Behavioral Intervention to Prevent Falls in Older Adults

描述（由研究者提供）：跌倒是老年人受伤死亡、严重非致命性伤害和住院的主要原因。1994年，老年人摔伤的费用为202亿美元，这些费用对个人和社会都是重大的。高危老年人受益于多因素预防跌倒干预措施；然而，这样的服务（在可用的情况下）通常无法更改底层行为。先前的研究表明，多媒体暴露在引发跌倒的环境中可以“启动”有风险的个体；提高他们预防跌倒的意识。建议的行为干预可以增加动机，参与和遵守预防跌倒计划。干预将包括一个交互式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引导发现过程将把注意力集中在这些情况中固有的风险上。在第一阶段的工作中，我们的主要重点将是通过技术开发程序测试和改进干预，该程序包括对正常和有风险的老年志愿者进行并行Alpha测试，以及软件和多媒体开发活动。对原型干预的前瞻性试点研究将在80名有风险的老年人中进行，他们将被随机分配到干预组或对照组。两组患者在初次就诊时都会接受面谈，干预组接受行为干预。受试者将被随访4周，并返回进行随访。他们将再次接受采访，对照组将观看预防跌倒的讲座。根据初步研究数据，将评估MBI的行为和认知结果以及技术充分性。预防老年人跌倒的行为干预是一项创新技术，可以作为一种独立的行为干预，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解决跌倒预防中被忽视的认知和行为方面的新方法。数以百万计的居家、长期护理、门诊或住院的高危老年人可以从提高跌倒风险意识和预防计划中受益，这些计划可以在全国许多服务不足的社区出现。

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.