Abstract: Background Falls represent a significant health threat for older adults in China. The risk of falls increases among young-old patients aged 60 to 74 years, which is also a critical period for achieving optimal benefits from fall prevention interventions. However, effective fall prevention intervention programs tailored to this population remain insufficient. Objective To develop a fall prevention continuous intervention program for young-old patients based on the Behavior Change Wheel (BCW) theory and to evaluate its application effects. Methods The fall prevention continuous intervention program for young-old patients was developed through evidence synthesis and expert panel discussions. From February to April 2025, 90 hospitalized youngold patients were selected as the study participants and randomly assigned via a random number table into either a control group(n=45) or an intervention group (n=45). The knowledge, attitude and practice of fall prevention, fall efficacy, balance ability and the numbers of fall were compared between the two groups before and after the intervention. Results Based on the BCW theoretical framework, we identified six intervention targets across three key dimensions in young-old patients, including "Capability" (poor knowledge of fall prevention, impaired balance), "Opportunity"(insufficient social support, inadequate environmental functionality), and "Motivation" (weak perception of fall risk, poor adherence to preventive measures). Specific behavior change objectives were established accordingly. To address these objectives, a fall prevention intervention program comprising 10 specific measures was developed. During the intervention period, 5 participants dropped out from the intervention group and 4 from the control group, resulting in 40 participants in the intervention group and 41 in the control group for final analysis. No statistically significant differences were observed between the two groups in terms of general characteristics, including gender, age, BMI, education level, living situation, presence of chronic diseases, history of falls, and fall risk scores (P>0.05). During the intervention period, no falls occurred in the intervention group, while one fall was recorded in the control group. At the 12th and 24th weeks of intervention, the intervention group showed significantly higher scores than the control group in fall prevention knowledge, attitude, and practice, fall efficacy, and balance ability (P<0.05), and all indicators showed significant group and time interaction effects (P<0.05). The improvement trend of each indicator in the intervention group over time was better than that of the control group (P<0.05). Conclusion The continuous intervention plan for preventing falls among young-old patients, which is constructed based on the BCW theory in this study, is scientifically sound and feasible. This plan helps to enhance the knowledge, belief and behavior level of fall prevention, fall efficacy and balance ability of young-old patients, thereby reducing the risk of falls.

Key words: Falls, Young-old patients, Behavior Change Wheel, Fall prevention, Fall efficacy, Balance ability

摘要： 背景 跌倒是我国老年人面临的重大健康威胁，其中60~74岁的年轻老年患者跌倒风险上升，同时也是实现跌倒干预效益最优化的关键时期。然而，针对该群体的有效跌倒预防干预方案仍显不足。目的 构建基于行为改变轮（BCW）理论的年轻老年患者跌倒预防延续性干预方案并探讨该方案的应用效果。方法 通过证据总结、专家论证法构建年轻老年患者跌倒预防延续性干预方案。2025年2—4月选取住院年轻老年患者90例为研究对象，通过随机数字表法将其分为对照组和干预组，每组45例。对照组进行常规护理及健康宣教；干预组在对照组基础上采用年轻老年患者跌倒预防延续性干预方案。比较干预前后两组患者的跌倒预防知信行、跌倒效能、平衡能力和跌倒发生次数。结果 本研究基于BCW理论，识别出年轻老年患者存在的能力（跌倒相关知识储备差、平衡能力减退）、机会（社会支持不足、环境功能不足）与动机（跌倒预防观念淡薄、措施执行力不足）三大维度共6个干预问题，并据此设定了具体的行为改变目标。针对这些目标，构建了涵盖10项干预措施的跌倒预防干预方案。干预过程中，干预组脱落5例，对照组脱落4例，最后干预组纳入40例，对照组纳入41例。两组患者性别、年龄、BMI、文化程度、居住情况、是否患慢性病、跌倒经历、跌倒风险评分等一般资料比较，差异均无统计学意义（P>0.05）。干预期间，干预组未发生跌倒事件，对照组发生1例跌倒事件；在干预12周末和24周末，干预组在跌倒预防知信行、跌倒效能及平衡能力上的得分均高于对照组（P<0.05），且所有指标均存在显著的组别与时间交互效应（P交互<0.05）间的改善趋势均优于对照组（P时间<0.05)。结论 本研究基于BCW理论构建的年轻老年患者跌倒预防延续性干预方案具有科学性和可行性。该方案有助于提高年轻老年患者的跌倒预防知信行水平、跌倒效能和平衡能力，从而降低跌倒发生风险。

关键词: 跌倒, 年轻老年患者, 行为改变轮, 跌倒预防, 跌倒效能, 平衡能力