[Managing concerns about falls in older people: evaluation of the implementation of an evidence-based program].
BACKGROUND
A cognitive behavioral program reduced concerns about falling and related avoidance behavior among older community-dwelling adults in a randomized controlled trial. In the current study we examined the effects and acceptability of the program after nation-wide implementation into home care organizations in The Netherlands.


METHODS
In a one-group pretest-posttest study with data collection before the start of the program and at 2 and 4 months, the effects and acceptability of the program were assessed in 125 community-dwelling older people. The outcomes of the effect evaluation included concerns about falls, related avoidance behavior, falls, fall-related medical attention, feelings of anxiety, symptoms of depression, and loneliness.


RESULTS
Pretest-posttest analyses with the Wilcoxon signed-rank test and the paired t-test showed significant improvements at 4 months for concerns about falls, activity avoidance, number of falls in the past 2 months, feelings of anxiety, and symptoms of depression. No significant differences were shown for the other outcomes.


CONCLUSIONS
After implementation in home care organizations, the outcomes indicate positive program effects on concerns about falls, avoidance behavior, and falls in community-dwelling older people. Given the similarity in results, i.e. between those of the previously performed randomized controlled trial and those of the current pretest-posttest study, we conclude that the program can be successfully implemented in practice. This article is an adjusted, Dutch version of Zijlstra GA, van Haastregt JC, Du Moulin MF, de Jonge MC, van der Poel A, Kempen GI. Effects of the implementation of an evidenc-based program to manage concerns about falls in older adults. The Gerontologist 2013;53(5):839-849; doi: 10.1093/geront/gns142.
Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands, r.zijlstra@maastrichtuniversity.nl.
G A R
GA
Zijlstra
M F M T
MF
Du Moulin
J C M
JC
van Haastregt
M
M
de Jonge
G I J M
GI
Kempen
A
A
van der Poel
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy / Q000379:methods; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic