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A protocol for evidence-based targeting and evaluation of statewide strategies for preventing falls among community-dwelling older people in Victoria, Australia.

Day L, Finch CF, Hill KD, Haines TP, Clemson L, Thomas M, Thompson C - Inj. Prev. (2010)

Bottom Line: Falls are a significant threat to the safety, health and independence of older citizens.The challenge now is to deliver the most effective interventions efficiently at a population level, and for these interventions to be taken up by older people.The RE-AIM model (Reach, Efficacy, Adoption, Implementation, Maintenance) was used to identify strategies for an effective programme.

View Article: PubMed Central - PubMed

Affiliation: Monash University, Melbourne, Australia. lesley.day@monash.edu

ABSTRACT

Background: Falls are a significant threat to the safety, health and independence of older citizens. Despite the now substantial evidence about effective falls prevention interventions, translation into falls reductions has not yet been fully realised. While the hip fracture rate is decreasing, the number and rate of fall-related hospital admissions among older people is increasing. The challenge now is to deliver the most effective interventions efficiently at a population level, and for these interventions to be taken up by older people.

Objective: To support the development, and evaluation of, effective falls prevention policy and practice in the state of Victoria, Australia.

Methods: The RE-AIM model (Reach, Efficacy, Adoption, Implementation, Maintenance) was used to identify strategies for an effective programme. Research objectives were developed to support the strategies. These include: (1) identification of subgroups of older people most frequently admitted to hospital for falls; (2) examining the acceptability of established falls interventions; (3) identification of factors that encourage and support relevant lifestyle changes; (4) identifying opportunities to incorporate confirmed interventions in existing programmes and services; (5) developing guidelines for sustainability. The research results will subsequently guide strategy details for the falls prevention plan. RE-AIM will provide the framework for the evaluation structure. OUTCOME MEASURES MEASURES: to monitor the implementation of the selected interventions will be determined for each intervention, based on the five key factors of the RE-AIM model. The overall effect of the falls prevention plan will be monitored by time series analysis of fall-related hospital admission rates for community-dwelling older people.

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Related in: MedlinePlus

Theoretical framework for understanding uptake of falls prevention interventions.
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Related In: Results  -  Collection

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fig1: Theoretical framework for understanding uptake of falls prevention interventions.

Mentions: A cross-sectional telephone survey of the priority participant subgroups identified from component 1 will be undertaken. Based on preliminary data, it is likely that community-dwelling older people, particularly women aged over 75 years, and those with co-morbid conditions, will emerge as priority groups. The proposed methods are described for these groups to illustrate our approach. If different subgroups emerge as a priority, then recruitment methods will be adjusted as necessary. The theoretical framework for the survey (figure 1) draws primarily upon the health belief model,38 with additional input from other relevant theories.38 39 Central to this framework is the individual's weighing up of anticipated benefits from undertaking an intervention as opposed to anticipated costs and disbenefits, to form an intention to undertake the intervention. Previous work using a similar framework found factors related to coping (theory of planned behaviour) were most strongly associated with the intention to undertake community-based strength and balance training among community-dwelling older adults.40 A limitation of this study was that the description of strength and balance training provided to participants was a heterogenous collection of activities with little description of how and where the exercise would take place.


A protocol for evidence-based targeting and evaluation of statewide strategies for preventing falls among community-dwelling older people in Victoria, Australia.

Day L, Finch CF, Hill KD, Haines TP, Clemson L, Thomas M, Thompson C - Inj. Prev. (2010)

Theoretical framework for understanding uptake of falls prevention interventions.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3064867&req=5

fig1: Theoretical framework for understanding uptake of falls prevention interventions.
Mentions: A cross-sectional telephone survey of the priority participant subgroups identified from component 1 will be undertaken. Based on preliminary data, it is likely that community-dwelling older people, particularly women aged over 75 years, and those with co-morbid conditions, will emerge as priority groups. The proposed methods are described for these groups to illustrate our approach. If different subgroups emerge as a priority, then recruitment methods will be adjusted as necessary. The theoretical framework for the survey (figure 1) draws primarily upon the health belief model,38 with additional input from other relevant theories.38 39 Central to this framework is the individual's weighing up of anticipated benefits from undertaking an intervention as opposed to anticipated costs and disbenefits, to form an intention to undertake the intervention. Previous work using a similar framework found factors related to coping (theory of planned behaviour) were most strongly associated with the intention to undertake community-based strength and balance training among community-dwelling older adults.40 A limitation of this study was that the description of strength and balance training provided to participants was a heterogenous collection of activities with little description of how and where the exercise would take place.

Bottom Line: Falls are a significant threat to the safety, health and independence of older citizens.The challenge now is to deliver the most effective interventions efficiently at a population level, and for these interventions to be taken up by older people.The RE-AIM model (Reach, Efficacy, Adoption, Implementation, Maintenance) was used to identify strategies for an effective programme.

View Article: PubMed Central - PubMed

Affiliation: Monash University, Melbourne, Australia. lesley.day@monash.edu

ABSTRACT

Background: Falls are a significant threat to the safety, health and independence of older citizens. Despite the now substantial evidence about effective falls prevention interventions, translation into falls reductions has not yet been fully realised. While the hip fracture rate is decreasing, the number and rate of fall-related hospital admissions among older people is increasing. The challenge now is to deliver the most effective interventions efficiently at a population level, and for these interventions to be taken up by older people.

Objective: To support the development, and evaluation of, effective falls prevention policy and practice in the state of Victoria, Australia.

Methods: The RE-AIM model (Reach, Efficacy, Adoption, Implementation, Maintenance) was used to identify strategies for an effective programme. Research objectives were developed to support the strategies. These include: (1) identification of subgroups of older people most frequently admitted to hospital for falls; (2) examining the acceptability of established falls interventions; (3) identification of factors that encourage and support relevant lifestyle changes; (4) identifying opportunities to incorporate confirmed interventions in existing programmes and services; (5) developing guidelines for sustainability. The research results will subsequently guide strategy details for the falls prevention plan. RE-AIM will provide the framework for the evaluation structure. OUTCOME MEASURES MEASURES: to monitor the implementation of the selected interventions will be determined for each intervention, based on the five key factors of the RE-AIM model. The overall effect of the falls prevention plan will be monitored by time series analysis of fall-related hospital admission rates for community-dwelling older people.

Show MeSH
Related in: MedlinePlus