Design and development of a theory-informed peer-led falls prevention education programme to translate evidence into practice: A systematic approach

Peer-led education has been shown to be an effective approach for raising community-dwelling older adults’ beliefs, knowledge and intention to engage in falls prevention strategies in a recent intervention trial. This article outlines the design and development of the intervention, which was a peer-led falls prevention education programme designed to promote older adult’s motivation to change their behaviour in the area of falls prevention. The elements of the programme that contributed to its efficacy are also described. The programme was designed using a four-step approach and was based on the constructs of a theoretical framework (the COM-B model). Feedback from older adults was also incorporated into the programme development. Programme components developed were a workshop to train older adult peer educators to deliver falls prevention education, a one-hour peer-led falls prevention presentation, and supporting resources to aid programme delivery. A questionnaire measuring older adults’ responses to the presentation was concurrently developed and pilot-tested prior to implementation of the education programme. Finally, resources to monitor and evaluate fidelity at five points in the programme were developed. It was found that seeking older adult consumer involvement, and adopting a theoretical framework-driven approach contributes to effective design and delivery of falls prevention education programmes. This ensured that the programme was acceptable to older adults, feasible to deliver and allowed robust measurement of the effect of the education programme on important behavioural change components

Do peers increase older adults\u27 participation in strength training? Pilot randomized trial

Fewer than 20% of older adults participate in strength training (ST). Barriers to ST participation include not knowing where to go or not having someone to go with. To address these barriers, the authors provided older adults with a peer (older person already participating in ST) to support their engagement. The aim of this pilot randomized controlled trial was to determine whether older adults who were provided with a peer when participating in ST were more likely to be participating in ST 4 weeks postintervention, compared with those receiving ST alone. Fifty-one ST participants were recruited; 40 completed the intervention and postintervention data collection (78.4%). Providing peer support with ST did not significantly increase ST participation (p = .775). However, both groups made significant improvements over time in lower-limb strength and mobility. Participants in either group who continued the ST program (55%) had made additional significant improvements in lower-limb strength and mobility

GONG p-mode parameters through two solar cycles

We investigate the parameters of global solar p-mode oscillations, namely damping width $\Gamma$, amplitude $A$, mean squared velocity $\langle v^2\rangle$, energy $E$, and energy supply rate $\mathrm{d}E/\mathrm{d} t$, derived from two solar cycles' worth (1996 - 2018) of Global Oscillation Network Group (GONG) time series for harmonic degrees $l=0 - 150$. We correct for the effect of fill factor, apparent solar radius, and spurious jumps in the mode amplitudes. We find that the amplitude of the activity related changes of $\Gamma$ and $A$ depends on both frequency and harmonic degree of the modes, with the largest variations of $\Gamma$ for modes with $2400\,\mu\text{Hz}\le \nu \le 3300\,\mu\text{Hz}$ and $31\le l \le 60$ with a min-to-max variation of $26.6\pm0.3\%$ and of $A$ for modes with $2400\,\mu\text{Hz}\le\nu\le 3300\,\mu\text{Hz}$ and $61\le l \le 100$ with a min-to-max variation of $27.4\pm0.4\%$. The level of correlation between the solar radio flux $F_{10.7}$ and mode parameters also depends on mode frequency and harmonic degree. As a function of mode frequency, the mode amplitudes are found to follow an asymmetric Voigt profile with $\nu_{\text{max}}=3073.59\pm0.18\,\mu\text{Hz}$. From the mode parameters, we calculate physical mode quantities and average them over specific mode frequency ranges. This way, we find that the mean squared velocities $\langle v^2\rangle$ and energies $E$ of p modes are anti-correlated with the level of activity, varying by $14.7\pm0.3\%$ and $18.4\pm0.3\%$, respectively, and that the mode energy supply rates show no significant correlation with activity. With this study we expand previously published results on the temporal variation of solar p-mode parameters. Our results will be helpful to future studies of the excitation and damping of p modes, i.e., the interplay between convection, magnetic field, and resonant acoustic oscillations.Comment: Accepted for publication in Solar Physics. 33 pages, 16 figures, 5 table

Incidence and prevalence of falls in adults living with an intellectual disability living in the community: A systematic review

Review question/objective: The objective of this review is to synthesize the best available evidence to determine the incidence and prevalence of falls in adults with intellectual disability living in the community

Can a web-based community of practice be established and operated to lead falls prevention activity in residential care?

The aims of this study were to evaluate establishing and operating a web-based community of practice (CoP) to lead falls prevention in a residential aged care (RAC) setting. A mixed methods evaluation was conducted in two phases using a survey and transcripts from interactive electronic sources. Nurses and allied health staff (n = 20) with an interest in falls prevention representing 13 sites of an RAC organization participated. In Phase 1, the CoP was developed, and the establishment of its structure and composition was evaluated using determinants of success reported in the literature. In Phase 2, all participants interacted using the web, but frequency of engagement by any participant was low. Participatory barriers, including competing demands from other tasks and low levels of knowledge about information communication technology (ICT) applications, were identified by CoP members. A web-based CoP can be established and operated across multiple RAC sites if RAC management support dedicated time for web-based participation and staff are given web-based training

The effect of complex falls prevention interventions on falls in residential aged care settings: A systematic review protocol

The objective of this review is to synthesize the best available evidence on the effectiveness of complex falls prevention interventions on fall reductions in the residential aged care population, implemented at two or more of the following levels: organization, facility or resident. Specifically the review question is: What is the effect of complex falls prevention interventions on falls in residential aged care settings

Assessing knowledge, motivation and perceptions about falls prevention among care staff in a residential aged care setting

Falls are a serious problem in residential aged care settings. The aims of the study were to determine the feasibility of surveying care staff regarding falls prevention, and describe care staff levels of knowledge and awareness of residents\u27 risk of falls, knowledge about falls prevention, motivation and confidence to implement falls prevention strategies. A custom designed questionnaire was administered to care staff at one site of a large residential aged care organization in Australia. The survey response was 58.8%. Feedback from staff was used to inform the administration of the survey to the wider organization. Seven (29.2%) care staff reported they were unsure or thought residents were at low risk of falls. Only five (20.8%) care staff were able to suggest more than three preventive strategies. These preliminary findings suggest that education to change care staff behavior regarding falls prevention should target improving care staff knowledge and awareness of falls

How older adults would like falls prevention information delivered: Fresh insights from a world cafe forum

Translation of falls prevention evidence into practice is problematic. Understanding older adults’ views about falls prevention information could enhance delivery of falls prevention, resulting in better engagement and uptake of recommended activities. The aim of this study was to examine the views and preferences of community-dwelling older adults about seeking and receiving falls prevention information. A community forum using a modified World Café approach was conducted. Participants discussed five topic areas in small groups, under the guidance of table facilitators. Perspectives were captured on paper. Thematic analysis was conducted to identify factors that influence participants’ engagement and uptake of information. Seventy-three older adults participated in the forum covering wide-ranging preferences around falls prevention information. Personal experience was considered the key influence on an older adult’s decision to initiate seeking information. While health professionals were often approached, alternative sources such as public libraries, peer educators and seniors’ organisations were also favoured as credible sources of information. Older adults proposed falls prevention information should be delivered with a positive tone, coupled with highly valued qualities of respect, empathy and time to listen to foster motivation to engage in recommended activities. Consumer-focused practical strategies were proposed to potentially improve future design, communication and dissemination of falls prevention information. This improvement could enhance engagement of messages and subsequent uptake of falls prevention recommended strategies