A Mixed-Methods Evaluation of a Fall Prevention Program at a Continuing Care Retirement Community

Background\ud \ud One-third of Americans over age 65 experience a fall each year. Risk of falling increases with age, thus individuals over the age of 80 are more prone to experience falls. Falling is a major public health concern due to its costly and disabling consequences.\ud \ud Falls result from an interaction between environmental hazards and inadequate physiology to cope with the hazards. Most fall risk factors are modifiable and preventable. The common threads throughout the literature suggest that in order to ensure fall prevention efforts are effective, interventions should be multi-factorial (containing educational, behavioral change and exercise components) and individualized as much as possible.\ud \ud Fall prevention research with seniors who are community-dwelling or institutionalized is plentiful. However, fall prevention efforts in continuing care retirement community (CCRC) settings are under-studied. \ud \ud The primary purpose of this study was to evaluate the influence of a fall prevention program (called Seniorcize) on the reduction of fall risk factors among high-functioning residents at Asbury Heights, a CCRC, in Pittsburgh, PA. A secondary purpose of this study was to examine the contextual factors at the study site, which influence program participation.\ud \ud Methods\ud \ud Quantitative data were collected and analyze on dependent variables (balance, gait, fear of falling and depression) for 82 high-functioning Asbury Heights residents. Outcomes from Seniorcize participants were compared with non-participants. To explore facilitators and barriers to program participation, qualitative data were also collected via interviews with key informants and two focus groups—one with Seniorcize participants and one with non-participants. \ud \ud Results\ud \ud Outcomes on the dependent variables were not significantly different between the group of Seniorcize participants and the group of non-participants. The frequency of program participation was only significantly related to depression. Male subjects had significantly less fear of falling than females.\ud \ud Facilitators to program participation pertained to staff, equipment, class offerings, and publicity. Barriers included pre-conceived notions of Seniorcize participants, competing priorities, and limited personnel.\ud \ud Public Health Significance \ud \ud CCRCs need to examine the individualized needs and motivations of high-functioning residents. Interventions should include customized education and behavioral assessments, in addition to exercise routines.\u