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完整且充足剂量的跌倒风险降低计划所产生的预测因素以及与健康和跌倒相关的计划结果。

Predictors of and health- and fall-related program outcomes resulting from complete and adequate doses of a fall risk reduction program.

作者信息

Mielenz Thelma J, Durbin Laura L, Hertzberg Fern, Nobile-Hernandez Diana, Jia Haomiao

机构信息

Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., Room 512, New York, NY, 10032, USA.

ARC XVI Fort Washington, Inc. (ARC), New York, NY, USA.

出版信息

Transl Behav Med. 2017 Jun;7(2):330-340. doi: 10.1007/s13142-016-0444-2.

Abstract

Falls are dangerous and costly for older adults. The A Matter of Balance/Volunteer Lay Leader (AMOB/VLL) program is an evidence-based fall risk reduction program that could help reduce this burden. This study introduced a door-through-door transportation program to improve program delivery (N = 126). Characteristics predicting completion of all eight AMOB/VLL sessions were identified using logistic regression. Individual growth models were employed to determine the immediate, intermediate, and long-term goal outcomes resulting from receiving an adequate dose of the program (five to eight sessions). Self-restriction of activities due to fear of falling (OR 5.04, 95 % CI 1.86-13.69) and a lower frequency of moderate and vigorous physical activity (OR 1.14, 95 % CI 1.04-1.27) were significantly predictive of receiving a complete dose. Three outcome goals were significant, including (1) immediate-improved self-efficacy of managing medications and treatments, (2) intermediate-reduced activity limitations, and (3) intermediate-reduced physical disability. Self-restriction of activities due to a fear of falling and physical activity levels may be simple and effective screening questions to prevent AMOB/VLL attrition. In our study, those who did receive the program improved on a specific type of self-efficacy and on self-reported physical functioning.

摘要

跌倒对老年人来说既危险又代价高昂。“平衡问题/志愿者外展领袖”(AMOB/VLL)项目是一项基于证据的跌倒风险降低项目,有助于减轻这一负担。本研究引入了一种逐户上门的交通项目,以改善项目实施情况(N = 126)。使用逻辑回归确定了预测完成所有八节AMOB/VLL课程的特征。采用个体成长模型来确定接受足够剂量的项目(五至八节)所产生的即时、中期和长期目标结果。因害怕跌倒而自我限制活动(比值比5.04,95%可信区间1.86 - 13.69)以及较低频率的中等强度和剧烈身体活动(比值比1.14,95%可信区间1.04 - 1.27)显著预测接受完整剂量。三个结果目标显著,包括(1)即时——改善管理药物和治疗的自我效能,(2)中期——减少活动受限,以及(3)中期——减少身体残疾。因害怕跌倒而自我限制活动和身体活动水平可能是防止AMOB/VLL项目参与者流失的简单有效的筛查问题。在我们的研究中,那些确实接受该项目的人在特定类型的自我效能和自我报告的身体功能方面有所改善。

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