Effectiveness of Education and Individualized Counseling in Reducing Environmental Hazards in the Homes of Community-Dwelling Older Women

Authors

  • Jean F. Wyman PhD,

    1. From the *Center for Gerontological Nursing, School of Nursing, School of Public Health, and College of Pharmacy, University of Minnesota, Minneapolis, Minnesota.
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  • Catherine F. Croghan MS, MPH,

    1. From the *Center for Gerontological Nursing, School of Nursing, School of Public Health, and College of Pharmacy, University of Minnesota, Minneapolis, Minnesota.
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  • Nancy M. Nachreiner PhD,

    1. From the *Center for Gerontological Nursing, School of Nursing, School of Public Health, and College of Pharmacy, University of Minnesota, Minneapolis, Minnesota.
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  • Cynthia R. Gross PhD,

    1. From the *Center for Gerontological Nursing, School of Nursing, School of Public Health, and College of Pharmacy, University of Minnesota, Minneapolis, Minnesota.
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  • Holly Hatch Stock MSc, MA,

    1. From the *Center for Gerontological Nursing, School of Nursing, School of Public Health, and College of Pharmacy, University of Minnesota, Minneapolis, Minnesota.
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  • Kristine Talley MS,

    1. From the *Center for Gerontological Nursing, School of Nursing, School of Public Health, and College of Pharmacy, University of Minnesota, Minneapolis, Minnesota.
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  • Melinda Monigold MS

    1. From the *Center for Gerontological Nursing, School of Nursing, School of Public Health, and College of Pharmacy, University of Minnesota, Minneapolis, Minnesota.
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Address correspondence to Jean F. Wyman, School of Nursing, University of Minnesota, 5-160 Weaver-Densford Hall, Minneapolis, MN 55455. E-mail: wyman002@umn.edu

Abstract

OBJECTIVES: To test the effectiveness of an education and counseling intervention on reducing environmental hazards in the homes of older women.

DESIGN: Secondary analysis from a randomized, controlled trial with two arms: fall prevention program and health education program (control). Environmental hazards were assessed at baseline and immediately posttreatment (12-weeks).

SETTING: Participants' homes.

PARTICIPANTS: Two hundred seventy-two community-dwelling women aged 70 and older at risk for falling.

INTERVENTION: The fall prevention program involved a comprehensive fall risk evaluation, exercise, education, individualized counseling, and referrals. The health education program included topics unrelated to fall prevention. With the exception of the fall risk evaluation conducted by a nurse practitioner, baccalaureate-prepared nurses carried out the interventions.

MEASUREMENTS: Summed and individual scores for hazards related to the bathroom, floor surfaces, lighting, furniture, stairways, and storage areas.

RESULTS: Environmental hazards were found in all homes, with a baseline mean±standard deviation of 10.7±2.6 total hazards and range of four to 17 hazards. Analysis of within-group changes indicated that the fall prevention group had significantly fewer bathroom, lighting, and total hazards after the intervention, whereas the health education group had significantly fewer bathroom hazards but more floor hazards. At follow-up, the fall prevention group had significantly fewer lighting hazards and total hazards than the health education group.

CONCLUSION: Education and counseling have only modest effects in helping older women make recommended home modifications. To be most effective in reducing environmental hazards, fall prevention programs may need to provide and install safety devices.

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