Key Factors Influencing Implementation of Falls Prevention Exercise Programs in the Community

2016 ◽  
Vol 24 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Lesley Day ◽  
Margaret J. Trotter ◽  
Alex Donaldson ◽  
Keith D. Hill ◽  
Caroline F. Finch
Keyword(s):  
Program Implementation ◽  
Diffusion Of Innovations ◽  
Exercise Program ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Relative Advantage ◽  
Diffusion Of Innovations Theory ◽  
Exercise Programs ◽  
Program Leaders ◽  
Home Based

The study aim was to evaluate the implementation of group- and home-based exercise falls prevention programs delivered through community health agencies to community-dwelling older people. Interviews with program staff were guided by the Diffusion of Innovations theory. Highly consistent themes emerged for the two types of programs. Both had high overall compatibility, high relative advantage, good observability and high inherent trialability—all factors known to strengthen implementation. The level of complexity and low financial compatibility emerged as the strongest potential inhibitors to program implementation in the context examined. The two main factors contributing to complexity were the need to challenge balance safely across a broad range of capability, and practical considerations associated with program delivery.A range of strategies to provide more technical support for exercise program leaders to tailor balance challenge for exercise program leaders may enhance implementation of falls prevention exercise programs.

scholarly journals Factors Associated with Participation of Community-Dwelling Older Adults in a Home-Based Falls Prevention Program

2019 ◽  
Vol 16 (6) ◽  
pp. 1087 ◽  
Author(s):  
Branko F. Olij ◽  
Lotte M. Barmentloo ◽  
Dini Smilde ◽  
Nathalie van der Velde ◽  
Suzanne Polinder ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Exercise Program ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Health Perceptions ◽  
Logistic Regression Models ◽  
Home Based ◽  
Health Related ◽  
Community Dwelling Older Adults ◽  
Over Time

This observational study was conducted to determine which factors are associated with frequent participation in a home-based exercise program. The effects of frequent participation on health-related outcomes over time are investigated, as well. Community-dwelling adults aged ≥65 years participated in a twelve-week home-based exercise program. The program consisted of an instruction book with exercises that were performed individually at home. Frequent participation was classified as performing exercises of the instruction book daily or a few days a week during the study period. A logistic regression analysis was performed to determine the association between factors (i.e., demographic and health-related characteristics) and frequent participation. Furthermore, to investigate the effects of frequent participation on health-related outcomes, generalized linear and logistic regression models were built. A total of 238 participants (mean age 81.1 years (SD ± 6.7), 71% female) were included in the study. Frequent participation during the study period was indicated by fifty-two percent of participants. Analyses showed that a higher degree of pain (OR: 1.02, 95% CI: 1.–1.04) was associated with frequent participation. In addition, the effect of frequent participation over time was a significant improvement in current health perceptions (B: 4.46, SE: 1.99).

“Are Your Clients Having Fun?” The Implications of Respondents’ Preferences for the Delivery of Group Exercise Programs for Falls Prevention

2016 ◽  
Vol 24 (1) ◽  
pp. 129-138 ◽  
Author(s):  
Lucy McPhate ◽  
Emily M. Simek ◽  
Terry P. Haines ◽  
Keith D. Hill ◽  
Caroline F. Finch ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interaction ◽  
Exercise Program ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Group Exercise ◽  
Exercise Programs ◽  
Cross Sectional ◽  
Advantages And Disadvantages ◽  
Framework Approach

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.

scholarly journals Development and Process Evaluation of a 5-Week Exercise Program to Prevent Falls in People after Stroke: The FALLS Program

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
H. J. R. van Duijnhoven ◽  
D. De Kam ◽  
W. Hellebrand ◽  
E. Smulders ◽  
A. C. H. Geurts ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Clinical Practice ◽  
Process Evaluation ◽  
Fall Prevention ◽  
Health Care Professionals ◽  
Exercise Program ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Common Complication

Falls are a common complication after stroke, with balance and gait deficits being the most important risk factors. Taking into account the specific needs and capacities of people with stroke, we developed the FALLS program (FALL prevention after Stroke), based on the “Nijmegen falls prevention program” (a proven-effective 5-week exercise program designed for community-dwelling elderly people). The program was tested in twelve community-dwelling persons with stroke, and a process evaluation was conducted with patients, trainers, health care professionals, and managers. The FALLS program was considered suitable and feasible by people with stroke in the study and relevant health care professionals, and recommendations for implementation in clinical practice have been suggested.

