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Fear of Falling, Fall-Related Efficacy, and Functional Mobility in a Falls Prevention Program: A Matter of Balance Volunteer Lay Leader Model
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Reducing fear of falling and improving fall-related efficacy (i.e., the confidence of carrying out daily activity without falling) are essential parts of maintaining an active lifestyle among older adults. A Matter of Balance Volunteer Lay Leader (AMOB/VLL) model is an evidence-based program that aims to reduce fear of falling and promote daily activities among community-dwelling older adults. It has been implemented across the US since 1998, yet the statistical synthesis of the individual studies, the role of fall-related efficacy, and factors related to changes in functional mobility in the AMOB/VLL had not been fully examined. The following topics were investigated to fill the research gaps: 1) the magnitude of the overall program effect on improving fall-related efficacy, 2) the mediating role of fall-related efficacy between fear of falling and functional mobility, and 3) factors associated with improvement in functional mobility. The secondary data of 522 older adults who enrolled in the AMOB/VLL in Central Texas were analyzed. A small to moderate program effect of improving fall-related efficacy was found. Variability in effects among the studies was partially due to outcome measures used for program evaluation. The mediating role of fall-related efficacy between fear of falling and functional mobility was confirmed. Three dimensions of fall-related efficacy, including steadiness/balance, gait, falls management, were identified using the Perceived Ability to Prevent and Manage Fall Risks scale. Improvement in functional mobility was particularly significant among older adults who were older, perceived poorer health, had mobility limitation and had lower levels of fall-related efficacy. Findings may provide guidance to program implementers in communities charged with selecting appropriate fall prevention programs to meet the needs of older adults. Greater consistency is needed regarding outcome measures. Such consistency will provide more definitive fall prevention programming recommendations for different settings and populations. The findings of the mediation testing also may help to further develop theories and models explaining a cognitive behavioral approach for reducing fall risks in older adults. More research is needed to further understand factors associated with improvement of mobility performance in older persons using an objectively measured functional assessment.
Yoshikawa, Aya (2018). Fear of Falling, Fall-Related Efficacy, and Functional Mobility in a Falls Prevention Program: A Matter of Balance Volunteer Lay Leader Model. Doctoral dissertation, Texas A & M University. Available electronically from