Efficacy of the Stroll Safe Outdoor Fall Prevention Program: A Randomized Controlled Trial

Gerontologist. 2022 Sep 23:gnac145. doi: 10.1093/geront/gnac145. Online ahead of print.


BACKGROUND AND OBJECTIVES: Outdoor falls can negatively impact the independence and well-being of community-dwelling older adults. Although there is some overlap, there are also differences in risk factors for indoor and outdoor falls. There are no existing community-based fall prevention programs that specifically target outdoor fall prevention. To fill this gap, the Stroll Safe program was developed.

RESEARCH DESIGN AND METHODS: A cluster randomized controlled trial design was used with randomization at the site level. Participants (N=86) were age 60 and older, with a history of an outdoor fall or who had a fear of falling outdoors. Eight naturally occurring retirement community program sites (NORC SSPs) were randomly assigned to the treatment or wait list control group. Outcome measures included the Outdoor Falls Questionnaire (OFQ), the Falls Behavioural Scale for the older Person (FaB), and the Falls Efficacy Scale-International (FES-I) to examine knowledge of risks, safe strategy use, protective behaviors, and fear of falling. An ANCOVA was used to compare change scores between groups with covariates included for any initial differences between groups. A linear mixed model was also conducted to account for any clustering effects.

RESULTS: Significant differences (ps<.05) were found between groups for knowledge of outdoor fall risks and safe strategy use. Effect sizes were large (Cohen’s d=1.2-1.9). Results were retained at 6-week follow up.

DISCUSSION AND IMPLICATIONS: Stroll Safe is effective in improving knowledge of outdoor fall risks and increasing safe strategy use for community mobility. Stroll Safe fills a gap in outdoor fall prevention programs.

PMID:36148513 | DOI:10.1093/geront/gnac145

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