scholarly journals Developing, Testing, and Implementing a Falls Prevention and Healthy Aging App (Keep-On-Keep-Up) for Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 516-516
Author(s):  
Emma Stanmore

Abstract Falls are a common and costly concern for older adults. Digital technologies can offer new, inexpensive approaches to increase access and engagement with falls prevention programmes. Keep-On-Keep-Up is a personalised, falls prevention App with strength and balance exercises plus health literacy games. This study reports on the user-centred design, usability testing and implementation of the KOKU App. Older adults aged 55 years and older in the UK were invited to take part in the study. Data collection included focus groups; baseline and 6 week questionnaires and assessments; semi-structured interviews and one focus group with falls prevention therapists to explore App usability. Thirty older adults were invited to use KOKU unsupervised, 3 times a week for 6 weeks. Data were analysed using thematic content analysis. Focus groups (n=11) with 66 older users and 11 therapists informed development. Thirty older adults (mean age = 75) were recruited for the in-depth testing. Mean SUS score was 71 indicating high usability. Qualitative themes included: ease of use (app usability; iPad properties; exercise presentation), usefulness (physical/psychological benefits; falls education), attitude towards the App and intention to use (technological barriers; flexibility of use; exercise class versus App). Therapists (n=6) viewed the KOKU platform positively and suggested extensions for further progression. No adverse events were reported during the study. This research demonstrates that KOKU is an acceptable and easy to use falls prevention intervention that facilitates older adults’ ability to access falls prevention training at a time, and in a location, that suits them.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Zastrow ◽  
K Neher ◽  
H Hassel

Abstract Background Healthy aging is one of the major challenges currently faced by an aging population. Food literacy (FL) refers to the ability to apply knowledge and practical skills regarding healthy and sustainable nutrition into everyday life. The project “GUSTO” is sponsored by the Bavarian State Ministry of Health and Care and aims to contribute to enjoyable aging by developing the nutritional skills of people aged 65 and over. This community-based program comprises independent working groups of older adults guided by peer moderators. The FL intervention is developed in cooperation with the target group. Methods The nutritional situation of older adults was first established through a literature research. The results of this research were compared to the “self-perceived food literacy scale” by Poelman et al. (2018) and the “nutritional framework for literacy courses” by Johannsen et al. (2019). The resulting data provided a basis for focus group discussions carried out in six municipalities, supported by local practice partners. In six guided focus group discussions, a number of recurring themes were identified and summarized. Results The focus groups consisted of a total of 44 people between 62 and 88 years of age (average age: 73.1 ± 6.1 years). 22.7 % were men. The group discussions revealed resources used and barriers encountered in terms of FL and interests of older adults. It was evident that, due to the high density of information available, the participants found it difficult to identify reliable information and to implement it in their everyday life. At the request of the focus groups, topics such as the best before date and the use of food waste were added to the intervention. Conclusions Older adults find it challenging to identify reliable nutritional information and implement it in their everyday life. With the help of the participatory approach outlined in this study, target group-related issues can be identified and taken into account in the intervention. Key messages Older adults can be involved in the development of an FL intervention. A participatory approach allows target group-related issues and specific needs to be taken into account in the intervention.


2021 ◽  
Vol 5 ◽  
Author(s):  
Kathryn McEwan

As trends of social and economic change allow precarity to inch into the lives of those who may have been more accustomed to security (Standing, 2011, 2014), this paper addresses the response of some young people who are caught “betwixt and between” in potentially liminal states (Turner, 1967). Those whose families have undertaken intra- or intergenerational social mobility and who have made a home in a place, Ingleby Barwick in Teesside, that seems to be of them and for them—an in-between place that is seen as “not quite” middle or working class. This paper draws data from a research project that adopted a qualitative phenomenological approach to uncover the meaning of experiences for participants. Methods included focus groups and semi-structured interviews through which 70 local people contributed their thoughts, hopes, concerns, and stories about their lives now and what they aspire to for the future. Places, such as the large private housing estate in the Northeast of England on which this research was carried out, make up significant sections of the UK population, yet tend to be understudied populations, often missed by a sociological gaze attracted to extremes. It was anticipated that in Ingleby Barwick, where social mobility allows access to this relatively exclusive estate, notions of individualism and deservingness that underlie meritocratic ideology (Mendick et al., 2015; Littler, 2018) would be significant, a supposition borne out in the findings. “Making it” to Ingleby was, and continues to be, indicative to many of meritocratic success, making it “a moral place for moral people” (McEwan, 2019). Consequently, the threat then posed by economic precarity, of restricting access to the transitions and lifestyles that create the “distinction” (Bourdieu, 1984) required to denote fit to this place, is noted to be very real in a place ironically marked by many outside it as fundamentally unreal.


