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Table 1 Main Topics of the In-home Multicomponent Cognitive Behavioural Intervention

From: Evaluating an in-home multicomponent cognitive behavioural programme to manage concerns about falls and associated activity avoidance in frail community-dwelling older people: Design of a randomised control trial [NCT01358032]

Session 1: Concerns about falls (home visit; 60 min)
Introduction of the programme
Discuss theme of the session using a DVD:
Beliefs and disbeliefs about concerns about falls
Thoughts related to concerns about falls and their effect on feelings and behaviour
Session 2: Exploring thoughts and concerns about falls (home visit; 60 min)
Review previous session and homework*
Discuss theme of the session using a checklist:
Thoughts and attitudes related to concerns about falls and challenging them
Adaptive responses to counter misconceptions about falls
Unhelpful thoughts and their effect on feelings and behaviour
Identifying activities in which concerns about falls are experienced
Formulating an action plan to perform an activity safely in which concerns about falls are experienced*
Session 3: Physical exercise (telephone; 35 min)
Review previous session and homework*
Discuss theme of the session using a checklist:
Misconceptions regarding physical exercise for older people
Potential consequences of inactivity and benefits of physical activity
Staying or becoming physically active to prevent falls
Recognising and overcoming barriers to staying or becoming physically active
Formulating an action plan to perform a physical exercise activity in daily life*
Session 4: Asserting oneself (telephone; 35 min)
Review previous session and homework*
Discuss theme of the session using a checklist and a leaflet about fall hazards:
Association between assertiveness and fall prevention
Potential barriers and benefits of being assertive
Reducing concerns about falls and falls-risks by being assertive
Recognising potential environmental fall hazards in one's home and community
Formulating an action plan to be assertive related to fall prevention*
Session 5: Overcoming personal barriers (home visit; 75 min)
Review previous session and homework*
Recognising and overcoming personal barriers for performing activities of daily living
Performing an activity in which concerns about falls are experienced together with the facilitator#
Shifting from self-defeating to self-motivating thoughts regarding activities in which concerns about falls are experienced
Formulating an action plan to repeat the activity performed in this session*
Session 6: Safe behaviour (telephone; 35 min)
Review previous session and homework*
Discuss theme of the session using a checklist:
Recognising risk-taking behaviour in daily life
Identifying personal risk-taking behaviour in daily life
Finding safe alternatives for unsafe behaviour
Prioritising fall-risk behaviour and planning behaviour-change strategies
Formulating an action plan to perform safe behaviour*
Session 7: Managing concerns about falls (telephone; 35 min)
Review previous session and homework*
Shifting from self-defeating to self-motivating thoughts regarding activities in which concerns about falls are experienced
Finding personal solutions to perform activities safely in which concerns about falls are experienced
Review and evaluation of the programme
Formulating an action plan to perform an activity safely in which concerns about falls are experienced*
  1. *More explicitly addressed in the individual programme compared to the group approach owing to the individual character of the programme and the contracting.
  2. #New element in the individual programme.
  3. Note: several intervention elements of the group programme were not included in the in-home programme, among others:
  4. ■ practising simple physical exercises
  5. ■ explicit addressing of physical risk factors for falls
  6. ■ prevention strategies to minimise potential negative consequences of a fall
  7. ■ sharing experiences related to concerns about falls and fall prevention
  8. ■ a booster session after six months