Outcomes of a Physical Therapist-Led, Statewide, Community-Based Fall Risk Screening.

Abstract

Falls are the leading cause of morbidity and mortality among US older adults and result in considerable medical and social consequences. Community-based screenings are a type of intervention that provides accessible fall risk screening and education at no cost to the participants. However, little is known about whether or how participants change behavior after screening events. Therefore, the purpose of this study was to quantify and characterize participant risk-reducing behaviors after community-based fall risk screenings. Participants were recruited during 22 community-based fall risk screening events in 2017 led by physical therapists. The screenings were conducted using a modified version of the Centers for Disease Control and Prevention Stopping Elderly Accidents, Deaths, and Injuries (CDC STEADI) toolkit. Screenings included risk reduction education via group format and individual recommendations tailored to fall risk classification based on the screening outcomes. For the study, questionnaires were used at baseline to collect demographics and screening results and at 1-month and 5-month follow-up to assess risk reduction behavior change. Descriptive statistics characterized behavior change and assessed outcome differences by baseline fall risk level. Logistic regression analyses examined factors impacting behavior change after screening. At baseline, 123 participants enrolled and 104 (84.6%) responded at 1- and 5-month follow-up. By 1 month, 50.0% of participants had adopted at least 1 fall risk-reducing behavior, which increased to 64.9% by 5 months. Moderate or high fall risk was significantly associated with adopting a new behavior change by 5 months compared with those with low fall risk (P = .04). The odds of adopting a fall risk reduction strategy by 5 months increased with higher education (odds ratio: 2.5, 95% confidence interval: 1.0-6.0) and moderate/high fall risk (odds ratio: 3.0, 95% confidence interval: 1.3-7.2) in a logistic regression model adjusted by age and sex. Screening and education using the STEADI toolkit during community-based screenings result in short- and long-term behavior change to reduce fall risk among older adults, particularly those with moderate to high fall risk. Further research is needed to identify barriers and incentives among participants who do not make fall-related behavioral changes after screening.