2019 ◽  
Vol 48 (1) ◽  
pp. 17-30 ◽  
Author(s):  
Kim Lombard ◽  
Laura Desmond ◽  
Ciara Phelan ◽  
Joan Brangan

Purpose As one ages, the risk of experiencing a fall increases and poses a number of serious consequences; 30 per cent of individuals over 65 years of age fall each year. Evidence-based falls prevention programmes demonstrate efficacy in reducing the rate and risk of falls among older adults, but their use in Irish occupational therapy practice is unknown. This study aims to investigate the implementation of falls prevention programmes by occupational therapists working with older adults in Ireland. Design/methodology/approach A cross-sectional survey was used to gather data on the use of falls prevention programmes among occupational therapists working with older adults in any clinical setting across Ireland. Purposeful, convenience and snowball sampling methods were used. The Association of Occupational Therapists of Ireland acted as a gatekeeper. Descriptive statistics and summative content analysis were used to analyse quantitative and qualitative data, respectively. Findings In all, 85 survey responses were analysed. Over 85 per cent of respondents reported “Never” using any of the evidence-based falls prevention programmes. The “OTAGO” Exercise Programme was the most “Frequently” used programme (9.5 per cent, n = 7); 29 respondents reported using “in-department” developed falls prevention programmes and 14 provided additional comments regarding current falls prevention practices in Ireland. Originality/value In the absence of Irish data on the subject, this study provides a benchmark to describe the use of evidence-based falls programmes by Irish occupational therapists with older adults.


BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e024982 ◽  
Author(s):  
Vicky Booth ◽  
Rowan Harwood ◽  
Jennie E Hancox ◽  
Victoria Hood-Moore ◽  
Tahir Masud ◽  
...  

ObjectivesThis review aimed to identify mechanisms underlying participation in falls prevention interventions, in older adults with cognitive impairment. In particular we studied the role of motivation.DesignA realist review of the literature.Data sourcesEMBASE, MEDLINE, CINAHL, the Cochrane Library, PsycINFO and PEDRO.Eligibility criteriaPublications reporting exercise-based interventions for people with cognitive impairment, including dementia, living in the community.Data extraction and synthesisA ‘rough programme theory’ (a preliminary model of how an intervention works) was developed, tested against findings from the published literature and refined. Data were collected according to elements of the programme theory and not isolated to outcomes. Motivation emerged as a key element, and was prioritised for further study.ResultsAn individual will access mechanisms to support participation when they think that exercise will be beneficial to them. Supportive mechanisms include having a ‘gate-keeper’, such as a carer or therapist, who shares responsibility for the perception of exercise as beneficial. Lack of access to support decreases adherence and participation in exercise. Motivational mechanisms were particularly relevant for older adults with mild-to-moderate dementia, where the exercise intervention was multicomponent, in a preferred setting, at the correct intensity and level of progression, correctly supported and considered, and flexibly delivered.ConclusionMotivation is a key element enabling participation in exercise-based interventions for people with cognitive impairment. Many of the mechanisms identified in this review have parallels in motivational theory. Clinically relevant recommendations were derived and will be used to further develop and test a motivationally considered exercise-based falls intervention for people with mild dementia.PROSPERO registration numberCRD42015030169.


2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Charlotte Dando ◽  
Dawn Bacon ◽  
Alan Borthwick ◽  
Catherine Bowen

