Barriers to participation in a community falls prevention program.

Introduction

Falls are a major cause to injuries, loss of independence and healthcare costs for older adults globally. An Australian study identified less than 8% of clients eligible for a 12 week education and exercise falls prevention program participate. The aim of this research was to describe the perspectives of clients, carers and staff on the barriers and enablers to participating in the community falls prevention program; to identify changes to the current model of care in order to improve participation rates.

Methods

A co-design methodology was used which involved consumer chief investigators, adherence to co-design principles and strategies. All clients assessed as high falls risk (n= 499) and their carers were invited to participate from across our culturally diverse community. Ethics approval was gained with data gathered through in-person or virtual, semi structured interviews or focus groups and recorded via Microsoft Teams. Analysis of the transcripts involved three researchers using both thematic analysis and a priori coding according to Levesque’s Access to Healthcare Framework. A Think Tank including consumer representatives and subject matter experts was run to envision model of care improvements.

Results

Fourteen clients and carers participated in a total of six focus groups or interviews. Thirteen staff participated in one focus group. Plain language summaries and member checking opportunities were used to confirm the data. Analysis confirmed barriers relating to healthcare access, utilisation and understanding the benefits to participation. The 11 participants in the Think Tank confirmed potential solutions addressing the barriers.

Conclusions

Participants reported access barriers including cost and transport, program factors including advertising, availability of resources in languages other than English and flexible delivery options and individual factors such as motivation and understanding the benefits of attending a falls prevention program as relevant to increasing participation. These results have informed a co-designed revised model of care.