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Evaluating audio-visual falls prevention messages with community-dwelling older people using a World Cafe forum approach.

ABSTRACT: BACKGROUND:Falls risk increases sharply with older age but many older people are unaware or underestimate their risk of falling. Increased population-based efforts to influence older people's falls prevention behavior are urgently needed. The aim of this study was to obtain a group of older people's collective perspectives on newly developed prototypes of audio-visual (AV) falls prevention messages, and evaluate changes in their falls prevention behaviour after watching and discussing these. METHODS:A mixed-method study using a community World Café forum approach. RESULTS:Although the forum participants (n?=?38) mostly responded positively to the three AV messages and showed a significant increase in their falls prevention capability and motivation after the forum, the participants collectively felt the AV messages needed a more inspirational call to action. The forum suggested this could be achieved by means of targeting the message and increasing the personal connection. Participants further suggested several alternatives to online falls prevention information, such as printed information in places in the community, as a means to increase opportunity to seek out falls prevention information. CONCLUSIONS:Falls prevention promotion messages need to be carefully tailored if they are to be more motivating to older people to take action to do something about their falls risk. A wider variety of revised and tailored AV messages, as one component of a community-wide falls prevention campaign, could be considered in an effort to persuade older people to take decisive action to do something about their falls risk. TRIAL REGISTRATION:This study was registered prospectively: NCT03154788. Registered 11 May 2017.

SUBMITTER: de Jong LD

PROVIDER: S-EPMC6902607 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Evaluating audio-visual falls prevention messages with community-dwelling older people using a World Café forum approach.

de Jong Lex D LD Francis-Coad Jacqueline J Wortham Chris C Haines Terry P TP Skelton Dawn A DA Weselman Tammy T Hill Anne-Marie AM

BMC geriatrics 20191209 1

<h4>Background</h4>Falls risk increases sharply with older age but many older people are unaware or underestimate their risk of falling. Increased population-based efforts to influence older people's falls prevention behavior are urgently needed. The aim of this study was to obtain a group of older people's collective perspectives on newly developed prototypes of audio-visual (AV) falls prevention messages, and evaluate changes in their falls prevention behaviour after watching and discussing th ...[more]

PMID: 31818252

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Project description:PurposeThe overall purpose of this study was to explore participants' and physiotherapists' experiences regarding the acceptability, implementation, and practicality of a novel group-based multifactorial falls prevention activity programme for community-dwelling older people after stroke. Specifically, the purpose was to explore if and how participating could impact on the participants' health-related quality of life (HRQoL) in terms of their daily lived experience regarding physical, mental, emotional and social well-being. A secondary purpose was to explore whether participating in the programme could positively influence participants' balance, strength, falls efficacy, mobility and motor impairment of the trunk.Materials and methodsThis was an exploratory mixed-method Phase I feasibility study. A convenience sample of five older community-dwelling people after stroke participated in a novel eight-week multifactorial activity programme which included falls education, a mix of individually tailored and group-based strength and balance exercises, exploring limits of stability and safe landing techniques and a social element. Qualitative data from post-intervention interview transcripts with the participants and the physiotherapists who delivered the programme were thematically analysed using both deductive and inductive approaches to explore the participants' and therapists' experiences with the programme. Quantitative outcomes included balance, strength, falls efficacy, mobility and motor impairment of the trunk.ResultsThe programme was deemed feasible in terms of acceptability, implementation and practicality by the participants as well as the physiotherapists delivering the programme. The overarching theme regarding HRQoL identified that participating in the programme was perceived to empower the participants living with stroke and positively influenced their daily physical, mental, emotional and social well-being. Participant outcomes showed a change in the direction of improvements in balance, strength, mobility, motor impairment of the trunk and reduced concerns about falling. Subjectively, participants only reported perceived improvements in balance and strength.ConclusionRunning a novel multifactorial falls prevention activity programme for older community-dwelling people after stroke was feasible. Participating in the programme helped participants to perceive improved balance, strength and empower them to make meaningful changes, improving their daily lived experiences. A future fully powered study could build on these results to investigate physical improvements, prevention of falls and improvements to domains of HRQoOL.

