1. A Self-Guided Online Cognitive Behavioural Therapy to Reduce Fear of Falling in Older People: a Randomised Controlled Trial.
- Author
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Lim, Mei Ling, Tran, Mymy, van Schooten, Kimberley S., Radford, Kylie A., O'Dea, Bridianne, Baldwin, Peter, and Delbaere, Kim
- Subjects
HEALTH education ,SOCIAL support ,POSTURAL balance ,BEHAVIOR therapy ,FEAR ,DISEASE incidence ,MEDICAL care costs ,MENTAL health ,HUMAN services programs ,TREATMENT effectiveness ,RANDOMIZED controlled trials ,PHYSICAL activity ,AVOIDANCE (Psychology) ,SELF-efficacy ,HEALTH literacy ,ACCIDENTAL falls ,INDEPENDENT living ,EXERCISE ,DESCRIPTIVE statistics ,RESEARCH funding ,STATISTICAL sampling ,COGNITIVE therapy ,ECONOMICS ,OLD age - Abstract
Background: Traditional face-to-face cognitive behavioural therapy (CBT) has been successful at reducing fear of falling (FOF) in older people but can be labour-intensive and costly. Online CBT has been suggested as a cost-effective alternative but has not yet been tested in the context of FOF. This study evaluates the effectiveness of a readily available, self-guided and generalised online CBT program (myCompass) on reducing FOF in older people. Methods: Fifty community-dwelling older people with FOF received a paper-based health education program, and half were randomly assigned to receive three selected modules from myCompass for 6 weeks. The primary outcome was feared consequences of falling at 6 weeks. Secondary outcomes were concern about falling, balance confidence, activity avoidance, physical activity, exercise self-efficacy, health literacy and mental health at 6/26/52 weeks and falls incidence at 12 months. Results: All intervention participants completed at least 2-out-of-3 myCompass modules. There was a significant main effect of time on feared consequences of falling (Cohen's f = 0.55). The group by time interactions for concern about falling (f = 0.28), stress (f = 0.26) and social support for health (health literacy) (f = 0.26) was also significant, favouring the control group. The overall attrition rate at 12 months was 24% (n = 12). Conclusion: The high program compliance and low attrition rate suggest that online CBT is feasible among older people. However, the myCompass program had no effect at reducing FOF in older people. A more targeted CBT program with a well-integrated psychoeducation module on FOF might be the solution to boost the therapeutic effects of a generalised CBT program at reducing FOF for older people. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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