Kiyoshi-Teo Hiroko, Eckstrom Elizabeth, Cohen Deborah J, De Lima Bryanna, Northrup-Snyder Kathlynn, Dieckman Nathan F, Winters-Stone Kerri
School of Nursing, Oregon Health & Science University, Portland, Oregon, USA.
Division of General Internal Medicine & Geriatrics, Oregon Health & Science University, Portland, Oregon, USA.
J Am Geriatr Soc. 2025 Apr;73(4):1210-1218. doi: 10.1111/jgs.19304. Epub 2024 Dec 3.
The Motivational Interviewing for Fall Prevention (MI-FP) study aimed to engage older adults in fall prevention strategies. We report on the feasibility, intervention fidelity, and preliminary impact of MI-FP.
We conducted a pilot randomized controlled trial to test MI-FP among older (age ≥ 65) primary care patients at high fall risk in a Pacific Northwest clinic in the United States. The intervention group received up to eight motivational interviewing (MI) sessions by MI practitioners over 6 months and the control group received standard care. Feasibility was defined as ≥75% retention and ≥75% reporting satisfaction at 6 months. Intervention fidelity was assessed by meeting pre-determined MI proficiency standards using MI Treatment Integrity (MITI 4.2) coding scheme, and ≥75% of the intervention group completing ≥6 MI sessions. Preliminary impact was assessed at 6 and 12 months for changes in concern about falling, readiness to engage in fall prevention, fall prevention behaviors, physical function, and fall rates between groups.
Participants (n = 200) had a mean age of 80 years and 67% were female. The overall retention rate was 75.0% (n = 150). Among 81.3% (n = 122) who reported satisfaction, 82.8% were satisfied (n = 101). The intervention group had significantly lower retention than the control group at 6 months (68.3% vs. 81.8%, p = 0.04). A proficient MI intervention was delivered, but only 57.4% (n = 58) engaged in ≥6 MI sessions. The preliminary impact of the intervention showed promising trends, but there were no significant differences by group for any outcome measure at 6 or 12 months (p > 0.05).
Virtual MI-FP may improve accessibility for older adults to discuss fall prevention, but future studies are needed to improve retention and intervention completion.
预防跌倒的动机性访谈（MI-FP）研究旨在让老年人参与预防跌倒策略。我们报告MI-FP的可行性、干预保真度和初步影响。
我们在美国太平洋西北地区一家诊所对年龄≥65岁、跌倒风险高的初级保健患者进行了一项试点随机对照试验，以测试MI-FP。干预组在6个月内接受MI从业者进行的多达8次动机性访谈（MI），对照组接受标准护理。可行性定义为6个月时保留率≥75%且报告满意度≥75%。使用MI治疗完整性（MITI 4.2）编码方案，通过达到预先确定的MI熟练标准来评估干预保真度，且干预组≥75%的人完成≥6次MI访谈。在6个月和12个月时评估两组之间在对跌倒的担忧、参与预防跌倒的意愿、预防跌倒行为、身体功能和跌倒率方面的变化，以评估初步影响。
参与者（n = 200）的平均年龄为80岁，67%为女性。总体保留率为75.0%（n = 150）。在报告满意的81.3%（n = 122）中，82.8%表示满意（n = 101）。干预组在6个月时的保留率显著低于对照组（68.3%对81.8%，p = 0.04）。进行了熟练的MI干预，但只有57.4%（n = 58）的人参与了≥6次MI访谈。干预的初步影响显示出有希望的趋势，但在6个月或12个月时，两组在任何结局指标上均无显著差异（p>0.05）。
虚拟MI-FP可能会提高老年人讨论预防跌倒的可及性，但未来需要开展研究以提高保留率和干预完成率。
