EXpress Prevent Rural oldEr Adults' fallS, fractureS and Dependency (EXPRESS)

Summary

Falls are the leading cause of injury-related death among individuals aged 65 and above in China. The incidence of falls shows a significant urban-rural disparity in China, with rural areas experiencing a markedly higher rate than urban regions. However, a systematic fall prevention strategy tailored to the needs of older people in rural China has not yet been established.

The EXPRESS study is a multicenter, cluster-randomized controlled trial designed to explore the effectiveness and health economic evaluation of an AI-assisted, village doctors and express services-involved, personalized fall screening and prevention strategy based on multidimensional risk profiling in reducing the incidence of falls and fall-related injuries among older people in rural China.

A total of 1,881 older individuals from 16 villages across four provinces in China (with four villages per province) will be recruited. These 16 rural areas will be randomly assigned to either the intervention group or the control group. The intervention group will receive the AI-assisted, village doctors and express services-involved personalized fall prevention strategy based on multidimensional fall risk screening and assessment, while the control group will follow routine primary health management practices.

The intervention period will last for one year, with randomization taking place after the baseline survey. The primary outcomes are the incidence of falls and fall-related injuries (including falls resulting in hospitalization and fractures, etc). Secondary outcomes include activity of daily living, quality of life, fall-related health literacy, depressive symptoms, cognitive function, dementia, physical function and performance, incidence of chronic non-communicable diseases, frailty, and sleep quality.

Conditions

• Falls
• Falls Injury
• Fall Prevention

Interventions

COMBINATION_PRODUCT

AI-assisted, village doctors and express services-involved personalized fall prevention strategy

The EXPRESS trial implements a pragmatic, community-based, AI-assisted fall prevention strategy tailored to the needs of older adults in rural China. The intervention is structured around five core components-SAFER: 1. Screening: multidimensional fall risk screening and assessment tailored to rural older adults; 2. AI-assisted recommendations: AI-assisted personalized fall prevention recommendations; 3. Fitness: Tailored balance and strength training via Health Intervention Cartoon Brochure and Action Demonstration Video; 4. Events-based engagement: culturally integrated seasonal intervention packages following the traditional Chinese calendar; 5. Reach-home delivery: home delivery of fall prevention services through local couriers.

Sponsors & Collaborators

• Peking University

  lead OTHER

Principal Investigators

• Yao Yao, MD · Peking University

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

65 Years

Max Age

95 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2024-08-06

Primary Completion

2025-08-30

Completion

2026-08-30

Countries

• China

Study Locations