title: Prevention of urinary incontinence in adults: population-based strategies.
abstract: BACKGROUND
  Urinary incontinence (UI) affects large numbers of adults, especially older adults, with an estimated 200 million adults worldwide having this life-altering condition.
  
  
  OBJECTIVE
  To identify key populations at risk for urinary incontinence and propose population-based strategies to promote continence with a substantive focus on UI prevention.
  
  
  METHODS
  Critical review of extant literature and iterative synthesis were undertaken to generate an action plan to guide future UI prevention research.
  
  
  RESULTS
  Key populations identified to be at risk for UI are women in selected occupations, childbearing women, older adults with lifestyle risk factors, older adults with comorbid conditions, and nursing home residents. Population-based research activities are proposed. Growing evidence supports the benefit of pelvic floor muscle training to prevent childbirth and prostatectomy-related UI. Bladder training has demonstrated preventive capacity.
  
  
  CONCLUSIONS
  Because of its high prevalence and chronic but preventable nature, UI is most appropriately considered a public health problem. Nursing research is needed to test prevention programs for UI using a population-based public health focus.
authors.affiliation: University of Michigan, Ann Arbor, USA. csampsll@umich.edu
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Sampselle
authors.forename: Mary H
authors.initials: MH
authors.lastname: Palmer
authors.forename: Alice R
authors.initials: AR
authors.lastname: Boyington
authors.forename: Katharine K
authors.initials: KK
authors.lastname: O'Dell
authors.forename: Leslie
authors.initials: L
authors.lastname: Wooldridge
mesh_terms: D000328:Adult; D000368:Aged; D001720:Birth Injuries / Q000150:complications / Q000534:rehabilitation; D002908:Chronic Disease; D018672:Community Health Planning / Q000458:organization & administration*; D017281:Cost of Illness; D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D014943:Global Health; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D020380:Needs Assessment / Q000458:organization & administration; D015399:Nursing Research / Q000458:organization & administration*; D017773:Pelvic Floor; D015995:Prevalence; D011322:Primary Prevention / Q000458:organization & administration*; D011468:Prostatectomy / Q000009:adverse effects / Q000534:rehabilitation; D011634:Public Health; D012107:Research Design; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*