Poster Presentation Lowitja Institute International Indigenous Health and Wellbeing Conference 2016

Working together to develop and trial a culturally appropriate fall prevention program for older Aboriginal people (#326)

Caroline Lukaszyk 1 , Julieann Coombes 1 , Lisa Keay 1 , Cathie Sherrington 1 , Anne Tiedemann 1 , Norma Jean Turner 2 , Robert Cumming 3 , Tony Broe 4 , Elizabeth Hillmann 5 , Rebecca Ivers 1
  1. The George Institute for Global Health, Sydney, NSW, Australia
  2. NSW Health, Illawarra Shoalhaven Local Health District, Nowra, NSW, Australia
  3. School of Public Health, University of Sydney, Sydney, NSW, Australia
  4. Neuroscience Research Australia , Sydney, NSW, Australia
  5. Mingaletta Aboriginal and Torres Strait Islander Corporation , Umina, NSW, Australia

Existing issue: Fall-related injury amongst Aboriginal people is a significant health issue, accounting for 24% of all injury related hospitalisations within the Aboriginal population. We conducted an audit of existing services which identified very few Aboriginal-specific programs with fall prevention elements available in NSW. Stakeholder interviews showed significant interest by aged care service providers in offering appropriate fall prevention programs for their older Aboriginal clientele. Informed by this data and from yarning circles with more than 70 older Aboriginal people, we developed a new fall-prevention program in partnership with Aboriginal community groups.

Aim: To evaluate the implementation of a fall prevention program designed to meet the needs of older Aboriginal people.

Methods: The Ironbark program is an on-going, weekly, group-based, strength and balance exercise class with an education component held within yarning circles. The program was piloted in six communities in NSW over a six-month period from June 2015. A mixed-methods approach was used for evaluation; measures of strength and balance were collected to determine physical outcomes, participants completed questionnaires and interviews to assess program acceptability, and calendars were used to track participant home exercise practice and fall incidence.

Results: A total of 98 participants registered for the program. Positive ongoing feedback was received, with attendance remaining constant and ranging from an average of 15 to 35 participants at each site. From those who underwent baseline assessment, 85% of participants were present for all follow-up measurements. On average, there was improvement in participant leg strength (sit-to-stand x 5: 14 sec to 11 sec), balance (single-leg stance: 5.6 sec to 7.8 sec) and gait speed (0.51m/s to 0.94m/s). Participants reported both the exercise and yarning components of the program to be enjoyable and valuable. Host services have continued to run the program, led by internal up-skilled staff, following the completion of the pilot.

Why does it matter? This is a promising program that now requires testing in a larger trial. This program has the potential to decrease hospitalisations from fall-related injury and prevent associated disability, allowing older Aboriginal people to remain healthy and strong in their homes and communities.