FALL PREVENTION IN RURAL COMMUNITIES OF NORTH DAKOTA

Abstract Fall-related injuries are common sources of morbidity and mortality for adults aged 65 and older. Thus, interventions for preventing falls can have substantial public health benefits. One promising fall prevention program is the Stepping On program, which involves seven community-based workshops. In these workshops, older adults learn about risk factors for falls, as well as safety-conscious behaviors. Stepping On has been offered in several states, and outcomes have been positive. However, research in rural areas has been lacking. To address this issue, the current study examined 508 older adults who participated in the Stepping On program across 53 rural communities in North Dakota through May of 2019. Most participants were female (82%), with an average age of 79 years (range 65-98). Participants completed baseline and post-test assessments of their knowledge regarding health, mobility, and safety issues. At baseline, 46% of participants reported falling at least once during the previous year. Repeated-measures ANOVAs showed that participants had improved significantly in the following areas at post-test: understanding how vision influences safety; knowledge of balance and strength exercises; recognizing hazards in the home; choosing safe footwear; confidence in mobility; understanding how medications affect fall risk; and the importance of bone health (p<0.001 for all). Just 14% of participants reported falling during the year following the workshops, and 62% felt that the program reduced their risk of falls “to a big extent.” These findings suggest that the Stepping On program is feasible to administer in rural areas and benefits older adults in such communities.

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Comparison of The Risk Factors For Falls Among Older Adults Between Urban and Rural Areas of Shantou City, China

10.21203/rs.3.rs-72830/v1 ◽

2020 ◽

Author(s):

Xiaodong Chen ◽

Zeting Lin ◽

Ran Gao ◽

Yijian Yang ◽

Liping Li

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fall Prevention ◽

Rural Areas ◽

Urban Areas ◽

Multivariable Analysis ◽

Living Environment ◽

Balance Function ◽

Urban And Rural Areas ◽

Risk Factors For Falls

Abstract Background: To investigate the prevalence of falls and risk factors among older adults in urban and rural areas and to facilitate the design of fall prevention interventions.Methods: We used cluster random sampling to investigate the sociodemographic information, living habits, medical history, and falls among 649 older adult participants. Univariable and multivariable logistic regression was used to examine fall risk factors in urban and rural areas.Results: The fall rate and rate of injury from falls among older adults in urban areas were 27.3% and 18.6%, respectively, which were higher than those in rural areas (17.0% and 12.2%; P<0.05). Multivariable analysis showed that the risk factors for falls among urban older adults included a high school or below education level (OR=3.737, 95% CI: 1.503~9.291); diabetes medicine use (OR=4.518, 95% CI: 1.228~16.626); incontinence (OR=8.792, 95% CI: 1.894~40.824); lack of fall prevention education (OR = 11.907, 95% CI: 1.321～107.354); and reduced balance function (OR = 3.901, 95% CI: 1.894~7.815). The risk factors among rural older adults included a previous nonfarming occupation (OR=2.496, 95% CI: 1.416~4.398); incontinence (OR =11.396, 95% CI: 1.901~68.327); poor living environment (OR=3.457, 95% CI: 1.488~8.033); and reduced balance function (OR =4.260, 95% CI: 2.361~7.688).Discussion: The rate of falls among older adults in urban areas is higher than that in rural areas of Shantou City. Fall prevention in urban areas should target older adults with low education and modify the diabetes medication use. Interventions should focus on improving the home environment of older adults in rural areas.

