Abstract
We aimed to describe and evaluate the implementation of a home-based exercise program among community-dwelling adults aged ≥65 years. In an observational study, the twelve-week program was implemented in a community setting. The implementation plan consisted of dialogues with healthcare professionals and older adults, development of an implementation protocol, recruitment of participants, program implementation, and implementation evaluation. The dialogues consisted of a Delphi survey among healthcare professionals, and of individual and group meetings among older adults. The implementation of the program was evaluated using the framework model RE-AIM. In the dialogues with healthcare professionals and older adults, it was found that negative consequences of a fall and positive effects of preventing a fall should be emphasized to older adults, in order to get them engaged in fall prevention activities. A total of 450 older adults enrolled in the study, of which 238 started the program. The process evaluation showed that the majority of older adults were recruited by a community nurse. Also, a good collaboration between the research team and the local primary healthcare providers was accomplished, which was important in the recruitment. Future fall prevention studies may use this information in order to translate an intervention in a research project into a community-based program.
Highlights
Fall-related injuries among older adults are recognized as a large burden to Western society [1], which is expected to increase, due to the ageing population
A total of 129 healthcare professionals participated in the Delphi survey
A perceived barrier for participating in a fall prevention program was that older adults are not aware of the possibilities in their neighborhood (n = 32/93; 34%)
Summary
Fall-related injuries among older adults are recognized as a large burden to Western society [1], which is expected to increase, due to the ageing population. If the yearly increase of fall-related emergency department (ED) visits in the United States remains the same until 2030, the number of visits is expected to increase by 137%, to 5.7 million [2]. These increasing ED visits have a major impact on healthcare costs [3]. Falls have a large impact on the lives of older adults, as it can result in functional decline and loss of autonomy [4].
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