title: Predictors of and health- and fall-related program outcomes resulting from complete and adequate doses of a fall risk reduction program.
abstract: Falls are dangerous and costly for older adults. The A Matter of Balance/Volunteer Lay Leader (AMOB/VLL) program is an evidence-based fall risk reduction program that could help reduce this burden. This study introduced a door-through-door transportation program to improve program delivery (N = 126). Characteristics predicting completion of all eight AMOB/VLL sessions were identified using logistic regression. Individual growth models were employed to determine the immediate, intermediate, and long-term goal outcomes resulting from receiving an adequate dose of the program (five to eight sessions). Self-restriction of activities due to fear of falling (OR 5.04, 95 % CI 1.86-13.69) and a lower frequency of moderate and vigorous physical activity (OR 1.14, 95 % CI 1.04-1.27) were significantly predictive of receiving a complete dose. Three outcome goals were significant, including (1) immediate-improved self-efficacy of managing medications and treatments, (2) intermediate-reduced activity limitations, and (3) intermediate-reduced physical disability. Self-restriction of activities due to a fear of falling and physical activity levels may be simple and effective screening questions to prevent AMOB/VLL attrition. In our study, those who did receive the program improved on a specific type of self-efficacy and on self-reported physical functioning.
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., Room 512, New York, NY, 10032, USA. tjm2141@columbia.edu.
authors.forename: Thelma J
authors.initials: TJ
authors.lastname: Mielenz
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., Room 512, New York, NY, 10032, USA.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Durbin
authors.affiliation: ARC XVI Fort Washington, Inc. (ARC), New York, NY, USA.
authors.forename: Fern
authors.initials: F
authors.lastname: Hertzberg
authors.affiliation: ARC XVI Fort Washington, Inc. (ARC), New York, NY, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Nobile-Hernandez
authors.affiliation: Department of Biostatistics (in Nursing), Columbia University Medical Center, New York, NY, USA.
authors.forename: Haomiao
authors.initials: H
authors.lastname: Jia
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D015444:Exercise; D005239:Fear; D005260:Female; D006040:Goals; D006293:Health Promotion; D006801:Humans; D016015:Logistic Models; D008297:Male; D040242:Risk Reduction Behavior; D020377:Self Efficacy; D057566:Self Report; D012959:Socioeconomic Factors; D016896:Treatment Outcome
keywords: Community-based interventions; Evidence-based programs; Fall prevention; Fall risk reduction program; Older adults; Program adherence