Systematic review and meta-analysis of fear of falling and fall-related efficacy in a widely disseminated community-based fall prevention program |
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| Institution: | 1. Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA;2. Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX 77843, USA;3. Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843, USA;4. Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA 30602, USA;1. Institute of Management and Department EMbeDS, Management and Health Laboratory, Scuola Superiore Sant’Anna, Pisa, Italy;2. Social and Political Sciences Department, Università Bocconi, Milan, Italy;3. CERGAS-SDA, Università Bocconi, Milan, Italy;4. Geriatric Institute “Camillo Golgi”, ASP Golgi Redaelli, Abbiategrasso, Milan, Italy;5. Golgi Cenci Foundation, Abbiategrasso, Milan, Italy;1. Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea;2. Institute of Health Promotion and Policy, Dankook University, Cheonan, Republic of Korea;3. Department of Psychology and Psychotherapy, College of Health Science, Dankook University, Cheonan, Republic of Korea;1. Department of Psychiatry, University Health Network and University of Toronto, Toronto, Ontario, Canada;2. Department of Family and Community Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada;3. Falls Prevention Program, University Health Network, Toronto, Ontario, Canada;4. Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada;5. Department of Surgery, Institute of Biomaterials and Biomedical Engineering, and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada;6. Regional Geriatric Program of Toronto, Division of Geriatric Medicine, Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Toronto, Ontario, Canada;1. Department of Health Promotion and Behavior, The University of Georgia College of Public Health, Athens, Georgia;2. Department of Epidemiology and Biostatistics, Texas A&M Health Science Center School of Public Health, College Station, Texas;3. Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis, Tennessee;4. Department of Statistics, Texas A&M University, College Station, Texas;5. Baylor Scott & White Health, Texas A&M Health Science Center School of Public Health, College Station, Texas;6. Texas A&M Health Science Center School of Public Health, College Station, Texas |
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| Abstract: | BackgroundFear of falling restricts mobility and increases fall risk among older adults. Fall-related efficacy (i.e. the confidence to perform activities without falling), a construct related to fear of falling, has also been associated with active living and fall prevention. This study statistically synthesized the program effects of A Matter of Balance Volunteer Lay Leader (AMOB/VLL) model, designed to improve fall-related efficacy and promote daily activities among community-dwelling older adults.MethodsResearch articles and doctoral dissertations that examined the effect of the AMOB/VLL on fear of falling and fall-related efficacy were searched from multiple databases. A random effects model was used to compute mean weighted effect sizes, 95 % CIs, and heterogeneity (I2). Bias was examined through a funnel plot and Egger’s test. Factors associated with heterogeneity were also explored.ResultsSeventeen AMOB/VLL studies involving 3,860 participants were identified. The pooled effects of the 13 studies with sufficient information for effect size calculation, were ?0.29 (95 % CI: ?0.40, ?0.19) for fear of falling and 0.51 (95 % CI: 0.42, 0.60) for fall-related efficacy. Effect sizes differed partially due to outcome measures of fall-related efficacy. Covariate adjustment and study quality were not associated with differences in effect sizes. No substantial evidence of asymmetry and publication bias was found.ConclusionThis study provides evidence supporting AMOB/VLL as an effective intervention for reducing fear of falling and improving fall-related efficacy. A greater consistency in outcome measures is needed to optimally capture changes in fear of falling and fall-related efficacy among community-dwelling older adults. |
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| Keywords: | Fear of falling Efficacy Intervention Meta-analysis Fall management |
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