‘‘Better for others than for me’’: A belief that should shape our efforts to promote participation in falls prevention strategies
- Authors: Haines, Terry , Day, Lesley , Hill, Keith , Clemson, Lindy , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Archives of Gerontology and Geriatrics Vol. 59, no. (2014), p. 136-144
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Falls are a common occurrence amongst older adults yet participation in prevention strategies is often poor. Although older adults may perceive a strategy works in general, they may not participate because they feel it will not benefit them personally. We aimed to describe how frequently and why older adults identify falls prevention strategies as being ‘‘better for others than for me’’. A cross-sectional survey with n = 394 community-dwelling older adults in Victoria, Australia was undertaken. Participants were provided with detailed descriptions of four evidence-based falls prevention strategies and for each were asked whether they felt that the strategy would be effective in preventing falls for people like them, and then whether they felt that the strategy would be effective for preventing falls for them personally. Follow-up questions asked why they thought the strategy would be more effective for people like them than for them personally where this was the case. We found the ‘‘better for others than for me’’ perception was present for between 25% and 34% of the strategies investigated. Participants commonly said they felt this way because they did not think they were at risk of falls, and because they were doing other activities they thought would provide equivalent benefit. Strategies to promote participation in evidence-based falls prevention strategies may need to convince older adults that they are at risk of falls and that what activities they are already doing may not provide adequate protection against falls in order to have greater effect.
A protocol for evidence-based targeting and evaluation of statewide strategies for preventing falls among community-dwelling older people in Victoria, Australia
- Authors: Day, Lesley , Finch, Caroline , Hill, Keith , Haines, Terry , Clemson, Lindy , Thomas, Margaret , Thompson, Catherine
- Date: 2011
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 17, no. 2 (2011), p. 1-8
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/546282
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- Description: 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.
Investigation of older adults’ participation in exercises following completion of a state-wide survey targeting evidence-based falls prevention strategies
- Authors: Lee, Den-Ching , Day, Lesley , Finch, Caroline , Hill, Keith , Clemson, Lindy , McDermott, Fiona , Haines, Terry
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Aging and Physical Activity Vol.23, no.2 (2014), p.256-263
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: This paper examines whether involvement in an observational study may prompt participants to change their exercise behaviors. Data was collected from 394 older community dwellers in Victoria, Australia using a baseline survey, and 245 of these participated in a follow-up survey one year later. Survey domains were drawn from constructs of relevant health behavior models. Results showed that the proportion of respondents who were currently participating in exercises to prevent falls at follow-up was 12% higher than at baseline (Wilcoxon p value<0.001). Twenty-nine percent reported they had changed their perceptions about falls and their risk of falls, with comments focused on threat appraisal. Forty-four percent reported having taken strategies to reduce their risk of falling, with comments based on implementation of different preventive strategies. Respondents who held favorable views towards exercises for the prevention of falls appear to change their behaviors that might address falls when participating in observational studies.
Identifying clusters of falls-related hospital admissions to inform population targets for prioritising falls prevention programmes
- Authors: Finch, Caroline , Stephan, Karen , Shee, Anna Wong , Hill, Keith , Haines, Terry , Clemson, Lindy , Day, Lesley
- Date: 2015
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 21, no. 4 (2015), p. 254-259
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/546282
- Full Text: false
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- Description: Background: There has been limited research investigating the relationship between injurious falls and hospital resource use. The aims of this study were to identify clusters of community-dwelling older people in the general population who are at increased risk of being admitted to hospital following a fall and how those clusters differed in their use of hospital resources. Methods: Analysis of routinely collected hospital admissions data relating to 45 374 fall-related admissions in Victorian community-dwelling older adults aged ≥65 years that occurred during 2008/2009 to 2010/2011. Fall-related admission episodes were identified based on being admitted from a private residence to hospital with a principal diagnosis of injury (International Classification of Diseases (ICD)-10-AM codes S00 to T75) and having a first external cause of a fall (ICD-10-AM codes W00 to W19). A cluster analysis was performed to identify homogeneous groups using demographic details of patients and information on the presence of comorbidities. Hospital length of stay (LOS) was compared across clusters using competing risks regression. Results: Clusters based on area of residence, demographic factors (age, gender, marital status, country of birth) and the presence of comorbidities were identified. Clusters representing hospitalised fallers with comorbidities were associated with longer LOS compared with other cluster groups. Clusters delineated by demographic factors were also associated with increased LOS. Conclusions: All patients with comorbidity, and older women without comorbidities, stay in hospital longer following a fall and hence consume a disproportionate share of hospital resources. These findings have important implications for the targeting of falls prevention interventions for community-dwelling older people. © 2015, BMJ Publishing Group. All right reserved.
