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      Effects of a Health Education Program on Fall Risk Prevention among the Urban Elderly: A Quasi-Experimental Study

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          Abstract

          Background:

          Elderly falls increase dramatically with age and are a leading cause of injury, carrying a risk of loss of independence and death. We studied the effects of a health education program on fall-risk prevention among urban elderly persons in the municipality of Khon Kaen, Thailand.

          Methods:

          A quasi-experimental study was conducted in 2 communities. The calculated sample size was 216 individuals: 108 for intervention and 108 for control, all of whom were 60 or older, and registered at the Samlium Primary Care Unit (SPCU). The educational intervention was a fall risk intervention program by an elderly buddy. A structured questionnaire that incorporated questions from the Thai Fall Risk Assessment Tool (Thai-FRAT) was used to collect general and specific information. Data were analyzed using the independent sample t -test and χ 2, with P<0.05 being statistically significant.

          Results:

          The response rate was 94.4%. More than half of the respondents were at risk of a fall. The prevalence of risk of a fall among the intervention group was slightly less than that for those within the control group [Intervention group=52.9% (95%CI: 42.85, 62.81, P<0.001); Control group=60.8% (95%CI: 50.59, 70.15, P=0.016)]. After 6 months of intervention, the balance impairment, medicine usage, and overall proportion with risk of fall were decreased. The difference between the intervention and control groups was statistically significant ( P<0.05).

          Conclusion:

          The provision of a health education program designed for fall risk prevention among the elderly would be a useful public health initiative.

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          Most cited references33

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          Interventions for preventing falls in older people living in the community

          Cochrane Database of Systematic Reviews
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            The Health Belief Model: a decade later.

            Since the last comprehensive review in 1974, the Health Belief Model (HBM) has continued to be the focus of considerable theoretical and research attention. This article presents a critical review of 29 HBM-related investigations published during the period of 1974-1984, tabulates the findings from 17 studies conducted prior to 1974, and provides a summary of the total 46 HBM studies (18 prospective, 28 retrospective). Twenty-four studies examined preventive-health behaviors (PHB), 19 explored sick-role behaviors (SRB), and three addressed clinic utilization. A "significance ratio" was constructed which divides the number of positive, statistically-significant findings for an HBM dimension by the total number of studies reporting significance levels for that dimension. Summary results provide substantial empirical support for the HBM, with findings from prospective studies at least as favorable as those obtained from retrospective research. "Perceived barriers" proved to be the most powerful of the HBM dimensions across the various study designs and behaviors. While both were important overall, "perceived susceptibility" was a stronger contributor to understanding PHB than SRB, while the reverse was true for "perceived benefits." "Perceived severity" produced the lowest overall significance ratios; however, while only weakly associated with PHB, this dimension was strongly related to SRB. On the basis of the evidence compiled, it is recommended that consideration of HBM dimensions be a part of health education programming. Suggestions are offered for further research.
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              Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention.

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                Author and article information

                Journal
                Iran J Public Health
                Iran. J. Public Health
                IJPH
                IJPH
                Iranian Journal of Public Health
                Tehran University of Medical Sciences
                2251-6085
                2251-6093
                January 2019
                : 48
                : 1
                : 103-111
                Affiliations
                [1. ]Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
                [2. ]Mahidol University Amnatchareon Campus, Amnatcharoen, Thailand
                Author notes
                [* ] Corresponding Author: Email: spiyat@ 123456kku.ac.th
                Article
                ijph-48-103
                10.18502/ijph.v48i1.788
                6401575
                30847317
                f9b97756-b9c2-4190-a00c-2f478c83cdb2
                Copyright© Iranian Public Health Association & Tehran University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 September 2017
                : 10 December 2017
                Categories
                Original Article

                Public health
                health education,fall risk prevention,elderly
                Public health
                health education, fall risk prevention, elderly

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