Exercise for Mild Balance Dysfunction: Research into Practice

2015 ◽  
Vol 23 (4) ◽  
pp. 588-596
Author(s):  
Susan Williams ◽  
Claudia Meyer ◽  
Frances Batchelor ◽  
Keith Hill
Keyword(s):  
Home Visit ◽  
Controlled Trial ◽  
Exercise Program ◽  
Community Dwelling ◽  
Community Settings ◽  
Balance Performance ◽  
Randomized Controlled ◽  
Normal Limits ◽  
Home Based ◽  
Strengthening Exercise

The objective of this study was to determine whether improved balance outcomes achieved in a randomized controlled trial (RCT) using balance screening to identify mild balance dysfunction and home exercises could be translated into community settings. Community-dwelling people aged over 65 who expressed concerns about their balance, had less than two falls in the preceding 12 months, and who had mild balance impairment on screening were given an individualized home-based balance and strengthening exercise program with intermittent home-visit support by a physiotherapist. Of 71 participants assessed (mean age 77.3 years, 76% female), 58 (82%) completed the six-month intervention. Twenty six percent of participants regained balance performance within normal limits—similar to those achieved in the previous RCT. Successful results from a previous RCT were able to be translated into community settings, with a similar magnitude of effect on balance and mobility.

scholarly journals Effects of modest testosterone supplementation and exercise for 12 weeks on body composition and quality of life in elderly men

2006 ◽  
Vol 155 (6) ◽  
pp. 867-875 ◽  
Author(s):  
Laurence Katznelson ◽  
Mara W Robinson ◽  
Caryn L Coyle ◽  
Hang Lee ◽  
Christina E Farrell
Keyword(s):  
Quality Of Life ◽  
Body Composition ◽  
Resistance Exercise ◽  
Exercise Program ◽  
Serum Testosterone ◽  
Exercise Group ◽  
Community Dwelling ◽  
Elderly Men ◽  
Home Based

Objective: One of the factors that may promote deterioration in quality of life and body composition in elderly men is the relative decline in serum testosterone levels with aging. In this study, we assessed the effects of modest doses of testosterone and a home-based strengthening program on quality of life and body composition in elderly men with relative testosterone insufficiency. Design: Double-blind, placebo-controlled randomized study (testosterone), and additional randomization to a resistance exercise program or no additional exercise for 12 weeks in men between ages of 65 and 85 years with relative testosterone insufficiency. Methods: Seventy sedentary, community dwelling men were randomized to a 5 mg testoderm transdermal system applied daily vs placebo system, and additionally randomized to a home-based resistance exercise program. Subjects were randomized to Group 1 (testosterone plus exercise), Group 2 (testosterone plus no exercise), Group 3 (placebo plus exercise), and Group 4 (placebo plus no exercise). Endpoints included quality of life (assessed by the short form-36 questionnaire) and body composition (measured by dual x-ray absorptiometry scan). Results: Serum testosterone increased by a mean of 10.0 ± 1.9, 6.6 ± 1.6, 0.52 ± 0.6, and 0.5 ± 0.6 nmol/l in Groups 1, 2, 3, and 4 respectively. There was a significant interaction of testosterone and exercise on quality of life in the domains of physical functioning (P = 0.03), role physical (P = 0.01), general health (P = 0.049), and social functioning (P = 0.04). There were no effects of testosterone or exercise on quality of life alone, nor in body composition parameters. Conclusions: Modest testosterone supplementation to elderly men with relative testosterone insufficiency improved quality of life when accompanied by an exercise program. The combination of testosterone and exercise may be an important strategy in the elderly, though further studies are necessary to determine the long-term impact on body composition and function and for analysis of risk/benefit ratios as well.

scholarly journals Innovation Adoption and Diffusion of Virtual Laboratories

2020 ◽  
Vol 16 (09) ◽  
pp. 4
Author(s):  
Krishnashree Achuthan ◽  
Prema Nedungadi ◽  
Vysakh Kolil ◽  
Shyam Diwakar ◽  
Raghu Raman
Keyword(s):  
Technology Acceptance ◽  
Diffusion Of Innovations ◽  
Teaching And Learning ◽  
Skill Training ◽  
Relative Advantage ◽  
Diffusion Of Innovations Theory ◽  
Sustainable Solutions ◽  
Early Adoption ◽  
Virtual Laboratories ◽  
Adoption And Diffusion

<p class="Title1" align="left">Educational technology such as Virtual laboratories (VLs) are being perceived as sustainable solutions to growing concerns related to laboratory skill training i.e. delivering quality laboratory education to a large number of students due to shortage of infrastructure and access especially in developing nations. With these VLs being an innovation for engineering education, the study of its diffusion in higher educational institutions is critical for gauging its impact. This study examines the five variables of Rogers Diffusion of Innovations theory in determining how VLs have changed or modified users through its adoption. The involvement of early adopters participating through a program called Nodal centers and their innovation decision stages are addressed. The study also analyzed the change agents as the nodal centers for diffusing the innovation in teaching and learning processes. Virtual laboratory adoption by users (n=43600) over 30 months was surveyed and factors of diffusion were reported. Similar scoring in assessment factors suggested relative advantage, technology acceptance, intention of use and relevance of trialability were pertinent in users' perception of VLs. Social hubs among higher education institutions promoted early adoption through better engagement of students.</p>

scholarly journals Effect of a Home-Based Exercise Program on Subsequent Falls Among Community-Dwelling High-Risk Older Adults After a Fall

