title: What factors influence older adults to discuss falls with their health-care providers?
abstract: OBJECTIVE
  To identify from the older adults' perspective, the factors associated with discussion about falls with their general practitioners and other health professionals and the factors associated with initiation of these discussions. We explored the content of and barriers to discussion about falls.
  
  
  METHODS
  A prospective cohort study where a baseline cross-sectional survey was followed by a survey 1 year later. Survey domains were drawn from constructs of behavioural change models. Data from 245 older community dwellers in Victoria, Australia, in the follow-up survey were used for this study. Survey format consisted of yes and no responses, Likert scale and open/closed-ended responses.
  
  
  RESULTS
  Few older adults talked with and initiated a talk with their health-care providers about falls in the follow-up period. Multiple regression showed anxiety or depression [OR = 2.78, 95% CI (1.21-6.41)], chronic medical conditions such as diabetes [OR = 2.71, 95% CI (1.19-6.17)] and having a self-reported fall in the last 12 months [OR = 4.26, 95% CI (2.16-8.41)] were associated with discussion of falls with general practitioners. Higher perception of risk of sustaining a serious injury from falling [OR = 1.49 (1.03-2.13)] was associated with discussion about falls with other health professionals. Participants discussed various topics of falls with their health-care providers. Different barriers to discussion about falls were identified.
  
  
  CONCLUSIONS
  Health-care providers should routinely discuss falls prevention with older adults. Dissemination of evidence-based advice and followed up with referral during consultations, particularly in general practitioners could advance falls prevention practice. The results could help to develop a conceptual framework to predict the likelihood of falls discussion.
authors.affiliation: Allied Health Research Unit, Kingston Centre, Monash Health, Cheltenham, Vic., Australia.
authors.forename: Den-Ching A
authors.initials: DC
authors.lastname: Lee
authors.affiliation: Monash Injury Research Institute, Monash University, Clayton, Vic., Australia.
authors.forename: Lesley
authors.initials: L
authors.lastname: Day
authors.affiliation: Faculty of Health Sciences, School of Physiotherapy, Curtin University, Bentley, WA, Australia.
authors.forename: Keith
authors.initials: K
authors.lastname: Hill
authors.affiliation: Occupational Therapy Department, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia.
authors.forename: Lindy
authors.initials: L
authors.lastname: Clemson
authors.affiliation: Social Work Department, Faculty of Medicine, Nursing and Health Sciences, Monash University, Caulfield East, Vic., Australia.|Social Work Department, Monash Medical Centre, Monash Health, Clayton, Vic., Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: McDermott
authors.affiliation: Allied Health Research Unit, Kingston Centre, Monash Health, Cheltenham, Vic., Australia.|Physiotherapy Department, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Vic., Australia.
authors.forename: Terry P
authors.initials: TP
authors.lastname: Haines
mesh_terms: D000056:Accident Prevention / Q000379:methods; D000058:Accidental Falls / Q000517:prevention & control*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D058005:General Practitioners; D006801:Humans; D057187:Independent Living; D011446:Prospective Studies; D014739:Victoria
keywords: barriers; discussions; falls prevention; health-care providers; older adults