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Icon: Multifaceted InterventionsMultifaceted Interventions: The SAFE Health Behavior and Exercise Intervention

Hornbrook, et al.

The Study of Accidental Falls in the Elderly (SAFE) health behavior intervention was a program of 4 group classes on how to prevent falls. The classes addressed environmental, behavioral, and physical risk factors and included exercise with instructions and supervised practice. The home safety portion included a home inspection with guidance and assistance in reducing fall hazards.

Overall, participants were 15 percent less likely to fall compared with those who did not receive the intervention. Male participants showed the greatest benefit.

Population

All were participants were 65 or older and lived in the community. About 60 percent of participants were female.

Geographic Locale

Portland, Oregon, and Vancouver, Washington, United State

Focus

Reduce risky behaviors, improve physical fitness through exercise, and reduce fall hazards in the home.

Program Setting

No information was available on where risk education and group exercise classes took place. Home safety inspections were conducted in participants’ homes.

Content

The SAFE health behavior intervention consisted of 4 1½-hour group classes that used a comprehensive approach to reducing fall risks. Classes addressed environmental, behavioral, and physical risk factors.

Classes included:

  • A slide presentation on common household risks
  • Discussions of behavioral risks such as walking on ice or using a chair to reach high places
  • A self-appraisal of home hazards using a specially designed form
  • Small group sessions during which participants worked together to develop action plans

Each class session also had an exercise component that included a brief demonstration of fall prevention exercises and about 20 minutes of supervised practice. Participants received a manual describing the exercises and were encouraged to begin walking at least 3 times a week. The exercises were chosen to: • Actively involve all parts of the body • Maintain full range of motion of all joints • Strengthen muscles • Improve posture • Improve balance During the home safety inspection, the assessor inspected the participant’s home and identified fall hazards using a standard protocol. The assessor encouraged the participant to remove or repair the hazards identified during this initial visit. The participant was also given fact sheets on how to obtain technical and financial assistance for making repairs and modifications to his or her home. After the 4 classes were completed, the assessor returned to the participant’s home to check on the progress of repairs and to offer financial and technical assistance if needed, as well as discounts on safety equipment.

Duration

  • Two home visits, each lasting about 15 minutes
  • Four weekly 1½-hour classes (including 20 minutes of supervised exercise) over a 1-month period

Delivered by

  • The home inspection was performed by a BA-level home assessor who was trained during a 2-day program that included practice assessments of elderly volunteers’ homes.
  • The fall prevention program and exercise sessions were delivered by MA-level lifestyle change experts with various backgrounds including health behavior change and sports training. Each group meeting was conducted by a team consisting of a lifestyle change expert and a physical therapist.

Minimum Level of Training Needed

Information was not provided by the principal investigator.

Key Elements

Information was not provided by the principal investigator.

Available Materials

No intervention materials were available for distribution at the time of publication. Please contact the principal investigator for information on how to obtain the exercise manual.

Study Citation

Hornbrook MC, Stevens VJ, Wingfield DJ, Hollis JF, Greenlick MR, Ory MG. Preventing falls among community-dwelling older persons: Results from a randomized trial. The Gerontologist. 1994 Feb;34(1):16-23.

Contact

Practitioners interested in using this intervention may contact the principal investigator for more information:

Mark C. Hornbrook, PhD
Chief Scientist
The Center for Health Research, NW/HI/SE
Kaiser Permanente Northwest
3800 North Interstate Avenue
Portland, OR 97227-1110, United States
Tel: 503-335-6746
Fax: 503-335-2428
E-mail: mark.c.hornbrook@kpchr.org

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