タイの高齢者を対象とした地域ベースの転倒予防プログラムの実装：クラスターランダム化比較試験

Falls are increasingly becoming a significant public health concern among older adults. Community-based interventions are needed to bridge the gap between clinical guidelines and routine practice for fall prevention. This study assessed the effectiveness of a community-based fall prevention program (CBFPP) for older persons in Thailand. This randomized controlled trial was conducted in 2024 (trial registration number: TCTR20240318005; 18/03/2024). In total, 250 older persons were selected using the inclusion criteria and randomly allocated to the intervention and control groups. Clusters served as the randomization units and were randomly allocated to the intervention and control groups at a 1:1 ratio via a computer-generated sequence. A four-month, two-arm, cluster-randomized trial was conducted across four villages in a central province in Thailand. The experimental group underwent the CBFPP and received usual care, while the comparison group received only usual care. The program, guided by the World Health Organization Falls Prevention Model and Self-Efficacy Theory, integrated fall awareness, risk assessment, and supportive fall prevention activities. The incidence of falls were tracked via monthly calendars and interviews at 8 and 16 weeks. Baseline and follow-up assessments were blinded, and participants were unaware of group allocation. At 16 weeks, the experimental group experienced a significantly larger reduction in falls compared with the comparison group (incidence rate ratio 0.20, 95% CI 0.04-0.92; p = 0.04). Participants also showed significant improvements in fall prevention behaviors, physical performance, and environmental modifications. A community-based fall prevention program effectively reduced falls and improved safety behaviors among Thai older adults. These findings indicate the feasibility and potential impact of community-driven fall prevention interventions in similar settings.