Project description:BackgroundOne-third of the community-dwelling older persons fall annually. Guidelines recommend the use of multifactorial falls prevention interventions. However, these interventions are difficult to implement into the community. This systematic review aimed to explore strategies used to implement multifactorial falls prevention interventions into the community.MethodsA systematic search in PubMed (including MEDLINE), CINAHL (EBSCO), Embase, Web of Science (core collection), and Cochrane Library was performed and updated on the 25th of August, 2022. Studies reporting on the evaluation of implementation strategies for multifactorial falls prevention interventions in the community setting were included. Two reviewers independently performed the search, screening, data extraction, and synthesis process (PRISMA flow diagram). The quality of the included reports was appraised by means of a sensitivity analysis, assessing the relevance to the research question and the methodological quality (Mixed Method Appraisal Tool). Implementation strategies were reported according to Proctor et al.'s (2013) guideline for specifying and reporting implementation strategies and the Taxonomy of Behavioral Change Methods of Kok et al. (2016).ResultsTwenty-three reports (eighteen studies) met the inclusion criteria, of which fourteen reports scored high and nine moderate on the sensitivity analysis. All studies combined implementation strategies, addressing different determinants. The most frequently used implementation strategies at individual level were "tailoring," "active learning," "personalize risk," "individualization," "consciousness raising," and "participation." At environmental level, the most often described strategies were "technical assistance," "use of lay health workers, peer education," "increasing stakeholder influence," and "forming coalitions." The included studies did not describe the implementation strategies in detail, and a variety of labels for implementation strategies were used. Twelve studies used implementation theories, models, and frameworks; no studies described neither the use of a determinant framework nor how the implementation strategy targeted influencing factors.ConclusionsThis review highlights gaps in the detailed description of implementation strategies and the effective use of implementation frameworks, models, and theories. The review found that studies mainly focused on implementation strategies at the level of the older person and healthcare professional, emphasizing the importance of "tailoring," "consciousness raising," and "participation" in the implementation process. Studies describing implementation strategies at the level of the organization, community, and policy/society show that "technical assistance," "actively involving stakeholders," and "forming coalitions" are important strategies.Trial registrationPROSPERO CRD42020187450.

Project description:In order to parse the world around us, we must constantly determine which sensory inputs arise from the same physical source and should therefore be perceptually integrated. Temporal coherence between auditory and visual stimuli drives audio-visual (AV) integration, but the role played by AV spatial alignment is less well understood. Here, we manipulated AV spatial alignment and collected electroencephalography (EEG) data while human subjects performed a free-field variant of the "pip and pop" AV search task. In this paradigm, visual search is aided by a spatially uninformative auditory tone, the onsets of which are synchronized to changes in the visual target. In Experiment 1, tones were either spatially aligned or spatially misaligned with the visual display. Regardless of AV spatial alignment, we replicated the key pip and pop result of improved AV search times. Mirroring the behavioral results, we found an enhancement of early event-related potentials (ERPs), particularly the auditory N1 component, in both AV conditions. We demonstrate that both top-down and bottom-up attention contribute to these N1 enhancements. In Experiment 2, we tested whether spatial alignment influences AV integration in a more challenging context with competing multisensory stimuli. An AV foil was added that visually resembled the target and was synchronized to its own stream of synchronous tones. The visual components of the AV target and AV foil occurred in opposite hemifields; the two auditory components were also in opposite hemifields and were either spatially aligned or spatially misaligned with the visual components to which they were synchronized. Search was fastest when the auditory and visual components of the AV target (and the foil) were spatially aligned. Attention modulated ERPs in both spatial conditions, but importantly, the scalp topography of early evoked responses shifted only when stimulus components were spatially aligned, signaling the recruitment of different neural generators likely related to multisensory integration. These results suggest that AV integration depends on AV spatial alignment when stimuli in both modalities compete for selective integration, a common scenario in real-world perception.

Project description:BACKGROUND:Falls in community-dwelling older people have been recognised as a significant public health issue in China given the rapidly growing aged population. Although there are several reviews documenting falls prevention programs for community-dwelling older adults, no systematic reviews of the scope and quality of falls prevention interventions in Mainland China exist. Therefore, the aim of this study was to systematically review falls prevention interventions for community-dwelling older people living in Mainland China. METHODS:We systematically reviewed literature from Chinese and English databases. All types of randomised controlled trials (RCTs) and quasi-experimental studies published from 1st January 1990 to 30th September 2019 were included. Observational studies and studies in care facilities and hospitals were excluded. Narrative synthesis was performed to summarise the key features of all included studies. Quality assessment was conducted using the Cochrane Risk of Bias Tool and ROBINS-I tool for randomised and non-randomised studies respectively. RESULTS:A total of 1020 studies were found, and 101 studies were included in the analysis. Overall, very few high quality studies were identified, and there was insufficient rigor to generate reliable evidence on the effectiveness of interventions or their scalability. Most interventions were multiple component interventions, and most studies focused on outcomes such as self-reported falls incidence or awareness of falls prevention. CONCLUSION:There is an opportunity to undertake an evaluation of a rigorously-designed, large-scale falls prevention program for community-dwelling older people in Mainland China. To help mitigate the rising burden of falls in Mainland China, recommendations for future falls prevention interventions have been made. These include: (1) target disadvantaged populations; (2) incorporate personalised interventions; and (3) investigate the effectiveness of those under-explored interventions, such as psychological, social environment, management of urinary incontinence, fluid or nutrition therapy and surgery. The study results will also potentially provide a useful evidence base for other low-and-middle income countries in a similar situation.

Dataset Information

Evaluating audio-visual falls prevention messages with community-dwelling older people using a World Cafe forum approach.

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Evaluating audio-visual falls prevention messages with community-dwelling older people using a World Café forum approach.

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