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Background. Hip protectors can prevent many hip fractures in older persons at high risk for falling. Few published studies have investigated the use of hip protectors in community-dwelling older persons, and the level of adherence with their use, and predictors of adherence in this setting, are not clear. The aim of this study was to report the predictors of adherence and the level of adherence with the use of hip protectors in frail community-dwelling older women. Methods. This cohort study of the intervention group of a randomized, controlled trial recruited participants from aged care health services in urban areas of northern Sydney, Australia. Participants were 302 women who were 74 years or older (mean age, 83 years) and who had 2 or more falls or 1 fall requiring hospital admission in the previous year and who lived in their own homes. The main outcome measure was adherence with the use of hip protectors. Results. Adherence was approximately 53% during the 2 years of the study, and hip protectors were worn at the time of 51% of falls. The significant independent predictors of nonadherence with hip protector use were lower self-efficacy for hip protector use (odds ratio [OR], 0.51; 95% confidence interval [CI], .33 to .79), higher number of perceived barriers to hip protector use (OR, 0.52; 95% CI, .38 to .72), and lower self-rated health (OR, 0.71; 95% CI, .55 to .93). Conclusions. Three easily measured factors independently predicted subsequent adherence with hip protector use. These findings may form the basis for strategies to improve adherence with the use of hip protectors and with other types of treatment or preventive strategies in older persons. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses the costs and health outcomes of restricted weight bearing after hip fracture surgery (HFS) of older people at the Hornsby Ku-ring-gai Hospital in Sydney, New South Wales.