Evaluation of tailored falls education on older adults’ behavior following hospitalization

Chiara Naseri, Steven McPhail, Terry P. Haines, Meg Morris, Christopher Etherton-Beer, Ron Shorr, Leon Flicker, Max Bulsara, Julie Netto, Den-Ching Angel Lee, Jacqueline Francis-Coad, Nicholas Waldron, Amanda Boudville, Anne-Marie Hill

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND: Older adults recently discharged from the hospital are known to be at risk of functional decline and falls. This study evaluated the effect of a tailored education program provided in the hospital on older adult engagement in fall prevention strategies within 6 months after hospital discharge. METHODS: A process evaluation of a randomized controlled trial that aimed to improve older adult fall prevention behaviors after hospital discharge. Participants (n = 390) were aged 60years and older with good cognitive function (greater than 7 of 10 Abbreviated Mental Test Score), discharged home from three hospital rehabilitation wards in Perth, Australia. The primary outcomes were engagement in fall prevention strategies, including assistance with daily activities, home modifications, and exercise. Data were analyzed using generalized linear modeling. RESULTS: There were 76.4% (n = 292) of participants who completed the final interview (n = 149 intervention, n = 143 control). There were no significant differences between groups in engagement in fall prevention strategies, including receiving instrumental activity of daily living (IADL) assistance (adjusted odds ratio [AOR] = 1.3 [95% confidence interval {CI} = 0.7-2.1]; P = .3), completion of home modifications (AOR = 1.2 [95% CI = 0.7-1.9]; P = .4), and exercise (AOR = 1.3 [95% CI = 0.7-2.2]; P = .3). There was a high proportion of unmet ADL needs within both groups, and levels of participant dependency remained higher at 6 months compared to baseline levels at admission. The proportion of all participants who engaged in exercise following hospital discharge increased by 30%; however, the mean duration of exercise reduced from 3 hours per week at baseline to 1 hour per week at 6-month follow-up (SD = 1.12 hours per week). CONCLUSION: Tailored education did not increase older adult engagement in fall prevention strategies after hospital discharge compared to usual care. Further research is required to evaluate older adults' capacity to change their behaviors once they return home from hospital, which may enable a safer recovery of their independence.
Original languageEnglish
Number of pages8
JournalJournal of the American Geriatrics Society
DOIs
Publication statusAccepted/In press - 2 Jul 2019

Cite this

Naseri, Chiara ; McPhail, Steven ; Haines, Terry P. ; Morris, Meg ; Etherton-Beer, Christopher ; Shorr, Ron ; Flicker, Leon ; Bulsara, Max ; Netto, Julie ; Lee, Den-Ching Angel ; Francis-Coad, Jacqueline ; Waldron, Nicholas ; Boudville, Amanda ; Hill, Anne-Marie. / Evaluation of tailored falls education on older adults’ behavior following hospitalization. In: Journal of the American Geriatrics Society. 2019.
@article{9f9552641c324d2ea9fb819b4cc12d2f,
title = "Evaluation of tailored falls education on older adults’ behavior following hospitalization",
abstract = "BACKGROUND: Older adults recently discharged from the hospital are known to be at risk of functional decline and falls. This study evaluated the effect of a tailored education program provided in the hospital on older adult engagement in fall prevention strategies within 6 months after hospital discharge. METHODS: A process evaluation of a randomized controlled trial that aimed to improve older adult fall prevention behaviors after hospital discharge. Participants (n = 390) were aged 60years and older with good cognitive function (greater than 7 of 10 Abbreviated Mental Test Score), discharged home from three hospital rehabilitation wards in Perth, Australia. The primary outcomes were engagement in fall prevention strategies, including assistance with daily activities, home modifications, and exercise. Data were analyzed using generalized linear modeling. RESULTS: There were 76.4{\%} (n = 292) of participants who completed the final interview (n = 149 intervention, n = 143 control). There were no significant differences between groups in engagement in fall prevention strategies, including receiving instrumental activity of daily living (IADL) assistance (adjusted odds ratio [AOR] = 1.3 [95{\%} confidence interval {CI} = 0.7-2.1]; P = .3), completion of home modifications (AOR = 1.2 [95{\%} CI = 0.7-1.9]; P = .4), and exercise (AOR = 1.3 [95{\%} CI = 0.7-2.2]; P = .3). There was a high proportion of unmet ADL needs within both groups, and levels of participant dependency remained higher at 6 months compared to baseline levels at admission. The proportion of all participants who engaged in exercise following hospital discharge increased by 30{\%}; however, the mean duration of exercise reduced from 3 hours per week at baseline to 1 hour per week at 6-month follow-up (SD = 1.12 hours per week). CONCLUSION: Tailored education did not increase older adult engagement in fall prevention strategies after hospital discharge compared to usual care. Further research is required to evaluate older adults' capacity to change their behaviors once they return home from hospital, which may enable a safer recovery of their independence.",
author = "Chiara Naseri and Steven McPhail and Haines, {Terry P.} and Meg Morris and Christopher Etherton-Beer and Ron Shorr and Leon Flicker and Max Bulsara and Julie Netto and Lee, {Den-Ching Angel} and Jacqueline Francis-Coad and Nicholas Waldron and Amanda Boudville and Anne-Marie Hill",
year = "2019",
month = "7",
day = "2",
doi = "10.1111/jgs.16053",
language = "English",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
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Naseri, C, McPhail, S, Haines, TP, Morris, M, Etherton-Beer, C, Shorr, R, Flicker, L, Bulsara, M, Netto, J, Lee, D-CA, Francis-Coad, J, Waldron, N, Boudville, A & Hill, A-M 2019, 'Evaluation of tailored falls education on older adults’ behavior following hospitalization', Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.16053

