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The impact of community-based interventions for the older population: a quasi-experimental study of a hip-fracture prevention program in Norway

Journal article
Authors H. Oien
N. Jakobsson
Carl Bonander
Published in Bmc Geriatrics
Volume 18
Issue 1
ISSN 1471-2318
Publication year 2018
Published at Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
Language en
Keywords Hip fracture, Community interventions, Natural experiments, Difference-in-differences, Matching, adjusted life-years, injury prevention, physical-activity, risk-factors, falls, epidemiology, prevalence, mortality, burden, costs
Subject categories Geriatrics


BackgroundHip fractures among older adults are a major public health problem in many countries. Hip fractures are associated with expensive health care treatments, and serious adverse effects on patients' health and quality-of-life. In this paper, we estimate the effect of a community-based hip fracture prevention program that was initiated in 16 Norwegian municipalities in 2007. Specifically, the participating municipalities implemented one or more of the following interventions: exercise programs for older adults, information and education campaigns to communicate how to effectively reduce falls to care workers and older adults, and preventive home safety assessment and modification help services.MethodsWe used a difference-in-difference design, and identified control municipalities by matching on pre-intervention trends in the outcome. The outcome measure was the incidence of hip-fractures among older adults (65years).ResultsWe found no statistically significant effects of the implemented program on the incidence of hip fractures, on average, in older subgroups (80years) or in municipality-specific analyses.ConclusionsIt is unclear whether the interventions managed to achieve a change in hip fracture rates at the population level.

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