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FALL RISK BEHAVIORS AND INTRINSIC RISK FACTORS FOR FALLS IN INDIGENOUS AND NON-INDIGENOUS RURAL OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.1758 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S471-S472

Author(s):

Andre G Bouweraerts ◽

Justus Ortega

Keyword(s):

Risk Factors ◽

Older Adults ◽

Rural Communities ◽

Risk Behaviors ◽

Rural Areas ◽

Fall Risk ◽

Future Studies ◽

Fall Risk Factors ◽

Fall Rates ◽

Risk Factors For Falls

Abstract Within California, older adults living in rural counties have reported higher rates of falls than urban dwelling older adults. Although many Indigenous people live in rural areas, it is unclear whether the rate of falls among Indigenous older adults is similar to that of non-indigenous older adults living in rural areas. Thus, the purpose of this study was to examine fall risk behaviors and intrinsic risk factors for falls in rural dwelling Indigenous (N = 89), and non-Indigenous (N = 68) older adults 60-95 years of age living in California. Results showed that both Indigenous and non-Indigenous older adults share similarly high fall rates, but there are a much greater number of Indigenous older adults falling multiple times a year. Moreover, fall risk behaviors and intrinsic fall risk factors were significantly different between Indigenous and non-Indigenous rural-dwelling older adults. Future studies should investigate falls and fall risk factors in different tribes/locations of Indigenous older adults to better understand whether these risk factors differ among tribes. Moreover, it would be beneficial for future studies to assess the effectiveness of fall prevention exercises on fall risk in these communities. Information gained from this study helps to inform clinicians and researchers alike about the prevalence of falls and factors contributing to falls among Indigenous older adults living in rural communities; and helps to influence decisions in the future of programs for reducing fall risk in this often neglected population.

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Prevalence and Associated Factors of Falls among Older Adults between Urban and Rural Areas of Shantou City, China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18137050 ◽

2021 ◽

Vol 18 (13) ◽

pp. 7050

Author(s):

Xiaodong Chen ◽

Zeting Lin ◽

Ran Gao ◽

Yijian Yang ◽

Liping Li

Keyword(s):

Older Adults ◽

Fall Prevention ◽

Rural Areas ◽

Urban Areas ◽

Associated Factors ◽

Average Rate ◽

Targeted Interventions ◽

Risk Of Falls ◽

Balance Ability ◽

Urban And Rural Areas

Background: To investigate the prevalence of falls and associated factors among older adults in urban and rural areas and to facilitate the design of fall prevention interventions. Methods: We used cluster random sampling to investigate the sociodemographic information, living habits, medical status, falls, home environment, and balance ability among 649 older adult participants. Univariate and multivariate logistic regression were used to examine the associated factors of falls. Results: The incidence of falls among older adults in Shantou City was 20.65%. Among them, the incidence was 27.27% in urban areas and 16.99% in rural areas. The rate of injury from falls among older adults was 14.48%, with18.61% in urban area and 12.20% in rural area. Multivariate analysis showed that the associated factors of falls among older adults in Shantou City included a high school or below education level (OR = 2.387, 95% CI: 1.305–4.366); non-farming as the previous occupation (OR = 2.574, 95% CI: 1.613–4.109); incontinence(OR = 2.881, 95% CI: 1.517–5.470); lack of fall prevention education (OR = 1.856, 95% CI: 1.041–3.311); and reduced balance ability (OR = 3.917, 95% CI: 2.532–6.058). Discussion: Older adults have a higher rate of falling in Shantou City, compared to the average rate in China. There are similarities and differences in the associated factors of falls among older adults between urban and rural areas of Shantou City. Targeted interventions for older adults in different regions may be more effective in reducing the risk of falls.

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Empowering traditional birth attendants as agents of maternal and neonatal immunization uptake in Nigeria: a repeated measures design

BMC Public Health ◽

10.1186/s12889-021-10311-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chinedu Anthony Iwu ◽

Kenechi Uwakwe ◽

Uche Oluoha ◽

Chukwuma Duru ◽

Ernest Nwaigbo

Keyword(s):

