Behavioral Intervention to Prevent Falls in Older Adults

描述（由研究者提供）：福尔斯是老年人受伤死亡、严重非致命性损伤和住院的主要原因。1994年，老年人跌倒伤害的费用为202亿美元，这些费用对个人和社会都很重要。高危老年人受益于多因素跌倒预防干预措施;然而，这些服务，在可用的情况下，往往无法改变潜在的行为。以前的工作表明，多媒体暴露于跌倒引发的情况下可以“启动”有风险的个人，增加他们的行动意识，他们可以采取措施，以防止福尔斯。拟议的行为干预可能会增加跌倒预防计划的动机，参与和遵守。干预将包括一个交互式DVD，包括常见的跌倒诱发情况，以及用于标准化管理的教学软件。使用锚定指令方法的引导发现过程将关注这些情况中固有的风险。在第一阶段的工作中，我们的主要重点将是通过一个技术开发计划来测试和完善干预，该计划包括与正常和有风险的老年志愿者进行的阿尔法测试，以及软件和多媒体开发活动。将对80名有风险的老年人进行原型干预的前瞻性试点研究，他们将被随机分配到干预组或对照组。两组都将在首次访问期间接受采访，干预组将接受行为干预。受试者将接受4周随访，并返回接受随访访视。他们将再次接受采访，对照组将观看预防跌倒的讲座。从试点研究的数据，行为和认知的结果和MBI的技术充分性将进行评估。预防老年人福尔斯跌倒的行为干预是一种创新技术，可作为独立的行为干预，也可作为其他跌倒预防方法的辅助手段。这项技术将提供一种新的方法来解决被忽视的认知和行为方面的跌倒预防。数百万在家中、长期护理和门诊或住院医疗环境中的高危老年人可以从增强的跌倒风险意识中受益，全国许多服务不足的社区可能会出现预防计划。

DESCRIPTION (provided by investigator): Falls are the leading cause of injury deaths, severe nonfatal injuries, and hospital admissions in older adults. In 1994 the cost of seniors' fall injuries was 20.2 billion, these costs are significant to individuals and to society. At-risk seniors benefit from multi-factorial fall prevention interventions; however, such services, where available, often fail to change underlying behaviors. Previous work suggests that a multimedia exposure to fall-provoking situations can 'prime' the at-risk individual; increasing their awareness of actions they can take to prevent falls. The proposed Behavioral Intervention may increase motivation, involvement and compliance in fall-prevention programs. The Intervention will consist of an interactive DVD including common fall-provoking situations, and instructional software for standardized administration. A Guided-Discovery process using an Anchored Instruction approach will focus attention on the risks inherent in these situations. In this Phase I effort our primary focus will be to test and refine the Intervention through a program of technical development consisting of concurrent Alpha testing with normal and at-risk senior volunteers, as well as software and multimedia development activities. A prospective pilot study of the prototype Intervention will be conducted with 80 at-risk older adults, who will be randomly assigned to intervention or control groups. Both groups will be interviewed during an initial visit and the intervention group will receive the Behavioral Intervention. Subjects will be followed for 4 weeks and return for a follow-up visit. They will be re-interviewed and the control group will view a fall-prevention lecture. From the pilot study data, behavioral and cognitive outcomes and technical adequacy of MBI will be evaluated. The Behavioral Intervention to Prevent Falls in Older Adults is an innovative technique that may be utilized as a stand-alone behavioral intervention, as well as an adjunct to other Fall-Prevention approaches. This technology would provide a novel approach to address the neglected cognitive and behavioral aspects of Fall-Prevention. Millions of at-risk seniors in home, long term care, and out- or in-patient medical settings could benefit from enhanced fall-risk awareness and prevention programs could emerge in many under-served communities nationwide.