Evaluating the PM ACTIVAS Nurse-Led Preventive Care Model for Community-Dwelling Older Adults: A Randomized...

Falls among community-dwelling older adults are a major public health challenge and a leading cause of functional decline. Although multifactorial fall prevention strategies are recommended, evidence on comprehensive nurse-led preventive care models in primary health care remains limited. This study evaluated the clinical effects of the PM ACTIVAS nurse-led preventive care model among community-dwelling older adults in routine primary health care.

This article reports the quantitative component of a broader mixed-methods research programme. A two-arm randomized controlled trial included 220 community-dwelling adults aged 65-80 years randomly assigned to the PM ACTIVAS intervention (n = 110) or usual care (n = 110). The 12-month intervention combined multidimensional fall-risk assessment, individualized care planning, home environmental assessment, health education, a home safety kit, family involvement, and monthly telephone follow-up. The primary outcome was the number of falls (fall frequency) during the 12-month follow-up; secondary outcomes were fall occurrence, modifiable fall-risk factors, recognition of environmental fall hazards, and fear of falling.

Primary outcome data were available for 145 participants, with no significant between-group difference in the number of falls (p = 0.164). Fall occurrence, a secondary outcome, also did not differ significantly between groups (17 participants [23.3%] in the intervention group vs. 19 [26.4%] in the control group; p = 0.666). After adjustment for baseline scores, the intervention group showed significantly fewer fall-risk factors (p = 0.001; partial η² = 0.07) and greater recognition of environmental fall hazards (p = 0.044; partial η² = 0.02). No between-group differences were observed in fear of falling.

Although the PM ACTIVAS nurse-led preventive care model did not significantly reduce the number of falls over 12 months, it reduced modifiable fall-risk factors and improved recognition of environmental hazards. These findings suggest that coordinated nurse-led care may provide a structured approach to operationalizing evidence-based fall prevention within routine primary health care and support further evaluation of this model in community settings.