Date Presented 4/19/2018
Using a mixed methods design, we examined knowledge of outdoor fall risks, outdoor fall experiences, and fall prevention practices among a random sample of 85 community-dwelling older adults who had sustained an outdoor fall. Results are informative for outdoor fall prevention practice.
Primary Author and Speaker: Tracy Chippendale
Contributing Authors: Victoria Raveis
BACKGROUND AND RATIONALE: The focus of fall prevention has been on indoor rather than outdoor falls. Given their negative impact on healthy aging, outdoor falls warrant further attention in research and practice (Kelsey et al., 2012; Li et al., 2006). The purpose of this study was to explore the experiences and fall prevention knowledge and practices of older adults who had sustained an outdoor fall.
METHOD: A mixed methods study design was used. Participant inclusion criteria were age 55 and older, English speaking, community dwelling, and able to ambulate outdoors independently with or without an assistive device. A cross-sectional survey using random digit telephone dialing in one U.S. city was conducted. The Outdoor Falls Questionnaire, a valid and reliable tool, was used as the survey instrument. One hundred participants were needed for a ±10% sampling error (Dillman, 2000). IBM SPSS Statistics Version 21 (IBM Corp., Armonk, NY) was used for descriptive quantitative analysis.
Phenomenological analysis was used for qualitative analysis of outdoor fall experiences. Two coders and the use of intercoder agreement were used to increase reliability of the analysis. Qualitative and quantitative data were analyzed separately and a mixed methods matrix used to interpret and integrate the findings.
RESULTS: Fifty-eight percent of potential participants for whom we could ascertain eligibility agreed to participate. Of the 120 people who completed the survey, 85 (71%) had sustained a fall outdoors. Results revealed diverse unmet education needs, including the importance of single vision glasses, risks associated with parks and parking lots, and how to report problems to the city. Maintaining a safe walking speed, carrying items on level and uneven surfaces, going up and down stairs, and opening doors safely warrant attention in outdoor fall prevention training.
CONCLUSION: Study findings revealed unmet education and training needs and are informative for prevention program development.
IMPACT STATEMENT: This study fills a gap in knowledge regarding outdoor fall prevention and can be used as a needs assessment to guide primary and secondary outdoor fall prevention programs and practice. The results of this study were used to inform the development of a manualized, occupational therapist–led, outdoor fall prevention program that is currently being implemented and studied.
References
Dillman, D. A. (2000). Mail and Internet surveys. New York: Wiley.
Kelsey, J. L., Proctor-Gray, E., Hannan, M. T., & Li, W. (2012). Heterogeneity of falls among older adults: Implications for public health prevention. American Journal of Public Health, 102, 2149–2156. https://doi.org/10.2105/AJPH.2012.300677
Li, W., Keegan, T. H. M., Sternfeld, B., Sidney, S., Quesenberry, C. P., & Kelsey, J. L. (2006). Outdoor falls among middle-aged and older adults: A neglected public health problem. American Journal of Public Health, 96, 1192–1199. https://doi.org/10.2105/AJPH.2005.083055
