Fall prevention in community settings: results from implementing stepping on in three States.
Fall prevention in community settings: results from implementing stepping on in three States.
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DOI：
10.3389/fpubh.2014.00232
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发表时间：
2014
影响因子：
5.2
通讯作者：
Parker EM
中科院分区：
文献类型：
--
作者：
Ory MG;Smith ML;Jiang L;Lee R;Chen S;Wilson AD;Stevens JA;Parker EM
踩踏是一种基于社区的干预，在一项随机对照试验中显示可以降低跌倒风险。威斯康辛健康老龄化研究所改编了《迈步前进》，供美国使用，并建立了一个培训基础设施，以促进传播。本研究的目的是：(1)描述踩踏参与者的个人特征；(2)量化参与者入组时的功能和自述健康状况；(3)测量参与者完成项目后功能和自述健康状况的变化。在2011年9月至2013年12月期间，研究人员收集了366名参与者的调查数据和观察到的功能状态数据，这些参与者参加了科罗拉多州、纽约州和俄勒冈州的32个Stepping On项目。采用配对t检验和一般估计方程模型对社会人口因素进行调整，以评估项目期间的变化。266名有调查前后资料的参与者平均年龄为78.7 （SD±8.0）岁。大多数参与者是女性（83.4%）、白人（96.9%）和健康状况良好（49.4%）。所有254名具有前后数据的参与者的TUG测试分数显著下降（p < 0.001）。在高风险参与者中变化最为明显，TUG时间从17.6秒减少到14.4秒。完成“踩上去”后，对保持跌倒的信心的调整比值比增加了三倍多。此外，报告“没有困难”离开直背椅子的调整比值比增加了89%。针对过去跌倒过或害怕跌倒的老年人，Stepping On有可能减少老年人跌倒的频率和负担。
Stepping On is a community-based intervention that has been shown in a randomized controlled trial to reduce fall risk. The Wisconsin Institute for Healthy Aging adapted Stepping On for use in the United States and developed a training infrastructure to enable dissemination. The purpose of this study is to: (1) describe the personal characteristics of Stepping On participants; (2) quantify participants’ functional and self-reported health status at enrollment, and (3) measure changes in participants’ functional and self-reported health status after completing the program. Both survey and observed functional status [timed up and go (TUG) test] data were collected between September 2011 and December 2013 for 366 participants enrolled in 32 Stepping On programs delivered in Colorado, New York, and Oregon. Paired t-tests and general estimating equations models adjusted for socio-demographic factors were performed to assess changes over the program period. Among the 266 participants with pre–post survey data, the average participant age was 78.7 (SD ± 8.0) years. Most participants were female (83.4%), white (96.9%), and in good health (49.4%). The TUG test scores decreased significantly (p < 0.001) for all 254 participants with pre–post data. The change was most noticeable among high risk participants where TUG time decreased from 17.6 to 14.4 s. The adjusted odds ratio of feeling confident about keeping from falling was more than three times greater after completing Stepping On. Further, the adjusted odds ratios of reporting “no difficulty” for getting out of a straight back chair increased by 89%. Intended for older adults who have fallen in the past or are afraid of falling, Stepping On has the potential to reduce the frequency and burden of older adult falls.