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International Journal of Behavioral Medicine
Published in: International Journal of Behavioral Medicine 3/2023

02-06-2022 | Behavioural Therapy | Brief Report

A Self-Guided Online Cognitive Behavioural Therapy to Reduce Fear of Falling in Older People: a Randomised Controlled Trial

Authors: Mei Ling Lim, Mymy Tran, Kimberley S. van Schooten, Kylie A. Radford, Bridianne O’Dea, Peter Baldwin, Kim Delbaere

Published in: International Journal of Behavioral Medicine | Issue 3/2023

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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.
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Metadata
Title
A Self-Guided Online Cognitive Behavioural Therapy to Reduce Fear of Falling in Older People: a Randomised Controlled Trial
Authors
Mei Ling Lim
Mymy Tran
Kimberley S. van Schooten
Kylie A. Radford
Bridianne O’Dea
Peter Baldwin
Kim Delbaere
Publication date
02-06-2022
Publisher
Springer US
Published in
International Journal of Behavioral Medicine / Issue 3/2023
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-022-10105-6

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