A Fall Prevention Program Integrated in Primary Health Care for Older People in Rural China

作者：Junyi Peng, Pengpeng Ye, Boya Nan, Shichun Yan, Zhifang Li, Qian Li, Ruilin Meng, Yangchun Li, Tianyou Hao, Lan Zhang, Dandan Peng, Zijian Xu, Yanni Wang, Lei Si, Minghui Yang, Yao Yao, Jing Zhang, Wei Tian, Yongchen Wang, Rebecca Ivers, Maoyi Tian · 发表于：JAMA · 年份：2025 · DOI：10.1001/jama.2025.12724 · 被引用次数：10 · 研究领域：Balance, Gait, and Falls Prevention、Health disparities and outcomes、Prosthetics and Rehabilitation Robotics

Importance: With rapidly aging populations globally, there is a lack of evidence on effective fall prevention strategies among community-dwelling older people in resource-constrained areas. Objective: To assess the effectiveness of a fall prevention program integrated in primary health care systems on the risk of falls among Chinese rural older adults. Design, Setting, and Participants: A 12-month, open-label, cluster randomized clinical trial, conducted in 128 rural villages from 4 Chinese provinces, involving adults 60 years or older at risk of falls (recruitment from September 19, 2023, to November 15, 2023; last follow-up, January 15, 2025). Interventions: The fall prevention intervention, consisting of balance and functional exercises and community-engaged health education, was integrated with the rural primary health care system. The control group received usual care, health education alone, without active involvement with the communities. Main Outcomes and Measures: The primary outcome was the proportion of participants who reported at least 1 fall in 12 months following the intervention. Six secondary outcomes included the rate of falls, 3 measures of functional mobility, the proportion of participants who reported fall-related injury, and health-related quality of life. Fall-related data were collected via quarterly participant self-reports supported by a calendar; functional mobility was measured at baseline and 12-month follow-up using validated measures. Results: ...