Yarning about fall prevention: community consultation to discuss falls and appropriate approaches to fall prevention with older Aboriginal and Torres Strait Islander people

Caroline Lukaszyk,Julieann Coombes,Rebecca Ivers,Norma Jean Turner,Lisa Keay,Elizabeth Hillmann,Anne Tiedemann,Cathie Sherrington

doi:10.1186/s12889-017-4628-6

Abstract

BackgroundFall related injury is an emerging issue for older Indigenous people worldwide, yet few targeted fall prevention programs are currently available for Indigenous populations. In order to inform the development of a new Aboriginal-specific fall prevention program in Australia, we conducted community consultation with older Aboriginal people to identify perceptions and beliefs about falls, and to identify desired program elements.MethodsYarning Circles were held with Aboriginal and Torres Strait Islander people aged 45 years and over. Each Yarning Circle was facilitated by an Aboriginal researcher who incorporated six indicative questions into each discussion. Questions explored the impact of falls on Yarning Circle participants, their current use of fall prevention services and investigated Yarning Circle participant’s preferences regarding the design and mode of delivery of a fall prevention program.ResultsA total of 76 older Aboriginal people participated in ten Yarning Circles across six sites in the state of New South Wales. Participants associated falls with physical disability, a loss of emotional well-being and loss of connection to family and community. Many participants did not use existing fall prevention services due to a lack of availability in their area, having no referral provided by their GP and/or being unaware of fall prevention programs in general. Program elements identified as important by participants were that it be Aboriginal-specific, group-based, and on-going, with the flexibility to be tailored to specific communities, with free transport provided to and from the program.ConclusionsOlder Aboriginal people reported falls to be a priority health issue, with a significant impact on their health and well-being. Few older Aboriginal people accessed prevention programs, suggesting there is an important need for targeted Aboriginal-specific programs. A number of important program elements were identified which if incorporated into prevention programs, may help to address the rising burden of falls.

Highlights

Fall related injury is an emerging issue for older Indigenous people worldwide, yet few targeted fall prevention programs are currently available for Indigenous populations
A total of 10 Yarning Circles were held with 76 participants (16 males, 60 females) across six sites in Sydney, the Central Coast, Central West and Illawarra Shoalhaven, New South Wales (NSW) (Table 2)
Existing mainstream fall prevention programs were generally not used by Yarning Circle participants due to their lack of availability in certain areas, no referral provided for fall prevention services by GPs and/ or being unaware of existing programs

Summary

Introduction

Fall related injury is an emerging issue for older Indigenous people worldwide, yet few targeted fall prevention programs are currently available for Indigenous populations. Community consultation has shown to be valuable in the development of health programs for Indigenous populations worldwide [2]. For Australia’s Aboriginal and Torres Strait Islander population, fall injury rates have increased by an average of 10.2% per year from 2007 to 08 to 2010– 11, compared to a 4.3% average annual increase for other older Australians [7]. Falls are the second most common cause of injury for all Aboriginal and Torres Strait Islander people in Australia [8], with the highest fall-injury rates reported for females aged 65 years and above, and males aged 60–64 years [9]. Experiences of past falls can lead to an increased fear of falling, preventing people from performing daily tasks and limiting their independence [11]

Methods

Results

Discussion

Conclusion