Effectiveness of education and individualized counseling in reducing environmental hazards in the homes of community-dwelling older women.
OBJECTIVE
To test the effectiveness of an education and counseling intervention on reducing environmental hazards in the homes of older women.


METHODS
Secondary analysis from a randomized, controlled trial with two arms: fall prevention program and health education program (control). Environmental hazards were assessed at baseline and immediately posttreatment (12-weeks).


METHODS
Participants' homes.


METHODS
Two hundred seventy-two community-dwelling women aged 70 and older at risk for falling.


METHODS
The fall prevention program involved a comprehensive fall risk evaluation, exercise, education, individualized counseling, and referrals. The health education program included topics unrelated to fall prevention. With the exception of the fall risk evaluation conducted by a nurse practitioner, baccalaureate-prepared nurses carried out the interventions.


METHODS
Summed and individual scores for hazards related to the bathroom, floor surfaces, lighting, furniture, stairways, and storage areas.


RESULTS
Environmental hazards were found in all homes, with a baseline mean+/-standard deviation of 10.7+/-2.6 total hazards and range of four to 17 hazards. Analysis of within-group changes indicated that the fall prevention group had significantly fewer bathroom, lighting, and total hazards after the intervention, whereas the health education group had significantly fewer bathroom hazards but more floor hazards. At follow-up, the fall prevention group had significantly fewer lighting hazards and total hazards than the health education group.


CONCLUSIONS
Education and counseling have only modest effects in helping older women make recommended home modifications. To be most effective in reducing environmental hazards, fall prevention programs may need to provide and install safety devices.
Wyman
Jean F
JF
Center for Gerontological Nursing, School of Nursing, University of Minnesota, Minneapolis, Minnesota 55455, USA. wyman002@umn.edu
Croghan
Catherine F
CF
Nachreiner
Nancy M
NM
Gross
Cynthia R
CR
Stock
Holly Hatch
HH
Talley
Kristine
K
Monigold
Melinda
M
D000058:Accidental Falls / Q000517:prevention & control*; D000061:Accidents, Home / Q000517:prevention & control*; D000368:Aged; D003376:Counseling; D004777:Environment; D005260:Female; D006266:Health Education / Q000379:methods*; D006299:Health Services for the Aged; D006801:Humans; D008910:Minnesota; D012307:Risk Factors; D014505:Urban Population