We are all one together : peer educators\u27 views about falls prevention education for community-dwelling older adults - a qualitative study

Background: Falls are common in older people. Despite strong evidence for effective falls prevention strategies, there appears to be limited translation of these strategies from research to clinical practice. Use of peers in delivering falls prevention education messages has been proposed to improve uptake of falls prevention strategies and facilitate translation to practice. Volunteer peer educators often deliver educational presentations on falls prevention to community-dwelling older adults. However, research evaluating the effectiveness of peer-led education approaches in falls prevention has been limited and no known study has evaluated such a program from the perspective of peer educators involved in delivering the message. The purpose of this study was to explore peer educators’ perspective about their role in delivering peer-led falls prevention education for community-dwelling older adults. Methods: A two-stage qualitative inductive constant comparative design was used.In stage one (core component) focus group interviews involving a total of eleven participants were conducted. During stage two (supplementary component) semi-structured interviews with two participants were conducted. Data were analysed thematically by two researchers independently. Key themes were identified and findings were displayed in a conceptual framework. Results: Peer educators were motivated to deliver educational presentations and importantly, to reach an optimal peer connection with their audience. Key themes identified included both personal and organisational factors that impact on educators’ capacity to facilitate their peers’ engagement with the message. Personal factors that facilitated message delivery and engagement included peer-to-peer connection and perceived credibility, while barriers included a reluctance to accept the message that they were at risk of falling by some members in the audience. Organisational factors, including ongoing training for peer educators and formative feedback following presentations, were perceived as essential because they affect successful message delivery. Conclusions: Peer educators have the potential to effectively deliver falls prevention education to older adults and influence acceptance of the message as they possess the peer-to-peer connection that facilitates optimal engagement. There is a need to consider incorporating learnings from this research into a formal large scale evaluation of the effectiveness of the peer education approach in reducing falls in older adults

‘Perceptions of non-accidental child deaths as preventable events: The impact of probability heuristics and biases on child protection work'

Anxiety about the possibility of non-accidental deaths of children has had a major influence on child care policy and practice over the last 40 years. The formal inquiry reports and media coverage of these rare events serve to maintain the perception that these are regular incidents that happen far too often and that they could have been prevented. This focus on individual events tends to distort a clear view of the actual probability of non-accidental deaths and serves to reinforce the notion that potentially all child care cases are risky and that any social work practitioner could be involved in such a case. As a result, work with children has become highly risk averse. However, in statistical terms, the probability of non-accidental child deaths is very low and recently has averaged about 55 deaths a year. Children are at considerably higher risk of being killed on the roads. This paper examines the way in which perceptions of the ‘high’ level of risk of possible child deaths are maintained despite the very low statistical probability of such incidents. It draws on thinking from behavioural psychology and, in particular the work of Kahneman and Tversky, to consider some of the biases in probability reasoning affecting people’s perception of risk and explores how inquiry reports into single past events reconfirm risk perceptions. It is suggested that recognition of the essentially unpredictable nature of future non-accidental child deaths would free up childcare professionals to work in a more positive and less risk-averse manner in the present

‘Perceptions of non-accidental child deaths as preventable events: The impact of probability heuristics and biases on child protection work'

Anxiety about the possibility of non-accidental deaths of children has had a major influence on child care policy and practice over the last 40 years. The formal inquiry reports and media coverage of these rare events serve to maintain the perception that these are regular incidents that happen far too often and that they could have been prevented. This focus on individual events tends to distort a clear view of the actual probability of non-accidental deaths and serves to reinforce the notion that potentially all child care cases are risky and that any social work practitioner could be involved in such a case. As a result, work with children has become highly risk averse. However, in statistical terms, the probability of non-accidental child deaths is very low and recently has averaged about 55 deaths a year. Children are at considerably higher risk of being killed on the roads. This paper examines the way in which perceptions of the ‘high’ level of risk of possible child deaths are maintained despite the very low statistical probability of such incidents. It draws on thinking from behavioural psychology and, in particular the work of Kahneman and Tversky, to consider some of the biases in probability reasoning affecting people’s perception of risk and explores how inquiry reports into single past events reconfirm risk perceptions. It is suggested that recognition of the essentially unpredictable nature of future non-accidental child deaths would free up childcare professionals to work in a more positive and less risk-averse manner in the present

Ethical challenges of conducting health research in UK school setting

This paper offers guidance for novice nurse researchers on the ethical and methodological challenges of conducting health research in high school settings. Over the course of two studies in UK high schools with students aged 11–16 years, the authors encountered common ethical and methodological challenges. This article draws on these studies to build a critique of approaches to health research in school settings. Issues of consent and assent, confidentiality and participation can highlight tensions between the expectations of schools and health researchers. In this context, feasible research designs raise complex ethical and methodological questions. Ethical and methodological norms for health research may not be suitable for high school settings. Successful school-based health research designs may need to be flexible and responsive to the social environment of schools