Abstract Background The aim of this study was to explore the views of stakeholders in podiatry services, patients, commissioners and general practitioners (GP), to further understand experiences of referral, access and provision of treatment in the National Health Service (NHS) for foot problems for patients living with arthritis. Method To explore in-depth individual views and experiences of stakeholders in podiatry services, 19 patients who had arthritis (osteoarthritis and/or rheumatoid arthritis) participated in one of four focus groups. In addition, seven commissioners and/or GPs took part in semi structured interviews. A purposive sampling strategy was adopted for all focus groups and semi structured interviews. To account for geographical variations, the focus groups and semi structured interviews were conducted across two predetermined regions of the United Kingdom (UK), Yorkshire and Hampshire. Data was rendered anonymous and transcribed verbatim. Thematic analysis was employed to identify key meanings and report patterns within the data. Results Five key themes derived from the focus groups and interviews suggest a variety of factors influencing referral, access and provision of treatment for foot problems within the UK. 1. Systems working together (navigation of different care pathways, access and referral opportunities for people with OA or RA, education around foot health services for people with OA or RA); 2.Finance (financial variations, different care systems, wasting resources); 3. Understanding what podiatry services have to offer (podiatrists are leaders in foot health services, service requirements in relation to training standards and health needs); 4. Person factors of foot pain (arthritis is invisible, affects quality of life, physical and mental wellbeing); 5. Facilitators of foot care (NICE guidelines, stakeholder events, supporting self-management strategies). Conclusion The findings indicate that patients, commissioners and GPs have very similar experiences of referral, access and provision of treatment for foot problems, for patients living with arthritis. Essentially, commissioners and GPs interviewed called for a transformational approach in current systems to include newer models of care that meet the footcare needs of individual patient circumstances. Patients interviewed called for better signposting and information about the different services available to help them manage their foot health needs. To address this, we have formulated a signposting pack for all stakeholders to help them facilitate access to appropriate clinicians ‘at the right time, in the right place’ to manage foot health problems.


2016 ◽  
Vol 12 (2) ◽  
pp. 210-224 ◽  
Author(s):  
Gordon Tait ◽  
Belinda Carpenter

AbstractThe long history of suicide as a criminal offence still has a significant contemporary effect on how it is perceived, conceptualised and adjudged. This is particularly the case within countries where suicide is largely determined within a coronial system, such as Australia, the UK and the US. This paper details the outcomes of a study involving semi-structured interviews with coroners both in England and Australia, as well as observations at inquests. It focuses around the widely held contention that the suicide rates produced within these coronial systems are underestimations of anywhere between 15 to 50 per cent. The results of these interviews suggest that there are three main reasons for this systemic underestimation. The first reflects the legacy of suicide as a criminal offence, resulting in the highest standard of proof for findings of suicide in the UK, and a continuing stigma attached to families of the deceased. The second is the considerable pressure brought to bear upon coroners by the family of the deceased, who, because of that stigma, commonly agitate for any finding other than that of suicide. The third involves the rise of ‘therapeutic jurisprudence’, wherein coroners take on the responsibility of the emotional well-being of the grieving families, which in turn affects the likelihood of reaching a finding of suicide. The conclusions drawn by the paper are also twofold: first – with respect to the stigma of suicide – it will take a lot more than simple decriminalisation to change deeply held social perceptions within the community. Second, given that suicide prevention programmes and policies are based on such deeply questionable statistics, targeted changes to coronial legislation and practice would appear to be required.


2017 ◽  
Vol 67 (660) ◽  
pp. e467-e473 ◽  
Author(s):  
Alice C Tompson ◽  
Sabrina Grant ◽  
Sheila M Greenfield ◽  
Richard J McManus ◽  
Susannah Fleming ◽  
...  

BackgroundBlood pressure (BP) self-screening, whereby members of the public have access to BP monitoring equipment outside of healthcare consultations, may increase the detection and treatment of hypertension. Currently in the UK such opportunities are largely confined to GP waiting rooms.AimTo investigate the reasons why people do or do not use BP self-screening facilities.Design and settingA cross-sectional, qualitative study in Oxfordshire, UK.MethodSemi-structured interviews with members of the general public recruited using posters in GP surgeries and community locations were recorded, transcribed, and coded thematically.ResultsOf the 30 interviewees, 20% were hypertensive and almost half had self-screened. Those with no history of elevated readings had limited concern over their BP: self-screening filled the time waiting for their appointment or was done to help their doctor. Patients with hypertension self-screened to avoid the feelings they associated with ‘white coat syndrome’ and to introduce more control into the measurement process. Barriers to self-screening included a lack of awareness, uncertainty about technique, and worries over measuring BP in a public place. An unanticipated finding was that several interviewees preferred monitoring their BP in the waiting room than at home.ConclusionBP self-screening appeared acceptable to service users. Further promotion and education could increase awareness among non-users of the need for BP screening, the existence of self-screening facilities, and its ease of use. Waiting room monitors could provide an alternative for patients with hypertension who are unwilling or unable to monitor at home.


