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Background: It is important to understand the elderly's subjective beliefs, attitudes, and behaviors regarding fall prevention. This study used the Health Belief Model (HBM) as a theoretical framework to develop a prediction model for the likelihood of fall prevention actions in community-dwelling older adults.

Methods: Subjects were 704 elderly in the communities of a county in northern Taiwan. Descriptive analysis, item analysis, factor analysis and Pearson's correlations were used for the statistical analysis. Structural equation modeling was used to verify the fit of the overall model and the amount of variance explained.

Results: The results showed good overall model fit. Perceived severity (β = 0.144, p < 0.01), Perceived benefit (β = 0.109, p < 0.05), Self-efficacy (β = 0.408, p < 0.01), and Cue to action (β = 0.212, p < 0.01) can effectively predict the likelihood of the community elderly taking action to prevent falls. Self-efficacy had the largest influence, followed by Cue to action, Perceived severity, and Perceived benefit. The overall predictive power was 39.0%.

Conclusion: The results provide evidence that the HBM is suitable for exploring the likelihood of fall prevention actions by community-dwelling older adults and identifying the significant influencing factors and the influence paths between factors. Understanding the impact process can help in the development of more effective interventions.