Health Promotion International, Vol. 15, No. 1, 27-33,
March 2000
© Oxford University Press 2000
Older people can stay on their feet: final results of a community-based falls prevention programme
Northern Rivers Institute of Health and Research, Northern Rivers Area Health Service, New South Wales, Australia
Address for correspondence: Tim Sladden, Northern Rivers Institute of Health and Research, PO Box 498, Lismore, NSW 2480, Australia, E-mail: tslad{at}doh.health.nsw.gov.au
Objective: To evaluate a multi-strategic community-based intervention to prevent older people falling.
Design: A prospective cohort study comparing randomly selected samples from intervention and control area target populations (residents over 60 years). Repeat, cross-sectional (annual) reviews of fall-related hospitalizations were also conducted providing an independent measure of falls incidence in the target populations.
Setting: North Coast of New South Wales, Australia (a large, rural region).
Subjects: Cohort study (1991–1995): randomly selected subjects aged 60 years and over, enrolled via telephone interview into intervention and control area cohorts. Cross-sectional study (1991/1992–1994/1995): all residents aged 60 years and over, from intervention and control areas hospitalized with fall-related injuries.
Intervention: A 4-year (1992–1995) multi-strategic intervention targeting fall-related knowledge, attitudes, behaviours and risk factors.
Main outcome measures: Self-reported falls and fall-related hospitalization incidence rates. Fall-related knowledge, attitudes, behaviours and risk factor prevalence rates.
Results: At follow-up there was a 22% non-significant lower incidence of self-reported falls in the intervention compared to the control cohort (p = 0.17). This was supported by a 20% lower fall-related hospitalization rate in target group residents from intervention compared to control areas (p < 0.01). Increased falls knowledge, physical activity and safe footwear were also observed in the intervention cohort together with improved balance and reduced intake of fall-related medications.
Conclusions: Promotion of appropriate behaviours, environments and policies can improve fall-related outcomes given a commitment to involvement of older people and sufficient lead time.
Key words: community-based prevention; falls; injury; older people
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