Smith Matthew Lee, Jiang Luohua, Prizer Lindsay P, Ahn SangNam, Chen Shuai, Cho Jinmyoung, Graham Kathleen, Ory Marcia G
Department of Health Promotion and Behavior, The University of Georgia College of Public Health, Athens, Georgia.
Department of Epidemiology and Biostatistics, Texas A&M Health Science Center School of Public Health, College Station, Texas.
Womens Health Issues. 2014 Nov-Dec;24(6):613-9. doi: 10.1016/j.whi.2014.08.004. Epub 2014 Oct 28.
Evidence-based fall prevention programs primarily attract older women, who are increasingly burdened by fall-related injuries. However, little is known about the relationship between older female participants' baseline health status and self-reported falls over the course of fall prevention interventions. Using data from A Matter of Balance/Volunteer Lay Leader Model (AMOB/VLL) workshops, this study examines female participants' sociodemographics and health indicators associated with self-reported falls at baseline and postintervention.
Data were analyzed from 837 older women (M = 76.2 years) collected during the statewide AMOB/VLL dissemination in Texas. Longitudinal Poisson regression models, using the generalized estimating equation method, were used to investigate the associations of personal characteristics and health indicators with and reductions in the number of self-reported falls from baseline to postintervention.
Approximately 21% of participants reported falling at baseline, and the number of reported falls significantly decreased from baseline to postintervention (β = -0.443). At baseline, more unhealthy physical days (β = 0.022), more unhealthy mental days (β = 0.018), and lower Falls Efficacy Scale scores (β = -0.052) were significantly associated with more falls reported at baseline. More falls at baseline was also associated with worse program attendance (β = -0.069). Greater improvements in Falls Efficacy Scale Scores (β = -0.069) and decreases in unhealthy physical health days (β = 0.026) over the course of the intervention were significantly associated with greater reductions in reported falls at postintervention, respectively.
Findings have implications for identifying at-risk older women upon enrollment, expanding the reach of AMOB/VLL, and leveraging AMOB/VLL to refer participants to other evidence-based exercise, disease management, and mental health interventions.
基于证据的跌倒预防项目主要吸引老年女性，她们因跌倒相关伤害而负担日益加重。然而，对于老年女性参与者的基线健康状况与跌倒预防干预过程中自我报告的跌倒之间的关系，我们知之甚少。本研究利用“平衡至关重要/志愿者外展领袖模式”（AMOB/VLL）工作坊的数据，考察了女性参与者的社会人口统计学特征和与基线及干预后自我报告跌倒相关的健康指标。
对在德克萨斯州全州范围内开展的AMOB/VLL传播活动期间收集的837名老年女性（平均年龄76.2岁）的数据进行分析。采用广义估计方程法的纵向泊松回归模型，研究个人特征和健康指标与从基线到干预后自我报告跌倒次数减少之间的关联。
约21%的参与者报告在基线时有跌倒情况，从基线到干预后报告的跌倒次数显著减少（β = -0.443）。在基线时，更多不健康的身体天数（β = 0.022）、更多不健康的心理天数（β = 0.018）以及更低的跌倒效能感量表得分（β = -0.052）与基线时报告的更多跌倒显著相关。基线时更多的跌倒也与较差的项目参与度相关（β = -0.069）。在干预过程中，跌倒效能感量表得分的更大改善（β = -0.069）和不健康身体天数的减少（β = 0.026）分别与干预后报告的跌倒次数更大幅度减少显著相关。
研究结果对于在招募时识别有风险的老年女性、扩大AMOB/VLL的覆盖范围以及利用AMOB/VLL将参与者转介至其他基于证据的运动、疾病管理和心理健康干预措施具有启示意义。
