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Falls in older adults are the most significant cause of injury leading to hospitalization, disability, and fatality. Fall prevention interventions have received considerable attention, but fall rates are still rising. Without effective fall prevention strategies, the number of injuries and associated direct and indirect costs caused by falls are projected to be higher and create a global burden. In 2015, the direct costs of fatal falls were more than $637 million, whereas Medicare costs for non-fatal falls were more than $31 billion (Burns et al., 2016). Indirect costs associated with falls remain a critical burden to family and household economies (Kelly, 2017).
Extensive systematic reviews confirm that a multifactorial approach, which includes a customized exercise program and enhanced self-management, has high effectiveness to prevent falls (Guirguis-Blake et al., 2018; Hopewell et al., 2018; McInnes et al., 2011). A recent systematic review also confirmed that exercise programs reduce the rate of falls by 23% and reduce the number of community-dwelling older adults experiencing falls by 18% (Sherrington et al., 2019). Several studies have also shown that older adults benefit from either supervised group- or home-based exercise, and both are cost-effective (El-Khoury et al., 2013). Little is known regarding the impact of combined group- and home-based exercise programs on maintaining activity engagement. In addition, older adults are more receptive to assistance and have increased attendance rates when someone from a similar background administers the fall prevention intervention (French et al., 2014). Therefore, the current authors proposed a peer coaching approach to providing exercise programs in this pilot study.
The majority of older people have sedentary behavior, which increases their risk of illness and falls. One in 10 community-dwelling older adults had low actual fall risk, but high fear of falling, and one in three older adults sustained falls (Delbaere et al., 2010). Falls may decrease in older adults who have an accurate appraisal of their physical abilities. Older adults with better-perceived physical health may experience less fear of falling (Kumar et al., 2014). Fall prevention is best approached from a participant-centered perspective (Kuhlenschmidt et al., 2016), and older adults prefer to adapt to realistic fall risk by taking self-control and implementing self-management strategies (McInnes et al., 2011).
Limited fall interventions were found that were tailored to older...