Wagner, et al.
This study tested a moderate-intensity intervention that used tailored strategies based on assessments of each participant’s risk factors. After 1 year, participants were 10 percent less likely to fall and 5 percent less likely to have an injurious fall, compared with people who received usual medical care.
All participants were 65 or older and lived in the community. About 60 percent of participants were female.
Seattle, Washington, United States
Reduce disability and/or falls by: improving physical fitness, modifying excessive alcohol use, improving home safety, reducing psychoactive medication use, and improving hearing and vision.
Participants received the assessments and interventions from a nurse at local health maintenance organization (HMO) centers. Participants conducted a home assessment or had it done by a family member or volunteer.
The assessments consisted of simple screening tests for 6 risk factors. The intervention content varied based on the individual’s risk factors.
|Inadequate exercise||Participated in a 2-hour exercise orientation class testing fitness, given exercise instruction, and encouraged to begin a program of brisk walking|
|Use of psychoactive drug||Reviewed medications using a pharmacist and sent written recommendations to the participant’s primary care provider|
|Impaired vision||Corrected when possible. Participants with uncorrectable visual impairments received information about available community resources|
|Impaired hearing||Had a hearing aid evaluation. Program provided behavioral intervention classes for participants with uncorrectable deficits|
|Excessive alcohol use||Referred to an alcohol treatment program if alcoholism was suspected, or given an instructional booklet that provided strategies for limiting use|
|Home hazards||Assessed home safety using an instructional home safety checklist|
The initial visit consisted of a 1- to 1½-hour interview. The length and number of subsequent sessions varied by the type of interventions selected for each participant.
The program was delivered by a single nurse educator who received brief training by the research team. There was no formal curriculum because only 1 nurse was involved. Either trained volunteers or participants’ family members completed the home safety assessment using the provided checklist.
Information was not provided by the principal investigator.
The nurse’s follow-up phone contacts and home visits may have had positive effects on participants’ health that were independent of the interventions for specific risk factors.
No intervention materials were available for distribution at the time of publication.
Wagner EH, LaCroix AZ, Grothaus L, Leveille SG, Hecht J, Artz K, Odle K, Buchner DM. Preventing disability and falls in older adults: A population-based randomized trial. American Journal of Public Health. 1994 Nov;84(11):1800-6.
Practitioners interested in using this intervention may contact the principal investigator for more information:
Edward H. Wagner, MD, MPH
Group Health Research Institute
1730 Minor Avenue, Ste. 1290
Seattle, WA 98101, United States
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