SBIR-STTR Award

Falls are the leading cause of injury deaths, severe nonfatal injuries, and hospital admissions in older adults. In 1994 the cost of seniors' fall injuries was 20.2 billion, these costs are significant to individuals and to society. At-risk seniors benefit from multi-factorial fall prevention interventions; however, such services, where available, often fail to change underlying behaviors. Previous work suggests that a multimedia exposure to fall-provoking situations can 'prime' the at-risk individual; increasing their awareness of actions they can take to prevent falls. The proposed Behavioral Intervention may increase motivation, involvement and compliance in fall-prevention programs. The Intervention will consist of an interactive DVD including common fall-provoking situations, and instructional software for standardized administration. A Guided-Discovery process using an Anchored Instruction approach will focus attention on the risks inherent in these situations. In this Phase I effort our primary focus will be to test and refine the Intervention through a program of technical development consisting of concurrent Alpha testing with normal and at-risk senior volunteers, as well as software and multimedia development activities. A prospective pilot study of the prototype Intervention will be conducted with 80 at-risk older adults, who will be randomly assigned to intervention or control groups. Both groups will be interviewed during an initial visit and the intervention group will receive the Behavioral Intervention. Subjects will be followed for 4 weeks and return for a follow-up visit. They will be re-interviewed and the control group will view a fall-prevention lecture. From the pilot study data, behavioral and cognitive outcomes and technical adequacy of MBI will be evaluated. The Behavioral Intervention to Prevent Falls in Older Adults is an innovative technique that may be utilized as a stand-alone behavioral intervention, as well as an adjunct to other Fall-Prevention approaches. This technology would provide a novel approach to address the neglected cognitive and behavioral aspects of Fall-Prevention. Millions of at-risk seniors in home, long term care, and out- or in-patient medical settings could benefit from enhanced fall-risk awareness and prevention programs could emerge in many under-served communities nationwide.

Falls are the leading cause of injury deaths, severe nonfatal injuries, and hospital admissions in older adults. In 1994 the cost of seniors' fall injuries was 20.2 billion, these costs are significant to individuals and to society. Multi-factorial fall prevention interventions are recommended for those who fall; however, such services, where available, often fail to change underlying behaviors. Our Pilot study demonstrated that an interactive multimedia experience can enhance an individuals' ability to detect fall-risks and encourage fall prevention. Subjects in the Intervention group perceived significantly more risks in novel situations one month later and made twice as many new fall-prevention efforts as the Control group in that month. The Multimedia Behavioral Intervention (MBI) may increase motivation, involvement and compliance in fall prevention programs. The Intervention consists of an interactive DVD including common fall-provoking situations, and instructional software or menus for standardized administration. Anchored Instruction methodology focuses attention on the risks inherent in each situation. In this Phase II effort our primary focus will be to test and refine MBI methodology through a program of exploratory and clinical studies. In addition, software and multimedia development activities will produce a DVD with a wide range of situations appropriate for individuals across the country in a variety of living settings. Exploratory studies with the prototype Intervention will evaluate the effect of individualization (90 subjects) and regimen (60 subjects, massed vs. distributed practice). Preliminary clinical studies including 240 subjects in home health care, Independent and Assisted Living settings, will be conducted in situ. These studies will establish clinical parameters for application of MBI and establish long-term behavioral outcomes. The Behavioral Intervention to Prevent Falls in Older Adults is an innovative technique that may be utilized as a stand-alone behavioral intervention, as well as an adjunct to other Fall-Prevention approaches. This technology will provide an important new means to address the neglected cognitive and behavioral aspects of Fall- Prevention. Millions of seniors in diverse community or medical settings will benefit from enhanced fall-risk awareness and prevention programs could emerge in many under-served communities nationwide.

Thesaurus Terms:
accidental fall, behavior modification, behavior therapy, computer assisted instruction, computer system design /evaluation, human old age (65+), human therapy evaluation, injury prevention, interactive multimedia DVD /CD ROM, computer program /software, home health care, psychological aspect of aging behavioral /social science research tag, case history, clinical research, human subject, interview