Behavioral Intervention to Prevent Falls in Older Adults

描述(由调查人员提供)：跌倒是老年人伤害死亡、严重非致命性伤害和住院的主要原因。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是巨大的。高危老年人受益于多因素的预防跌倒干预措施；然而，如果有这种服务，往往无法改变潜在的行为。先前的研究表明，通过多媒体暴露在容易摔倒的情况下，可以使处于危险之中的人“做好准备”；提高他们对预防跌倒的行动的认识。拟议的行为干预可能会增加摔倒预防计划的动机、参与度和遵从性。干预措施将包括一张互动DVD，其中包括常见的跌倒情况，以及标准化管理的教学软件。使用锚定教学方法的指导-发现过程将把注意力集中在这些情况下固有的风险上。在第一阶段的工作中，我们的主要重点将是通过一项技术开发计划来测试和完善干预措施，该计划包括与正常和有风险的高级志愿者同时进行Alpha测试，以及软件和多媒体开发活动。将对80名高危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访谈，干预组将接受行为干预。受试者将被跟踪4周，并返回进行后续访问。他们将被重新采访，控制组将观看预防跌倒的讲座。从试点研究数据中，将评估MBI的行为和认知结果以及技术充分性。老年人预防跌倒的行为干预是一项创新的技术，可以用作独立的行为干预，也可以作为其他预防跌倒方法的辅助手段。这项技术将提供一种新的方法来解决预防跌倒被忽视的认知和行为方面的问题。数百万居家、长期护理以及门诊或住院医疗环境中的高危老年人可能会受益于增强的跌倒风险意识，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.