Older adult perceptions of participation in group- and home-based falls prevention exercise
- Authors: Robins, Lauren , Hill, Kylie , Day, Lesley , Clemson, Lindy , Finch, Caroline , Haines, Terry
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Aging and Physical Activity Vol. 24, no. 3 (2016), p. 350-362
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: This paper describes why older adults begin, continue, and discontinue group-and home-based falls prevention exercise and benefits and barriers to participation. Telephone surveys were used to collect data for 394 respondents. Most respondents reported not participating in group-(66%) or home-based (78%) falls prevention exercise recently. Reasons for starting group-based falls prevention exercise include health benefits (23-39%), health professional recommendation (13-19%), and social interaction (4-16%). They discontinued because the program finished (44%) or due to poor health (20%). Commonly reported benefits were social interaction (41-67%) and health (15-31%). Disliking groups was the main barrier (2-14%). Home-based falls prevention exercise was started for rehabilitation (46-63%) or upon health professional recommendation (22-48%) and stopped due to recovery (30%). Improvement in health (18-46%) was the main benefit. These findings could assist health professionals in prescribing group-based falls prevention exercise by considering characteristics of older adults who perceive social interaction to be beneficial.
Does action follow intention with participation in home and group-based falls prevention exercise programs? An exploratory, prospective, observational study
- Authors: Haines, Terry , Hill, Keith , Vu, Trang , Clemson, Lindy , Finch, Caroline , Day, Lesley
- Date: 2016
- Type: Text , Journal article
- Relation: Archives of Gerontology and Geriatrics Vol. 64, no. (2016), p. 151-161
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Background: Exercise for falls prevention is effective but of limited uptake in real life. The link between intention and behavior is central to many health-behavior models, but has not been examined in the falls prevention exercise context. Objective: This study examines this relationship and prospectively identifies factors associated with participation in group and home-based falls prevention exercise. Design: This was an observational study of community-dwelling adults in Australia >70 years of age with a 12 month follow-up (n = 394 commenced baseline assessment, n = 247 commenced follow-up). Methods: Intention, and other potential predictive factors examined, were measured at baseline while participation was measured using self-report at 12 month follow-up. Results: Between 65% and 72% of our sample at baseline agreed or strongly agreed they would participate in the falls prevention exercise programs. n = 27 respondents participated in home-based exercise during follow-up and had intention to do so while n = 29 who participated did not have intention. In contrast, n = 43 respondents participated in group exercise and had intention to do so compared to 11 who participated but did not intend to at baseline. Perception of personal effectiveness and previous exposure to the exercise intervention were most strongly predictive of future participation. Conclusion: More people who do not want to participate in home exercise actually participate in home exercise than people who do not want to participate in group exercise that actually do. It may be easier to convince people who do not want to participate in falls prevention exercise to participate in a home program. © 2016 Elsevier Ireland Ltd.
What are the characteristics of home exercise programs that older adults prefer? A cross-sectional study
- Authors: Simek, Emily , McPhate, Lucy , Hill, Keith , Finch, Caroline , Day, Lesley , Haines, Terry
- Date: 2015
- Type: Text , Journal article
- Relation: American Journal of Physical Medicine & Rehabilitation Vol. 94, no. 7 (2015), p. 508-521
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: Objective The aim of this study was to examine the preferences of older adults toward the structure and delivery of home exercise programs for the prevention of falls as well as the perceived benefits of and barriers to program adherence. Methods A two-wave cross-sectional telephone survey of community-dwelling older adults was conducted in Victoria, Australia. Respondents were categorized as current, previous, or nonparticipants of a home exercise program in the last 6 yrs. Thematic analysis of open-response questions examining the preferences of current and previous participants toward participation in, and delivery of, home exercise programs for falls preventions was performed. Results A total of 245 respondents completed the follow-up survey. The respondents were classified as current (n = 54), previous (n = 22), or nonparticipants (n = 169) of a home exercise program in the last 6 yrs. Program adherence was influenced by the perceived effect of programs on physical and mental health, participant autonomy, and how well the program structure complemented individual exercise and lifestyle preferences. Conclusions Adherence to home exercise programs for falls prevention is influenced by personal preferences toward program structure and delivery as well as perceived benefits of and barriers to program participation. To optimize participant adherence, service providers need to consider personal preferences and some flexibility in the program being delivered.
"Are your clients having fun?" The implications of respondents' preferences for the delivery of group exercise programs for falls prevention
- Authors: McPhate, Lucy , Simek, Emily , Haines, Terry , Hill, Keith , Finch, Caroline , Day, Lesley
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Aging and Physical Activity Vol. 24, no. 1 (2016), p. 129-138
- Full Text: false
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- Description: Background: Group exercise has been shown to be effective in preventing falls; however, adherence to these interventions is often poor. Older adults' preferences for how these programs can be delivered are unknown. Objective: To identify older people's preferences for how group exercise programs for falls prevention can be delivered. Design: A two-wave, cross-sectional, state-wide telephone survey was undertaken. Respondents were community-dwelling men and women aged 70+ in Victoria, Australia. Methods: Open-ended questions were asked to elicit information regarding respondent preferences of the program, which were analyzed using a framework approach. Results: Ninetyseven respondents completed the follow-up survey. The results indicate that older adults most frequently report the short-term advantages and disadvantages when describing their preferences for group exercise, such as enjoyment, social interaction, and leader qualities. Longer-term advantages such as falls prevention were described less frequently. Conclusions: This study indicates the importance of interpersonal skills, and that the opportunity for social interaction should not be overlooked as a positive feature of a group exercise program. © 2016 Human Kinetics, Inc.