Clinical Interventions in Aging (Mar 2024)
Evaluation of a Fall Prevention Program to Reduce Fall Risk and Fear of Falling Among Community-Dwelling Older Adults and Adults with Disabilities
Abstract
Melissa Hawkins,1 Tori Goldhammer,2 Robin McClave,1 Edwinta Jenkins-Smith3 1Department of Health Studies, American University, Washington, DC, USA; 2Safe at Home Program, Home Care Partners, Washington, DC, USA; 3Department of Aging and Community Living, District of Columbia Department of Health, Washington, DC, USACorrespondence: Melissa Hawkins, Department of Health Studies, American University, McCabe Hall Room 222, 4400 Massachusetts Avenue NW, Washington, DC, 20016, USA, Tel +1 202-885-6252, Email [email protected]: The overarching goal of the program evaluation was to determine the reach and impact of the District-funded Safe At Home (SAH) modification program in reducing falls, fall injuries, and fear of falls among community-dwelling older adults and adults with disabilities. The SAH program has served over 6000 adults since 2016, the majority of whom are women (79%) and over age 60 (92%).Materials and Methods: Letters were mailed in September 2022 to clients (n=492) who had home modifications completed between October 2021-March 2022 inviting them to participate in a brief phone survey about program satisfaction, falls, fall location, and severity. The validated Fall Efficacy Scale (FES) was administered pre (at first visit), post (at last visit), and during the phone survey (within 6 months to 1 year of program completion) to assess fear of falling. The response rate was 55% (n=241).Results: Older adults (n=219) and adults with disabilities (n=22) reported high program satisfaction. Most clients, 79%, did not report a fall since the completion of the home modifications. The majority of falls reported, 76%, occurred inside the home. The average evaluation FES score was 32.5 (SD=22.6, range 10– 100), indicating relatively low fear of falling. Higher FES scores were associated with a greater likelihood of reporting a fall (r=0.44, p < 0.001, n=51) and older age (r = 0.17, p < 0.01). FES scores were not related to gender. Evaluation FES scores were significantly lower than the pre-FES scores, indicating a reduction in fear of falling and positive impact of the home modifications (T(107) = 5.14, p < 0.001).Conclusion: The client-centered SAH program demonstrates significant reductions in falls, fear of falling, and high satisfaction among clients. Recommendations include program expansion to offer other evidence-based components to reduce falls and support safe aging in place.Keywords: program evaluation, home modification, fall efficacy scale, FES, injury, prevention, independent living
