Motivational interviewing for fall prevention (MI-FP) pilot study: Randomized controlled trial

Abstract

Background

The Motivational Interviewing for Fall Prevention (MI-FP) study aimed to engage older adults in fall prevention strategies. We report on the feasibility, intervention fidelity, and preliminary impact of MI-FP.

Methods

We conducted a pilot randomized controlled trial to test MI-FP among older (age ≥ 65) primary care patients at high fall risk in a Pacific Northwest clinic in the United States. The intervention group received up to eight motivational interviewing (MI) sessions by MI practitioners over 6 months and the control group received standard care. Feasibility was defined as ≥75% retention and ≥75% reporting satisfaction at 6 months. Intervention fidelity was assessed by meeting pre-determined MI proficiency standards using MI Treatment Integrity (MITI 4.2) coding scheme, and ≥75% of the intervention group completing ≥6 MI sessions. Preliminary impact was assessed at 6 and 12 months for changes in concern about falling, readiness to engage in fall prevention, fall prevention behaviors, physical function, and fall rates between groups.

Results

Participants (n = 200) had a mean age of 80 years and 67% were female. The overall retention rate was 75.0% (n = 150). Among 81.3% (n = 122) who reported satisfaction, 82.8% were satisfied (n = 101). The intervention group had significantly lower retention than the control group at 6 months (68.3% vs. 81.8%, p = 0.04). A proficient MI intervention was delivered, but only 57.4% (n = 58) engaged in ≥6 MI sessions. The preliminary impact of the intervention showed promising trends, but there were no significant differences by group for any outcome measure at 6 or 12 months (p > 0.05).

Conclusions

Virtual MI-FP may improve accessibility for older adults to discuss fall prevention, but future studies are needed to improve retention and intervention completion.