Rural Communities ◽

Rural Areas ◽

Repeated Measures ◽

Average Length ◽

Traditional Birth Attendants ◽

Post Intervention ◽

Repeated Measures Design ◽

Birth Attendants ◽

Culturally Adapted ◽

Workshop Intervention

Abstract Background Adequate immunization coverage in rural communities remain a challenge in Nigeria. Traditional birth attendants (TBAs) form an integral part of the social, cultural and religious fabric in most rural communities in Nigeria. Despite their limitations in handling the complications of childbirth, TBAs are widely accepted and patronized, especially in rural areas. The objectives of the project were to empower TBAs and assess the use of a culturally adapted audio-visual workshop intervention to change their knowledge, attitude and willingness to promote immunization uptake. Methods A repeated-measures design that used a convenience sampling technique to select 90 TBAs from the three geopolitical zones of Imo State, Nigeria. The TBAs were engaged through a culturally adapted audio-visual workshop. Data were collected before and immediately after intervention using a pretested questionnaire. Chi square test was done to determine any significant association with the zone of practice and paired sample t-test analysis to determine any significant pre and post intervention change. Level of significance was set at p ≤ ·05. Results More than half of the TBAs had at most, a secondary level of education (54·4%). The average length of time they practiced as TBAs was 16 years with an average of ten birth deliveries per month. After the intervention, all the respondents (100%) reported a willingness to always promote immunization uptake and also, there was a statistically significant increase in Knowledge (p < ·000). Similarly, the level of knowledge in the post intervention period appeared to be significantly associated with the zone of practice (p = ·027). Conclusion The workshop intervention empowered the TBAs irrespective of their zones of residence by successfully improving their knowledge, though at varying levels; and consequently, their willingness to always promote immunization uptake.

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Empowering Traditional Birth Attendants as Agents of Maternal and Neonatal Immunization Uptake in Nigeria: a repeated measures design.

10.21203/rs.3.rs-51299/v3 ◽

2020 ◽

Author(s):

Chinedu Anthony IWU ◽

Kenechi Uwakwe ◽

Uchechukwu Raphael Oluoha ◽

Chukwuma Duru ◽

Ernest Nwaigbo

Keyword(s):

Rural Communities ◽

Rural Areas ◽

Repeated Measures ◽

Average Length ◽

Traditional Birth Attendants ◽

Post Intervention ◽

Repeated Measures Design ◽

Birth Attendants ◽

Culturally Adapted ◽

Workshop Intervention

Abstract Background: Adequate immunization coverage in rural communities remain a challenge in Nigeria. Traditional birth attendants (TBAs) form an integral part of the social, cultural and religious fabric in most rural communities in Nigeria. Despite their limitations in handling the complications of childbirth, TBAs are widely accepted and patronized, especially in rural areas. The objectives of the project were to empower TBAs and assess the use of a culturally adapted audio-visual workshop intervention to change their knowledge, attitude and willingness to promote immunization uptake. Methods: A repeated-measures design that used a convenience sampling technique to select 90 TBAs from the three geopolitical zones of Imo State, Nigeria. The TBAs were engaged through a culturally adapted audio-visual workshop. Data were collected before and immediately after intervention using a pretested questionnaire. Chi square test was done to determine any significant association with the zone of practice and paired sample t-test analysis to determine any significant pre and post intervention change. Level of significance was set at p ≤ ·05.Results: More than half of the TBAs had at most, a secondary level of education (54·4 %). The average length of time they practiced as TBAs was 16 years with an average of ten birth deliveries per month. After the intervention, all the respondents (100%) reported a willingness to always promote immunization uptake and also, there was a statistically significant increase in Knowledge (p<·000). Similarly, the level of knowledge in the post intervention period appeared to be significantly associated with the zone of practice (p= ·027). Conclusion: The workshop intervention empowered the TBAs irrespective of their zones of residence by successfully improving their knowledge, though at varying levels; and consequently, their willingness to always promote immunization uptake.

