Using Assistive Health Technology to Assess Fall Risk Appraisal, Body Composition, and Physical Activity

One-third of older adults have a discrepancy between perceived and physiological fall risks or maladaptive fall risk appraisal (FRA). Older adults who report high fear of falling and overestimate their physiological fall risk are less likely to participate in physical activity (PA). Limited data suggest the interrelation between fall risk appraisal, body composition, and objective measured PA. This cross-sectional study examines the feasibility of recruitment and acceptability of Assistive Health Technology (AHT), including the BTrackS Balance System (BBS), Bioelectrical Impedance Analysis (InBody s10), and ActiGraph GT9X Link wireless activity monitor. This study demonstrates the benefits of using AHT to study the associations among FRA, body composition, and PA in older adults. We hypothesize that rational FRA is associated with higher levels of PA and skeletal muscle mass and lower levels of percent of body fat and body mass index. Topics presentation included research protocol and preliminary results.

Associations among Fall Risk Appraisal, Body Composition, and Physical Activity in Older Adults

One-third of older adults have maladaptive fall risk appraisal (FRA), a condition in which there is a discrepancy between perceived fall risk or levels of fear of falling (FOF) and physiological fall risk (balance performance). We aimed to examine the associations among FRA, body composition, and physical activity (PA) using Assistive Health Technology, including the Bioelectrical Impedance Analysis, BTrackS Balance System, and activity monitoring devices. We evaluated 124 older adults with a mean age of 74.81 (SD=7.31, range 60 to 96), 77% were female, and 72% had no history of falls. The multinomial logistic regression was used to analyze the data. FRA was classified into 4 quadrants, and we found 47% of rational FRA (low FOF and normal balance), 19% of incongruent FRA (low FOF despite poor balance), 18% of irrational FRA (high FOF despite normal balance), and 16% congruent FRA (high FOF and poor balance). We found these following variables are associated with FRA: accelerometer-based moderate to vigorous physical activity (MVPA: mins), self-reported PA score (strength & flexibility), had difficulty walking up 10 steps without resting (resistance), had difficulty walking several city blocks (ambulation), left-hand average handgrip strength, CDC fall risk score, Senior Technology Acceptance (STA) score and body composition including Body Fat Mass (BFM), Percent Body Fat (PBF), Body Mass Index (BMI), Whole Body Phase Angle, Skeletal Muscle Mass (SMM) and Skeletal Muscle Index (SMI). Our results support the efficacy of using Assistive Health Technology on screening individuals with maladaptive FRA with targeted interventions to reduce fall risk.

A Risk Appraisal Framework for Injury Etiology

Unintentional injury is a significant worldwide health concern. Researchers have called on several occasions for conceptual frameworks to guide work on unintentional injury. Using conceptual approaches to organize our inquiry is one way to advance our knowledge of injury etiology. To this end, we suggest a risk appraisal framework for examining enactment or avoidance of injury risk behaviors. Our framework comprises broad antecedents, focusing on the evaluative stage preceding behaviors. Four categories influencing efficacy related to injury risk behavior are included: environmental context, experience, social context, and strategy. In this article, we explain the categories and concepts in our framework, discuss each in terms of etiology, briefly discuss interrelations between the categories, and suggest future paths using the framework.

Warning Messages in Crisis Communication: Risk Appraisal and Warning Compliance in Severe Weather, Violent Acts, and the COVID-19 Pandemic

BackgroundIn crisis communication, warning messages are key to informing and galvanizing the public to prevent or mitigate damage. Therefore, this study examines how risk appraisal and individual characteristics influence the intention to comply with behavioral recommendations of a warning message regarding three hazard types: the COVID-19 pandemic, violent acts, and severe weather.MethodsA cross-sectional survey examined 403 German participants from 18 to 89 years (M = 29.24; 72% female). Participants were allocated to one of three hazard types (COVID-19 pandemic, violent acts, severe weather) and presented with warning messages that were previously issued via an official warning app. Four components of risk appraisal—perceived severity (PS), anticipated negative emotions (AE), anticipatory worry (AW), and risk perception (RP)—were assessed before and after presenting the warning message. Path models were calculated to predict the intention to comply with the warning message, controlling for age, gender, and previous hazard experience.ResultsFor the COVID-19 pandemic, higher age (β = 0.18) predicted warning compliance (R2 = 0.05). AE (β = 0.20) predicted compliance in the case of violent acts (R2 = 0.09). For severe weather, PS (β = 0.28), age (β = 0.29), and female gender (β = 0.34) lead to higher compliance (R2 = 0.27). Changes across risk appraisal components were not consistent, as some facets decreased after the receipt of a warning message.DiscussionRisk appraisal has shown a marginal yet differential influence on warning message compliance in different types of hazards. Regarding the COVID-19 pandemic, the impact of sociodemographic factors on compliance should be studied more intensively. Moreover, integrating intermediary variables, such as self-efficacy, is necessary.