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Abstract AimsTo examine how perceived balance problems are associated with self‐reported falls in the past month after controlling for known correlates of falls among older adults. BackgroundApproximately 30% of adults age 65 and older fall each year. Most accidental falls are preventable, and older adults' engagement in fall prevention is imperative. Limited research suggest that older adults do not use the term ‘fall risk’ to describe their risk for falls. Instead, they commonly use the term ‘balance problems’. Yet, commonly used fall risk assessment tools in both primary and acute care do not assess older adults' perceived balance. Design and MethodThe Health Belief Model and the concept of perceived susceptibility served as the theoretical framework. A retrospective, cross‐sectional secondary analysis using data from the National Health and Aging Trends Study from year 2015 was conducted. The outcome variable was self‐reported falls in the last month. ResultsA subsample of independently living participants (N = 7499) was selected, and 10.3% of the sample reported a fall. Multiple logistic regression analysis revealed that the odds of reporting a fall in the past month was 3.4 times (p < .001) greater for participants who self‐reported having a balance problem compared to those who did not. In contrast, fear of falling and perceived memory problems were not uniquely associated with falls. Using a mobility device, reporting pain, poor self‐rated health status, depression and anxiety scores were also associated with falling. Conclusion and ImplicationsOlder adults' perceived balance problem is strongly associated with their fall risk. Perceived balance may be important to discuss with older adults to increase identification of fall risk. Older adults' perceived balance should be included in nursing fall risk assessments and fall prevention interventions. A focus on balance may increase older adults' engagement in fall prevention.
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Eliciting Risk Perceptions: Does Conditional Question Wording Have a Downside?
BackgroundTo assess the impact of risk perceptions on prevention efforts or behavior change, best practices involve conditional risk measures, which ask people to estimate their risk contingent on a course of action (e.g., “if not vaccinated”). PurposeTo determine whether the use of conditional wording—and its drawing of attention to one specific contingency—has an important downside that could lead researchers to overestimate the true relationship between perceptions of risk and intended prevention behavior. MethodsIn an online experiment, US participants from Amazon’s MTurk ( N = 750) were presented with information about an unfamiliar fungal disease and then randomly assigned among 3 conditions. In all conditions, participants were asked to estimate their risk for the disease (i.e., subjective likelihood) and to decide whether they would get vaccinated. In 2 conditional-wording conditions (1 of which involved a delayed decision), participants were asked about their risk if they did not get vaccinated. For an unconditional/benchmark condition, this conditional was not explicitly stated but was still formally applicable because participants had not yet been informed that a vaccine was even available for this disease. ResultsWhen people gave risk estimates to a conditionally worded risk question after making a decision, the observed relationship between perceived risk and prevention decisions was inflated (relative to in the unconditional/benchmark condition). ConclusionsThe use of conditionals in risk questions can lead to overestimates of the impact of perceived risk on prevention decisions but not necessarily to a degree that should call for their omission. HighlightsConditional wording, which is commonly recommended for eliciting risk perceptions, has a potential downside. It can produce overestimates of the true relationship between perceived risk and prevention behavior, as established in the current work. Though concerning, the biasing effect of conditional wording was small—relative to the measurement benefits that conditioning usually provides—and should not deter researchers from conditioning risk perceptions. More research is needed to determine when the biasing impact of conditional wording is strongest.
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- Award ID(s):
- 1851738
- PAR ID:
- 10486521
- Publisher / Repository:
- SAGE Publications
- Date Published:
- Journal Name:
- Medical Decision Making
- Volume:
- 44
- Issue:
- 2
- ISSN:
- 0272-989X
- Format(s):
- Medium: X Size: p. 141-151
- Size(s):
- p. 141-151
- Sponsoring Org:
- National Science Foundation
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