A case of community-based fall prevention: Survey of organization and content of minor home help services in Swedish municipalities

Purpose – The purpose of the this study was to explore the development of commitment to change among leaders in the home help services during organizational change and to study this development in relation to workload and stress. During organizational change initiatives, commitment to change among leaders is important to ensure the implementation of the change. However, little is known of development of commitment of change over time. Design/methodology/approach – The study used a qualitative design with semi-structured interviews with ten leaders by the time an organizational change initiative was launched and follow-up one year later. Thematic content analysis was used to analyze the interviews. Findings – Commitment to change is not static, but seems to develop over time and during organizational change. At the first interview, leaders had a varied pattern reflecting different dimensions of commitment to change. One year later, the differences between leaders’ commitment to change was less obvious. Differences in commitment to change had no apparent relationship with workload or stress. Research limitations/implications – The data were collected from one organization, and the number of participants were small which could affect the results on workload and stress in relation to commitment to change. Practical implications – It is important to support leaders during organizational change initiatives to maintain their commitment. One way to accomplish this is to use management team meetings to monitor how leaders perceive their situation. Originality/value – Qualitative, longitudinal and leader studies on commitment to change are all unusual, and taken together, this study shows new aspects of commitment.

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Effect of a Fall Prevention Program on Balance Maintenance Using a Quasi-experimental Design in Real-World Settings

Journal of Aging and Health ◽

10.1177/0898264312436713 ◽

2012 ◽

Vol 24 (5) ◽

pp. 827-845 ◽

Cited By ~ 5

Author(s):

Yvonne Robitaille ◽

Michel Fournier ◽

Sophie Laforest ◽

Lise Gauvin ◽

Johanne Filiatrault ◽

...

Keyword(s):

Real World ◽

Fall Prevention ◽

Prevention Program ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Community Dwelling ◽

Balance Performance ◽

Community Based ◽

Fall Prevention Program ◽

Quasi Experimental

Objectives: To examine the effect of a fall prevention program offered under real-world conditions on balance maintenance several months after the program. To explore the program’s impact on falls. Method: A quasi-experimental study was conducted among community-dwelling seniors, with pre- and postintervention measures of balance performance and self-reported falls. Ten community-based organizations offered the intervention (98 participants) and 7 recruited participants to the study’s control arm (102 participants). An earlier study examined balance immediately after the 12-week program. The present study focuses on the 12-month effect. Linear regression (balance) and negative binomial regression (falls) procedures were performed.falls. Results: During the 12-month study period, experimental participants improved and maintained their balance as reflected by their scores on three performance tests. There was no evidence of an effect on falls.falls. Discussion: Structured group exercise programs offered in community-based settings can maintain selected components of balance for several months after the program’s end.

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Effects of Community-based Comprehensive Fall Prevention Program on Muscle Strength, Postural Balance and Fall Efficacy in Elderly People

Journal of Korean Academy of Nursing ◽

10.4040/jkan.2014.44.6.697 ◽

2014 ◽

Vol 44 (6) ◽

pp. 697 ◽

Cited By ~ 9

Author(s):

Jeongyee Bae ◽

Seong-il Cho

Keyword(s):

Muscle Strength ◽

Elderly People ◽

Fall Prevention ◽

Prevention Program ◽

Postural Balance ◽

Community Based ◽

Fall Prevention Program

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A falls prevention programme to improve quality of life, physical function and falls efficacy in older people receiving home help services: study protocol for a randomised controlled trial

BMC Health Services Research ◽

10.1186/s12913-017-2516-5 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 11

Author(s):

Maria Bjerk ◽

Therese Brovold ◽

Dawn A. Skelton ◽

Astrid Bergland

Keyword(s):

Quality Of Life ◽

Randomised Controlled Trial ◽

Older People ◽

Controlled Trial ◽

Falls Prevention ◽

Improve Quality ◽

Home Help ◽

Home Help Services ◽

Randomised Controlled

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Determinants of Fall Prevention Guideline Implementation in the Home- and Community-Based Service Setting

The Gerontologist ◽

10.1093/geront/gnaa133 ◽

2020 ◽

Author(s):

Lisa A Juckett ◽

Alicia C Bunger ◽

Shannon E Jarrott ◽

Holly I Dabelko-Schoeny ◽

Jessica Krok-Schoen ◽

...

