The Impact of Transitioning to Virtual Fall-Prevention Programs on Falls and Social Connectedness in...

Older adults participating in Falls Prevention Evidence-Based Programs experience a decrease in falls, loneliness, and social isolation, but virtual implementation may alter the program's reach and effectiveness.

We examined the comparative effectiveness of in-person versus virtual fall-prevention evidence-based programs using a nonrandomized study design. Community-dwelling older adults (age ≥ 50) completed surveys on falls (OMB 0985-0039), loneliness (UCLA three-item scale), and social isolation (Duke Social Support Index) at baseline, 6 weeks, and 6 months. Changes in individual outcomes over time were analyzed using a generalized additive model.

In-person (n = 382) and virtual participants (n = 214) did not differ by age (76.6 vs. 76.5  years) or gender (83.4% vs. 82.5% women). Virtual programs had fewer non-Hispanic Black participants (8.2% vs. 43.5%, P < .001), more non-Hispanic white participants (70.4% vs. 42%, P < .001), and more with income >$30,000 (P = .012). In-person participants' Duke Social Support Index scores improved at 6 weeks (Estimate 0.50, 95% confidence interval [CI] [0.19, 0.82], P = .011) and 6 months (Estimate 0.67, 95% CI [0.30, 1.05], P = .003); loneliness improved at 6 months (Estimate 0.94, 95% CI [0.90, 0.97], P = .003). Virtual participants reported no change in Duke Social Support Index scores or in loneliness. At 6 months, virtual participants reported a 43.9% reduction in falls per month compared with baseline (Estimated Ratio 0.561, 95% CI [0.541, 0.582], P < .001); in-person participants reported no change in falls.

Virtual implementation of fall-prevention programs results in participant-reported reductions in falls but no change in loneliness or social isolation. Significance/Implications: Virtual falls evidence-based programs should make efforts to foster connectedness and reach low-income and racially diverse communities.