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Exploring Daily Activity Patterns on the Typical Day of Older Adults for Supporting Aging-in-Place in China’s Rural Environment

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17228416 ◽

2020 ◽

Vol 17 (22) ◽

pp. 8416

Author(s):

Ziqi Zhang ◽

Zhi Qiu

Keyword(s):

Older Adults ◽

Rural Communities ◽

Rural Areas ◽

Rural China ◽

Activity Patterns ◽

Real Life ◽

Working Hours ◽

Economic Security ◽

Paid Work ◽

Definition Of

Severe aging in rural China is prompting communities to promote support for older people to age in place. The study of the daily life of older adults in rural areas is conducive to understanding their real life and demands, as well as the way they interact with their environment, to develop feasible strategies. In this study, 171 older adults over 60 years old in two different types of villages in Northern Zhejiang Province were investigated and analyzed in terms of the temporal and spatial features of daily activities, as well as their relationship with population attributes, personal competence, and subjective demands. The results show that: (1) significant association can be seen between working hours and the demand for health services, housework hours and gender and age, as well as leisure hours and ADL and the demand for recreational services. (2) The older adults appear to have inter-group homogeneity in some aspects: basic living activities, leisure hours, the gender difference in housework hours, and recreational preference, while they have higher average paid work hours and fewer leisure alternatives than their urban counterparts. Their definitions of paid work, housework, and leisure activities are vague. (3) The definition of home by the older adults in rural places sometimes seems to go beyond the scope of their own house, and the extensive definition of home may change their recognitions of some activities. They also inclined to assign meaning to a place through frequent use rather than through external definitions. (4) The weak consciousness on buying services and deteriorated financial situation hinders the older adults in rural communities from expressing their real demands. Unspoken demands include economic security, recreational choices, and assistance in housework. The results will help to provide references for the improvement of eldercare services and the community environment.

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Exploring the Three-Way Destination Safety Solution to Crisis Management in Tourist Destinations in Rural Nigeria

Public Sector Crisis Management ◽

10.5772/intechopen.89727 ◽

2020 ◽

Author(s):

Elochukwu A. Nwankwo

Keyword(s):

Rural Communities ◽

Crisis Management ◽

Rural Areas ◽

Developing Nations ◽

Tourist Destination ◽

Safety Issues ◽

Tourist Destinations ◽

Rural Nigeria ◽

Principal Factors ◽

Tourism Resources

Development of tourist destinations is among topical issues in national discourse for economic growth and sustainability. The past two decades have witnessed massive development and investment in tourist destinations in rural areas. This is owing to the fact that rural tourism has been identified as among the development options for rural communities in most developing nations. Of recent, crisis and other safety issues have been among the militating factors against tourist destinations hence the cry for destination safety. These are said to emanate from the activities of the three major principals in the management of tourist destinations (hosts, tourism resources, and tourists/visitors). Incidentally, destination safety discourse is source of worry for these principal factors in tourist destination management. This has left many tourist destinations devastated, abandoned and abused. However, this chapter proposal would seek to identify the way out of this predicament. It tends to explore the meaning and application of the three-way destination safety (TWaDeSS) model in the management of crisis at tourist destinations in rural Nigeria. This will not only promote harmony among the three major principals in tourist destination but also enhance the rate of investment as a result of quality crisis control in these destinations.

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Community-Engaged Older Adult-Led Policy, Systems, and Environment Interventions in the MS High Obesity Program

Innovation in Aging ◽

10.1093/geroni/igab046.1620 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 420-420

Author(s):

Masey Smith ◽

Katie Halfacre ◽

Megan Holmes ◽

David Buys

Keyword(s):

Older Adults ◽

Rural Communities ◽

Rural Areas ◽

Food Systems ◽

Community Gardens ◽

Community Based Participatory Research ◽

Poor Outcomes ◽

New Policies ◽

Policy Systems ◽

Work Done

Abstract Older adults in rural areas are at unique risk for poor outcomes due to social isolation and limited access to resources. The Mississippi High Obesity Program (HOP) aims to enhance access to social connections and resources like community gardens, food pantries, and physical activity as part of its broader objective to prevent and reduce obesity. Through policy, systems and environment strategies, development of Memoranda of Understanding (MOUs) between aforementioned entities, and community based participatory research approaches, Mississippi HOP efforts enhance food systems improvement efforts; grow multi-sectoral collaboration; and evaluate the effectiveness of new policies, and specifically MOUs, in reaching these goals. Older adults represent more than 40% (n=27) of all coalition members and stakeholder leaders (n=61); they are essential for the success of these initiatives. This presentation will highlight the work done during the COVID-19 pandemic and the role of and benefits to older adults, especially ones in rural communities.

