The European Journal of Public Health Advance Access originally published online on January 5, 2007
The European Journal of Public Health 2007 17(5):464-470; doi:10.1093/eurpub/ckl272
Prevention |
A multifactorial fall prevention programme in the community-dwelling aged: predictors of adherence
Noora Maria Sjösten1, Maritta Salonoja2, Maarit Piirtola1,3, Tero Juhani Vahlberg4, Raimo Isoaho1,5,6, Hanna Kristiina Hyttinen7, Pertti Toivo Aarnio2 and Sirkka-Liisa Kivelä1,2,8
1 The Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland
2 Satakunta Central Hospital, Pori, Finland
3 Lieto Health Center, Lieto, Finland
4 Biostatistics, University of Turku, Finland
5 Pori Health Center, Pori, Finland
6 Nordic School of Public Health, Gothenburg, Sweden
7 Satakunta University of Applied Sciences, Pori, Finland
8 Turku University Hospital, Unit of Family Medicine, Turku, Finland
Correspondence: Noora Sjösten, Institute of Clinical Medicine, Family Medicine, Lemminkäisenkatu 1, 20014 University of Turku, Finland, tel: +358-2-333-8485, fax: +358-2-333-8439, e-mail: nookau{at}utu.fi
Received August 8, 2006 , accepted December 5, 2006
Background: Overall adherence rates have usually been reported in fall prevention studies, but predictors of adherence have rarely been described. The aim of this study was to determine the adherence rates and the predictors of adherence in four key activities of a multifactorial fall prevention trial.
Methods: This study is part of a multifactorial fall prevention programme implemented among the 65-year-old or older community-dwelling aged who had fallen at least once during the previous 12 months. Subjects (n = 591) were randomly assigned to an intensive prevention programme or to a counselling group. Four key activities of prevention programme included physical exercise in small groups, psychosocial group activities, lectures and home exercises. Associations between adherence rates and potential predictors were analysed using cumulative logistic regression.
Results: The mean adherence rate was 58% in the physical exercise groups, 25% in the psychosocial groups and 33% in lectures. Subjects performed home-exercises on average 11 times per month. In multivariate analyses, infrequent feelings of loneliness, low self-perceived probability of falling at home and good physical functional abilities were significant predictors of active physical exercise group adherence. Good physical and cognitive functional abilities predicted active psychosocial group adherence. Female gender and good physical and cognitive functional abilities predicted more active lecture adherence.
Conclusion: Persons with the poorest physical, cognitive and psychological functional abilities representing the part of the population at highest risk of falling do not seem reachable in multifactorial risk-based intervention.
Keywords: adherence, fall prevention, multifactorial, aged, predictor