Personal response systems are used to support frail, older people, and people with disabilities to live independently in their own homes. This paper describes the patterns, characteristics, and outcomes of Personal Alert Victoria (PAV) clients who experience a fall. It also examines the current falls prevention referral practices of assessors who determine whether an older person would benefit from a personal response system. Deidentified data on clients from the PAV service provider from 2012 to 2014 were linked to routine data maintained by the Department of Health and Human Services in Victoria. Falls prevention referral practices of assessors were examined using an online survey. Personal response systems were most frequently activated because of a fall in this group of older people (n = 16,822; 44%). No demographic or clinical factors differentiated PAV clients who activated the system because of a fall compared to those who did not, despite a significant increase in the rate of falls-related system activations (p = 0.001) and hospitalisation (p < 0.001) between 2012 and 2014. Assessors believed that PAV clients were at increased risk of falls and frequently recommended falls prevention interventions such as strength and balance interventions (n = 112; 93%) in order to address this risk. This study has provided an insight into the issue of falls among PAV clients, which can help guide the tailoring of falls prevention interventions that can be integrated within existing service models.
This paper explores the perceptions and experiences of falls among Personal Alert Victoria (PAV) clients and identifies barriers and enablers to engagement in falls prevention interventions. Data were collected via semistructured telephone interviews (n = 12) and a client survey with open-ended and closed-ended questions (n = 46). Descriptive statistics and thematic analysis was guided by the COM-B model (capability, opportunity, and motivation) for behaviour change. The interview and survey explored experiences of falls, falls risk factors, access and participation in falls prevention interventions, access to health and support services, and experiences using the PAV service. Capability barriers identified included poor health, lack of time, low health literacy, and perceived high intensity of exercise classes. Opportunity barriers were lack of transport, high cost, and long waiting times for falls prevention interventions. Motivation barriers were the belief that falls are inevitable and a perceived lack of relevance of falls prevention interventions. Enablers identified were a focus on broader health and well-being benefits (capability), hospitalisations or rehabilitation that incorporates falls prevention in recovery (opportunity), and raising awareness of falls risk (motivation). Findings suggest that further research is required to inform the tailoring of positive health messages to improve the uptake of falls prevention interventions by PAV clients.
Objectives: Effective public policy to prevent falls among independent community-dwelling older adults is needed to address this global public health issue. This paper aimed to identify gaps and opportunities for improvement of future policies to increase their likelihood of success.Methods: A systematic scoping review was conducted to identify policies published between 2005–2020. Policy quality was assessed using a novel framework and content criteria adapted from the World Health Organization’s guideline for Developing policies to prevent injuries and violence and the New Zealand Government’s Policy Quality Framework.Results: A total of 107 articles were identified from 14 countries. Content evaluation of 25 policies revealed that only 54% of policies met the WHO criteria, and only 59% of policies met the NZ criteria. Areas for improvement included quantified objectives, prioritised interventions, budget, ministerial approval, and monitoring and evaluation.Conclusion: The findings suggest deficiencies in a substantial number of policies may contribute to a disconnect between policy intent and implementation. A clear and evidence-based model falls prevention policy is warranted to enhance future government efforts to reduce the global burden of falls.
Unintentional injury is a leading cause of death for children and is a major reason for hospital and emergency department admissions. In Victoria, Australia, an average of 34 children die per year and over 150 children are treated in hospital per day as a result of unintentional injury. The State Government of Victoria dedicated $1.9 million over 4 years to the SafeStart initiative to prevent serious injuries to children living in selected local communities. SafeStart was part of the Victorian Governments $788 million ‘A Fairer Victoria’ package of initiatives to address social disadvantage. SafeStart is a model for the integrated management of injury prevention activity at a local level and tests the approach of involving communities in the implementation of proven interventions. SafeStart was locally focused and managed and encouraged partnerships with health, education, retail, sport and community sectors to target areas where children under 8 years lived, played or gathered. SafeStart was implemented by two selected local governments during 2006–2010, based on a previous trial in three local communities during 2002–2005. A comprehensive independent evaluation of SafeStart is ongoing and will be complete by December 2010. This presentation will address the key themes of the conference and report on how each of the local communities implemented the SafeStart initiative, will highlight preliminary impacts, equity and sustainability issues, and will reflect on the cost-effectiveness of State Government investment into local community commitment to prevent child injury and create safe home and play environments.
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