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.