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Do Age-Friendly Rural Communities Affect Quality of Life? A Comparison of Perceptions from Middle-Aged and Older Adults in China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147283 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7283

Author(s):

Jingyu Yu ◽

Guixia Ma ◽

Shuxia Wang

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Rural Communities ◽

Public Transportation ◽

Rural Areas ◽

Test Reliability ◽

Middle Aged ◽

Aged People ◽

Outdoor Spaces

The aging population in rural areas of China faces serious challenges due to urban–rural disparities. In order to improve the active aging of rural older adults, the establishment of age-friendly communities is encouraged. However, globally, the focus is on age-friendly communities in urban areas, not reflecting rural communities. Hence, we addressed the importance of age-friendly rural communities (AFRCs) and aimed to investigate their impact on the quality of life (QoL) of older adults. We examined different perceptions of AFRCs among older adults (aged over 60) and middle-aged people (45–60) in rural communities with questionnaire surveys (n = 470 and 393, respectively). Several statistical methods, such as Chi-squared test, t-test, reliability test, and multiple regression, were adopted to investigate and compare the perceptions of these two. The results indicated that (1) middle-aged people were more satisfied with AFRC components and had a higher QoL than older adults; (2) the QoL of middle-aged people was predicted by housing, accessibility, and outdoor spaces; (3) the QoL of older adults was affected by housing, outdoor spaces, social participation, and public transportation. These findings aid in our understanding of rural communities and the QoL of rural residents. They are helpful for urban planners and policymakers to improve the planning of AFRCs and supplement research on age-friendly communities in rural areas. Practical implementations are proposed for the planning of AFRCs, such as the passive design of residential housing, grouping of community facilities together, and improvement in the hygiene of outdoor spaces in rural areas.

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The revitalization of “Osekkai”: How the COVID-19 pandemic has emphasized the importance of Japanese voluntary social work

Qualitative Social Work ◽

10.1177/1473325020973343 ◽

2020 ◽

pp. 147332502097334

Author(s):

Ryuichi Ohta ◽

Akiko Yata

Keyword(s):

Older Adults ◽

Rural Communities ◽

Rural Areas ◽

Social Connections ◽

Evidence Based ◽

Social Connection ◽

Sources Of Information ◽

Rural People ◽

Japanese Word ◽

The Face

Coronavirus disease 2019 (COVID-19) has caused worldwide panic, and rural areas are no exception. In Japanese rural areas, many older people live alone and lack access to reliable sources of information. During the pandemic, older adults were initially isolated from their communities because of the recommended social isolation measures, even when there were no cases in rural communities. However, various formal and informal caregivers went beyond their usual roles and tried to reconnect the older rural population with their communities and nurtured their social connections; Japanese community workers mitigated the stress and fear experienced by the rural elderly in the COVID-19 pandemic. Furthermore, this pandemic encouraged rural Japanese customs. One such custom is “Osekkai.” The Japanese word Osekkai describes actions that someone considers useful and meaningful to perform for others. Osekkai involves both formal and informal care, and as social gatherings began to disappear, Osekkai allowed individuals to deal with the various social problems created by the pandemic. Conferences based on Osekkai can strengthen rural people’s connections and improve their social capital. Activities of rural people that are constructed through Osekkai conferences are not only evidence-based but also based on reliance. This unprecedented pandemic has taught us not only the importance of usual healthcare and precautions against infection but also that nurturing social connection in communities is crucial in the face of social turbulence.

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