Keyword(s):

Older Adult ◽

Fall Prevention ◽

Fall Risk ◽

Adult Population ◽

Guideline Implementation ◽

Implementation Strategies ◽

Semistructured Interview ◽

Community Based ◽

Prevention Guideline ◽

Prevention Guidelines

Abstract Background and Objectives Home- and community-based service (HCBS) recipients often possess multiple fall risk factors, suggesting that the implementation of evidence-based fall prevention guidelines may be appropriate for the HCBS setting. The purpose of this exploratory study was to examine the determinants of fall prevention guideline implementation and the potential strategies that can support implementation in HCBS organizations. Research Design and Methods Semistructured interview and focus group data were collected from 26 HCBS professionals representing the home-delivered meals, personal care, and wellness programs. Qualitative codes were mapped to the Consolidated Framework for Implementation Research by means of directed content analysis. The Consolidated Criteria for Reporting Qualitative research checklist was used to report the findings of this study. Results We identified 7 major determinants of guideline implementation: recipient needs and resources, cosmopolitanism, external policy and incentives, networks and communication, compatibility, available resources, and knowledge/beliefs. Strategies to support guideline implementation included the involvement of recipient and caregiver feedback, building fall prevention networks, and conducting educational meetings for HCBS staff. Discussion and Implications Falls and fall-related injuries will continue to plague the older adult community unless innovative approaches to fall prevention are developed and adopted. The implementation of fall prevention guidelines in the HCBS setting can help mitigate fall risk among a highly vulnerable older adult population and may be facilitated through the application of multifaceted implementation strategies.

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220 Is Multifactorial Risk Assessment a Team Sport? Disciplinary Differences in Perceived Acceptability and Feasibility of a Community-based Fall Prevention Service

Age and Ageing ◽

10.1093/ageing/afz103.134 ◽

2019 ◽

Vol 48 (Supplement_3) ◽

pp. iii17-iii65

Author(s):

Sheena McHugh ◽

Finola Cronin ◽

Eileen Moriarty ◽

Spencer Turvey ◽

Patrick Barry ◽

...

Keyword(s):

Public Health ◽

Risk Assessment ◽

Fall Prevention ◽

Relative Advantage ◽

Public Health Nurses ◽

Multidisciplinary Teams ◽

Community Based ◽

Disciplinary Differences ◽

Falls Risk ◽

Prevention Interventions

Abstract Background Multifactorial falls risk assessment is an evidence-based practice recommended to prevent falls among older people. Previous research has identified cultural, practical and professional challenges to implementing complex fall prevention interventions. Fall prevention interventions are frequently delivered by multidisciplinary teams (MDTs). This requires multiple health professionals, who practice under different professional norms and governance structures, to accommodate new ways of working. Our aim is to explore disciplinary differences in the perceived acceptability, appropriateness and feasibility of community-based multifactorial falls risk assessment clinics during initial implementation. Methods A mixed methods study is being conducted with analysis of administrative data on delivery of risk assessments (2016-2018), and semi-structured interviews staff involved in multidisciplinary teams (physiotherapists (PT, n=5), occupational therapists (OT, n=6), and public health nurses (n=4)]. Interviews were conducted prior to implementation and at 6 months (n=30 interviews total). Framework-driven thematic analysis was used to identify factors influencing implementation and explore perceptions of acceptability, appropriateness and feasibility. Results Implementation varied across disciplines; 28% of assessments were conducted by nurses (n=83), 36% (n=111) by physiotherapists, and 36% (n=108) by OTs. Preliminary qualitative analysis suggests that OTs welcomed the opportunity to expand their scope of practice. Conducting assessments at set times in static clinics was incompatible with public health nurses’ workflow. Their limited availability and time-sensitive competing priorities were barriers to the feasibility of an MDT-approach. Physiotherapists questioned the relative advantage of a broad assessment, and whether it was an appropriate use of resources given waiting lists for physiotherapy intervention. Data analysis is ongoing. Conclusion The study results have already been used to inform service adaptations including the introduction of dedicated intervention sessions. Training and implementation support for multidisciplinary teams may need to be tailored to the needs of different professional groups to enhance adoption and fidelity.

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