Evaluation of tailored falls education on older adults’ behavior following hospitalization. / Naseri, Chiara; McPhail, Steven ; Haines, Terry P.; Morris, Meg; Etherton-Beer, Christopher; Shorr, Ron; Flicker, Leon; Bulsara, Max; Netto, Julie; Lee, Den-Ching Angel; Francis-Coad, Jacqueline; Waldron, Nicholas; Boudville, Amanda; Hill, Anne-Marie.

In: Journal of the American Geriatrics Society, 02.07.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Evaluation of tailored falls education on older adults’ behavior following hospitalization

AU - Naseri, Chiara

AU - McPhail, Steven

AU - Haines, Terry P.

AU - Morris, Meg

AU - Etherton-Beer, Christopher

AU - Shorr, Ron

AU - Flicker, Leon

AU - Bulsara, Max

AU - Netto, Julie

AU - Lee, Den-Ching Angel

AU - Francis-Coad, Jacqueline

AU - Waldron, Nicholas

AU - Boudville, Amanda

AU - Hill, Anne-Marie

PY - 2019/7/2

Y1 - 2019/7/2

N2 - BACKGROUND: Older adults recently discharged from the hospital are known to be at risk of functional decline and falls. This study evaluated the effect of a tailored education program provided in the hospital on older adult engagement in fall prevention strategies within 6 months after hospital discharge. METHODS: A process evaluation of a randomized controlled trial that aimed to improve older adult fall prevention behaviors after hospital discharge. Participants (n = 390) were aged 60years and older with good cognitive function (greater than 7 of 10 Abbreviated Mental Test Score), discharged home from three hospital rehabilitation wards in Perth, Australia. The primary outcomes were engagement in fall prevention strategies, including assistance with daily activities, home modifications, and exercise. Data were analyzed using generalized linear modeling. RESULTS: There were 76.4% (n = 292) of participants who completed the final interview (n = 149 intervention, n = 143 control). There were no significant differences between groups in engagement in fall prevention strategies, including receiving instrumental activity of daily living (IADL) assistance (adjusted odds ratio [AOR] = 1.3 [95% confidence interval {CI} = 0.7-2.1]; P = .3), completion of home modifications (AOR = 1.2 [95% CI = 0.7-1.9]; P = .4), and exercise (AOR = 1.3 [95% CI = 0.7-2.2]; P = .3). There was a high proportion of unmet ADL needs within both groups, and levels of participant dependency remained higher at 6 months compared to baseline levels at admission. The proportion of all participants who engaged in exercise following hospital discharge increased by 30%; however, the mean duration of exercise reduced from 3 hours per week at baseline to 1 hour per week at 6-month follow-up (SD = 1.12 hours per week). CONCLUSION: Tailored education did not increase older adult engagement in fall prevention strategies after hospital discharge compared to usual care. Further research is required to evaluate older adults' capacity to change their behaviors once they return home from hospital, which may enable a safer recovery of their independence.

AB - BACKGROUND: Older adults recently discharged from the hospital are known to be at risk of functional decline and falls. This study evaluated the effect of a tailored education program provided in the hospital on older adult engagement in fall prevention strategies within 6 months after hospital discharge. METHODS: A process evaluation of a randomized controlled trial that aimed to improve older adult fall prevention behaviors after hospital discharge. Participants (n = 390) were aged 60years and older with good cognitive function (greater than 7 of 10 Abbreviated Mental Test Score), discharged home from three hospital rehabilitation wards in Perth, Australia. The primary outcomes were engagement in fall prevention strategies, including assistance with daily activities, home modifications, and exercise. Data were analyzed using generalized linear modeling. RESULTS: There were 76.4% (n = 292) of participants who completed the final interview (n = 149 intervention, n = 143 control). There were no significant differences between groups in engagement in fall prevention strategies, including receiving instrumental activity of daily living (IADL) assistance (adjusted odds ratio [AOR] = 1.3 [95% confidence interval {CI} = 0.7-2.1]; P = .3), completion of home modifications (AOR = 1.2 [95% CI = 0.7-1.9]; P = .4), and exercise (AOR = 1.3 [95% CI = 0.7-2.2]; P = .3). There was a high proportion of unmet ADL needs within both groups, and levels of participant dependency remained higher at 6 months compared to baseline levels at admission. The proportion of all participants who engaged in exercise following hospital discharge increased by 30%; however, the mean duration of exercise reduced from 3 hours per week at baseline to 1 hour per week at 6-month follow-up (SD = 1.12 hours per week). CONCLUSION: Tailored education did not increase older adult engagement in fall prevention strategies after hospital discharge compared to usual care. Further research is required to evaluate older adults' capacity to change their behaviors once they return home from hospital, which may enable a safer recovery of their independence.

U2 - 10.1111/jgs.16053

DO - 10.1111/jgs.16053

M3 - Article

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

ER -