Abstract
This study sought to evaluate A Matter of Balance/Volunteer Lay Leaders (AMOB/VLL) fall prevention curriculum in combination with a “door-through-door” program: Coordinated Older-Adult Senior Transportation Services (COASTS) for older adults living in an urban, underserved community. AMOB/VLL participants were offered eight 2-hour classes as part of the training program. Focus groups were conducted with older adult participants, COASTS mobility facilitators, and AMOB/VLL master trainers. A thematic analysis was conducted, and primary themes relating to curriculum content, cultural relevancy, and outcomes were examined. Older adults and facilitators felt the course was rewarding and led to improvements in mobility and confidence. Master trainers were more critical and recommended simplifying content, with tailored guidance for specific populations. They also recommended increased emphasis on balance and physical activity. Although participants and MoFas felt combining AMOB/VLL and COASTS was rewarding and improved participant mobility, master trainers and participants suggested minor modifications to increase program benefits for urban, underserved communities.
Highlights
Every year, one out of every four adults over the age of 65 experiences a fall [1]
Ross et al [8] highlighted in a meta-analysis on falls prevention that there is a need for increased translation of evidence-based programs, such as the A Matter of Balance/ Volunteer Lay Leader (AMOB/VLL) program. e AMOB/ VLL program [9] focuses on cognitive-behavioral techniques to reduce fear of falling and improve outcomes associated with falling, rather than targeting falls directly [8]
Starting in March 2013, the AMOB/VLL program was offered to older adults residing in the Washington Heights, New York metropolitan area, who were participating in the Coordinated Older-Adult Senior Transportation Services (COASTS) “door-through-door” transportation service. e Action for the Retired Community XVI Fort Washington, Inc. (ARC) senior center had previously received a grant through the Department of Transportation to provide doorthrough-door transportation to their older adult members with mobility disability throughout Northern Manhattan above 110th Street. is service includes Mobility Facilitators (MoFas) who assist older adults with transportation to and from locations throughout the city, such as the store, the hospital, or their local senior center
Summary
One out of every four adults over the age of 65 experiences a fall [1]. Falls are the leading cause of injuryrelated death in this age group and can result in other negative outcomes including fear of falling (often leading to decreased mobility), loss of independence, and reduced quality of life [2,3,4]. e associated, direct medical costs of nonfatal falls have recently been estimated to be nearly $31.3 billion annually [5]. Numerous evidence-based interventions have been developed in recent years to increase fall prevention behaviors program adoption has been poor [3]. Ross et al [8] highlighted in a meta-analysis on falls prevention that there is a need for increased translation of evidence-based programs, such as the A Matter of Balance/ Volunteer Lay Leader (AMOB/VLL) program. E AMOB/ VLL program [9] focuses on cognitive-behavioral techniques to reduce fear of falling and improve outcomes associated with falling, rather than targeting falls directly [8]. The AMOB/VLL behavioral change approach is vital for sedentary people with limited mobility, as starting exercise programs among this population too Journal of Aging Research quickly could increase the rate of falls [10, 11]. AMOB/VLL has been found to be effective in increasing balance confidence, physical activity, and social interaction [12,13,14,15]
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