Ms Rebecca Morris1, Associate Professor Ilana Ackerman1, Professor Keith D Hill2, Doctor Darshini Ayton1, Associate Professor Anna Barker1
1Monash University, Melbourne, Australia, 2Curtin University, Perth, Australia
A process evaluation was conducted alongside an RCT of a falls prevention program – RESPOND – with the aim of identifying barriers and facilitators to delivery of the program.
RESPOND recruited 541 adults presenting to two Australian public hospital emergency departments (ED’s). The program comprised an initial home visit and subsequent telephone coaching for targeted falls risk factors, over six months. The program was delivered by allied health professionals who received RESPOND-specific training and support, including application of motivational interviewing techniques. Implementation barriers and facilitators from the perspective of those delivering the program were explored through individual interviews with six RESPOND clinicians.
Participants’ competing health and social priorities, and clinicians’ limited prior experience with delivering specific RESPOND components, were the main barriers to implementing RESPOND. Limited capacity for clinical decision-making within the constraints of an RCT was also perceived as a challenge to delivering RESPOND, however, peer support was considered a useful strategy to overcome this issue. Clinicians perceived that the use of positive health messages, delivered in a patient-centred manner, helped facilitate delivery of the program.
Significance of the findings to allied health:
A targeted telephone-based falls prevention program delivered by allied health professionals can reduce the rate of further falls and fractures in older people who have presented to an ED with a fall. Clinicians’ discipline-specific prior experience and skills should be considered when providing RESPOND training and support.
Ms Morris is a PhD candidate in the Health Services Research Unit & The Centre of Cardiovascular Research and Education in Therapeutics (CCRET) at Monash University. Her research focuses on a program evaluation of a falls prevention initiative for older adults – RESPOND. Ms Morris developed an interest in health services research following completion of her Master of Health and Human Services Management degree at Deakin University in 2011. Ms Morris is a registered physiotherapist with over a decade of clinical experience working with older adults in hospital settings in both the UK and Australia.