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Factors Influencing the Implementation of a Fall Prevention Exercise Program for Community-Dwelling Older Adults: A Qualitative Study Guided by the PRECEDE-PROCEED Model.
Ong, Rebecca Hui Shan; Nurjono, Milawaty; Oh, Hong Choon; Lien, Christopher Tsung Chien; Jumala, Junisha; Teo, Raymond Choon Chye; Gan, Peiying; Kan, Karen Lai Ming; Rosle, Lina Farhana; Wee, Moi Kim; Low, Shou Lin.
Afiliación
  • Ong RHS; Health Services Research, Changi General Hospital, Singapore.
  • Nurjono M; Health Services Research, Changi General Hospital, Singapore.
  • Oh HC; Health Services Research, Changi General Hospital, Singapore.
  • Lien CTC; Centre for Population Health Research and Implementation, Singapore Health Services, Singapore.
  • Jumala J; Health Services & Systems Research, Duke-NUS Medical School, Singapore.
  • Teo RCC; Geriatric Medicine, Changi General Hospital, Singapore.
  • Gan P; Rehabilitative Services, Changi General Hospital, Singapore.
  • Kan KLM; Singapore Sport & Exercise Medicine Centre, Changi General Hospital, Singapore.
  • Rosle LF; Community Nursing, Changi General Hospital, Singapore.
  • Wee MK; Community and Mental Health, Changi General Hospital, Singapore.
  • Low SL; Community and Mental Health, Changi General Hospital, Singapore.
Clin Interv Aging ; 19: 857-871, 2024.
Article en En | MEDLINE | ID: mdl-38770185
ABSTRACT

Purpose:

Multiple falls preventions exercise programs have been rolled out globally, however, few studies have explored the factors necessary for their implementation. This study aimed to investigate the factors influencing the implementation of "Steady Feet" (SF), a 12-week community fall prevention exercise intervention, for older adults living in Singapore. Material and

Methods:

This study utilized purposive sampling to recruit two participant groups (i) older adults who declined or withdrew from the program and (ii) providers of the program (eg, instructors). We conducted 22 semi-structured interviews, recordings were transcribed and translated, followed by thematic analysis. Data collection and analysis were informed by the PRECEDE-PROCEED framework, focusing on predisposing, enabling, and reinforcing factors.

Results:

Findings revealed two predisposing, four enabling, and two reinforcing themes. Predisposing themes encompassed (i) knowledge, attitudes, and practices of older adults towards exercises and falls prevention, and (ii) perceptions and attitudes of providers towards SF. Both older adults and providers identified several enabling elements in implementing SF, emphasizing the significance of (i) accessibility, availability, and affordability. Providers highlighted (ii) tools and structural support for continual engagement, (iii) minimizing variations in capabilities through a competency development program, and (iv) fostering synergistic partnerships. Positive reinforcement included (i) the role of providers in engaging and promoting participation, (ii) family support, social networks, and (iii) incentives for older adults. Conversely, both groups highlighted negative reinforcements, including (iv) communication issues and (v) repetitive exercises, while providers specifically identified (vi) labor constraints as a deterrent for implementation.

Conclusion:

Findings indicate that effective implementation necessitates a multifaceted approach. Promoting participation involves engaging instructors, emphasizing social bonds and family involvement, offering incentives, and providing subsidized or free classes. A competency development program proved effective in reducing variations in providers' capabilities. Strengthening community partnerships, with management support, was crucial for ensuring the availability and accessibility of falls prevention programs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Accidentes por Caídas / Investigación Cualitativa / Terapia por Ejercicio / Vida Independiente Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Clin Interv Aging Asunto de la revista: GERIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Nueva Zelanda

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Accidentes por Caídas / Investigación Cualitativa / Terapia por Ejercicio / Vida Independiente Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Clin Interv Aging Asunto de la revista: GERIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Nueva Zelanda