Author(s):  
Deshini Naidoo ◽  
Jacqueline Van Wyk ◽  
Robin W. E. Joubert

Background: Re-engineering of primary healthcare (PHC) was initiated nationally in 2009. There is, however, little information on the role expected of occupational therapists (OTs)in PHC. Objectives: This research aimed to understand how stakeholders of the Department of Health (DOH) perceived the role of OT in PHC service. Method: This exploratory, qualitative study used purposive sampling to recruit community health-care workers (CHW; n = 23), primary healthcare nurses (PHC; n = 5), DOH management (n = 5), experienced (n = 14) and novice OTs (n = 37) who graduated from the University of KwaZulu-Natal. The PHC nurses and the CHW represented PHC clinics in one district in KwaZulu-Natal. Data were collected through semi-structured interviews and focus groups. Interviews with CHWs were conducted in isiZulu. These were transcribed and translated prior to data analysis. Audio recordings of English interviews and focus groups were transcribed. Data for each participant group were inductively and thematically analysed to identify the themes. Results: The findings provided an indication of the role of OTs in PHC settings. All participants perceived the role of OTs as predominantly curative/rehabilitation-based and individualised. Participants had a limited understanding of the key principles of PHC. They identified a need for adult and paediatric rehabilitation and early childhood intervention. Limited mention was made of population-based approaches, collaborative, and health promotion and prevention programmes. Conclusion: The study has highlighted that neither management nor OTs seemed to align practice and planning according to PHC principles. A review of the theory and experiential learning in the OT programme is required.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicola Morant ◽  
Alyssa Milton ◽  
Eleanor Gilbert ◽  
Sonia Johnson ◽  
Nicholas Parsons ◽  
...  

Abstract Background Employment within social firms in the UK is under-developed and under-researched, but a potentially beneficial route to vocational rehabilitation for people with mental health problems. This study explores the views and experiences of employees with mental ill-health, managers of social firms and mental health clinicians, in order to understand the potential value of social firms for the vocational rehabilitation, employment and well-being of people with mental health problems. Methods Semi-structured interviews were conducted with 23 employees with mental health problems in 11 social firms in England. A focus group and individual interviews were conducted with 12 managers of social firms. Two focus groups were held with 16 mental health clinicians. Data were analysed using thematic analysis. Results Most employees expressed very positive views about working in a social firm. In responses from both employees and social firm managers, an overarching theme regarding the supportive ethos of social firms encompassed several related features: openness about mental health issues; peer, team and management support; flexibility; and support to progress and develop skills over time. Managers identified benefits of employing people with mental health problems who were sufficiently recovered. Knowledge of social firms within clinician focus groups was very limited, although clinicians thought they could be a welcome additional vocational resource. Conclusions High levels of job satisfaction among social firm employees may be explained by the supportive ethos of these working environments. Social firms have potential to be a helpful addition to the range of vocational pathways available for people with mental ill-health. Further mixed methods investigations of experiences and outcomes in order to understand who engages with and benefits from this form of vocational rehabilitation would be valuable in informing decisions about scaling up the model.


2018 ◽  
Vol 7 (3) ◽  
pp. 228-247 ◽  
Author(s):  
Jenni Jones

Purpose The purpose of this paper is to attempt to demonstrate that formal mentoring is a helpful tool to develop managers within the changing context of the UK Police, and to highlight how managers can have an influence on mentoring programmes and the learning within them. Design/methodology/approach A longitudinal qualitative case study approach was chosen and semi-structured interviews were conducted alongside focus groups. Findings The findings showed that both mentees and mentors perceived they were learning within the mentoring relationship. Also, despite some common themes in relation to the key moderating factors, managers were seen as both facilitating and hindering these mentoring relationships. Research limitations/implications It was recognised that although interesting to compare and contrast the findings between the two different case study organisations, the findings drawn from this study may not be directly applicable to other mentoring programmes beyond these UK Police Forces. More could have been explored in the focus groups and information could have been collected from those that did not attend the interviews or the focus groups. Originality/value This research adds value as there is little written about the mentoring and managers, within the interesting changing context of the UK Police force. The insights from this mentoring research suggest that there is much learning to be gained by both parties through mentoring and that line managers need to be encouraged away from the day to day reactive approach towards being more proactive with supporting the personal development of their team members (and themselves) into the future. If they are more involved and supportive of learning and development interventions, then they and their team members will gain more from the experience and this will ultimately help them to make a more positive difference within their role.


Sign in / Sign up

Export Citation Format

Share Document