JAMA ◽  
2019 ◽  
Vol 321 (21) ◽  
pp. 2092 ◽  
Author(s):  
Teresa Liu-Ambrose ◽  
Jennifer C. Davis ◽  
John R. Best ◽  
Larry Dian ◽  
Kenneth Madden ◽  
...  
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Exercise Program ◽  
Community Dwelling ◽  
Home Based

Home-Based Exercise Program Improves Balance and Fear of Falling in Community-Dwelling Older Adults with Mild Alzheimer’s Disease: A Pilot Study

2017 ◽  
Vol 59 (2) ◽  
pp. 565-574 ◽  
Author(s):  
Kalpana P. Padala ◽  
Prasad R. Padala ◽  
Shelly Y. Lensing ◽  
Richard A. Dennis ◽  
Melinda M. Bopp ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Pilot Study ◽  
Fear Of Falling ◽  
Exercise Program ◽  
Community Dwelling ◽  
Home Based ◽  
Community Dwelling Older Adults

A Diffusion Perspective on the Discontinuance of Sustainable Tourism Quality Control Tools

2021 ◽  
pp. 004728752110172
Author(s):  
Laura Lesar ◽  
David Weaver
Keyword(s):  
Quality Control ◽  
Diffusion Of Innovations ◽  
Critical Infrastructure ◽  
Sustainable Tourism ◽  
Theory And Practice ◽  
Relative Advantage ◽  
Diffusion Of Innovations Theory ◽  
Bottom Line ◽  
Practical Applications ◽  
First Time

Quality control tools such as certification are the critical infrastructure of sustainable tourism that facilitate triple bottom-line outcomes. Prior scholarship investigates tool adoption, but examination of discontinuance is absent. Using Diffusion of Innovations Theory, we investigate the diversity of discontinuance among practitioners in a destination by tool type, discontinuance manifestations, and influential attributes. Semistructured interviews revealed selective tool discontinuance and salient influence of relative advantage, compatibility, complexity, and observability attributes. Conventional replacement and disenchantment discontinuance manifestations were augmented by emergent induced, episodic, and recalibration forms and organized along an original typology from pure discontinuance to retention. Findings suggest practitioner alignment with “post-Fordist” sustainable tourism. Implications for tool counterdiffusion are assimilated into ongoing discourses of sustainable tourism theory and practice. Prospects for tool-specific attributes also emerge, for the first time, and when paired with those theoretical can inform an entirely novel realm of supply-side tool design; practical applications are illustrated.

scholarly journals Minimal clinically important differences in treadmill, 6-minute walk, and patient-based outcomes following supervised and home-based exercise in peripheral artery disease

2018 ◽  
Vol 23 (4) ◽  
pp. 349-357 ◽  
Author(s):  
Andrew W Gardner ◽  
Polly S Montgomery ◽  
Ming Wang
Keyword(s):  
Peripheral Artery Disease ◽  
Exercise Program ◽  
Exercise Group ◽  
Treadmill Test ◽  
Peripheral Artery ◽  
Exercise Programs ◽  
Supervised Exercise ◽  
Home Based ◽  
Artery Disease ◽  
Minute Walk

We estimated minimal clinically important differences (MCIDs) for small, moderate, and large changes in measures obtained from a standardized treadmill test, a 6-minute walk test, and patient-based outcomes following supervised and home-based exercise programs in symptomatic patients with peripheral artery disease (PAD). Patients were randomized to either 12 weeks of a supervised exercise program ( n=60), a home-based exercise program ( n=60), or an attention-control group ( n=60). Using the distribution-based method to determine MCIDs, the MCIDs for small, moderate, and large changes in peak walking time (PWT) in the supervised exercise group were 38, 95, and 152 seconds, respectively, and the changes in claudication onset time (COT) were 35, 87, and 138 seconds. Similar MCID scores were noted for the home-based exercise group. An anchor-based method to determine MCIDs yielded similar patterns of small, moderate, and large change scores in PWT and COT, but values were 1–2 minutes longer than the distribution approach. In conclusion, 3 months of supervised and home-based exercise programs for symptomatic patients with PAD results in distribution-based MCID small, moderate, and large changes ranging from 0.5 and 2.5 minutes for PWT and COT. An anchor-based approach yields higher MCID values, ranging from a minimum of 73 seconds for COT to a maximum of 4 minutes for PWT. The clinical implication is that a goal for eliciting MCIDs in symptomatic PAD patients through a walking exercise intervention is to increase PWT and COT by up to 4 minutes, which corresponds to two work stages during the standardized progressive treadmill test.

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