Enhancing Motivation for Physical Activity to Reduce the Risk of Falls

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Unintentional falls among community-dwelling older adults are a common, serious and potentially preventable public health problem. In the United States, the annual incidence of fall related injuries per 100,000 persons was 4616 in 2001, rising to 5252 in 2008. The annual incidence of fall related deaths per 100,000 persons was 29.3 in 2000, rising to 41.86 in 2006. Older adults are particularly vulnerable to falls as they age. The consequences of falls are significant to both individuals and communities exerting a negative impact on the health of older adult populations. Potential consequences include fractures, fear of falling, emergency room, hospital and nursing home admissions, dependence, confusion, immobilization, depression, and death. Significant modifiable fall risk factors include muscle weakness, gait problems, and balance problems. While researchers have demonstrated the positive effects of fall preventive physical activity, the majority of older adults remain sedentary and the rate of falls continues to increase. Older adults participate in regular physical activity and fitness activities less often than younger populations; disparities are greater among older adults who are poor and living in rural communities. While knowledge about causes, risk factors, and efficacious physical activity to prevent falls has grown exponentially in the last several decades, bridging the gap between research and practice continues to be a challenge. As a strategy to address the gap between research and practice, the proposed study will utilize a tested theory, the wellness motivation theory, to address behavioral change in combination with instruction for physical activity. The target population of the proposed pilot intervention study includes rural community dwelling older adults, an understudied population in this field. Innovative measures of fall risk (balance) and physical activity patterning will include an accelerometer with remote sensitivity. Primary aims of the proposed pilot study include (a) examining acceptability and feasibility of the wellness motivation intervention, and (b) pilot testing the efficacy of the wellness motivation intervention to increase contextual resources, behavioral change process variables, the behavioral outcome of physical activity, and health outcome of fall risk reduction (increased balance and strength). The proposed study is the first step in a program of research focusing on the prevention of falls and frailty among older adults.