Characteristics and fall experiences of older adults with and without fear of falling outdoors

Objective: Using a theoretical model that combines an ecological perspective and Bandura's theory of self-efficacy as a guide, we sought to compare experiences and characteristics of community dwelling older adults with and without concern about falling outdoors. Method: A survey of randomly selected community dwelling older adults across NYC (N = 120) was conducted using the outdoor falls questionnaire. Descriptive quantitative analyses of participant characteristics were conducted for all participants and for those with and without concern about falling outside. Conventional content analysis using two coders was employed to examine outdoor fall experiences for each group. A mixed methods matrix was used to integrate qualitative and quantitative findings. Results: Some participant characteristics were more common among those with a concern about falling outside such as decreased functional status, female gender, and number of prior outdoor falls. As per descriptions of outdoor fall experiences, participants with concern were more likely to report a fall while climbing stairs or stepping up a curb, describe an intrinsic factor as a cause of their fall, use an injury prevention strategy during the fall, sustain a moderate to severe injury, seek medical attention, have had an ambulance called, require help to get up, and describe implementation of a behavioral change after the fall. Conclusions: Differences exist in participant characteristics and outdoor fall experiences of those with and without concern about falling outside. The proposed model can be used to understand fear of falling outdoors and can help to inform the target population and content of intervention programs.