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Am J Public Health. 2014 May;104(5):e77-84. doi: 10.2105/AJPH.2013.301829. Epub 2014 Mar 13.

Primary prevention of falls: effectiveness of a statewide program.

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Steven M. Albert and Jennifer King are with the Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Robert Boudreau, Tanushree Prasad, and Anne B. Newman are with the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh. Chyongchiou J. Lin is with the Department of Family Medicine, School of Medicine, University of Pittsburgh.



We examined a population-wide program, Pennsylvania's Healthy Steps for Older Adults (HSOA), designed to reduce the incidence of falls among older adults. Older adults completing HSOA are screened and educated regarding fall risk, and those identified as being at high risk are referred to primary care providers and home safety resources.


From 2010 to 2011, older adults who completed HSOA at various senior center sites (n = 814) and a comparison group of older adults from the same sites who did not complete the program (n = 1019) were recruited and followed monthly. Although participants were not randomly allocated to study conditions, the 2 groups did not differ in fall risk at baseline or attrition. We used a telephone interactive voice response system to ascertain the number of falls that occurred each month.


In multivariate models, adjusted fall incidence rate ratios (IRRs) were lower in the HSOA group than in the comparison group for both total (IRR = 0.83; 95% confidence interval [CI] = 0.72, 0.96) and activity-adjusted (IRR = 0.81; 95% CI = 0.70, 0.93) months of follow-up.


Use of existing aging services in primary prevention of falls is feasible, resulting in a 17% reduction in our sample in the rate of falls over the follow-up period.

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