

Ethics approval and consent to participate

We use aggregate non-sensitive data. The data set is aggregated from individual data and the consent to participate was waived under the following ethics approval: Ethics approval was granted by the Regional Ethics Committee South-East, Norway (ref. 2013/796b) and the Norwegian Data Inspectorate (ref. 13/00993).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

The funding bodies have no role in the development of this research.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Caption: Trends in hip fracture incidence across age and gender in treatment and matched control municipalities. Notes: Estimated effects of the intervention on the number hip-fractures per 100.000 person-years in Norwegian municipalities in six different subgroups. The solid line is the treatment group, and the dashed line is the control group. The shaded area shows a 95% confidence interval assuming a Poisson distribution
Fig. 2
Fig. 2
Caption: Forest plot of the estimated municipality-specific relative effects in the 15 treated municipalities. Notes: Point estimates are shown in boxes, along with 95% confidence intervals
See this image and copyright information in PMC

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