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A qualitative investigation exploring neighbourhood environment, risks and fear of falling, and fall prevention strategies among urban-dwelling older adults in a high-density city

Published online by Cambridge University Press:  10 November 2022

Chun-Qing Zhang*
Affiliation:
Department of Psychology, Sun Yat-sen University, Guangzhou, China
Ru Zhang*
Affiliation:
School of Physical Education & Sports Science, South China Normal University, Guangzhou, China
Julien S. Baker
Affiliation:
Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
Martin S. Hagger
Affiliation:
Psychological Sciences, University of California, Merced, California, USA Health Sciences Research Institute, University of California, Merced, California, USA Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland School of Applied Psychology, Griffith University, Brisbane, Australia
Kyra Hamilton
Affiliation:
Health Sciences Research Institute, University of California, Merced, California, USA School of Applied Psychology, Griffith University, Brisbane, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
*
*Corresponding authors. Email: zhangchq28@mail.sysu.edu.cn; ruzhang@m.scnu.edu.cn
*Corresponding authors. Email: zhangchq28@mail.sysu.edu.cn; ruzhang@m.scnu.edu.cn

Abstract

Falls in older adulthood can have serious consequences. It is therefore important to identify ways to prevent falls, particularly from the voice of older adults. Bottom-up qualitative exploration of the perspectives of older adults can provide rich insights that can help inform the development of effective fall prevention programmes. However, currently there is a dearth of such empirical data, especially among urban-dwelling older adults in high-density cities where fall rates are high. The current study aimed to examine qualitatively perceptions of neighbourhood physical environment in relation to falls, perceived risks and fear of falling, and strategies and behaviours for fall prevention in a sample of urban-dwelling older adults in the high-density city of Hong Kong. Face-to-face semi-structured in-depth interviews were conducted with 50 community-dwelling older adults. Interviews were transcribed verbatim and analysed using thematic analysis techniques. Five general themes were revealed: risks and circumstances of falls, consequences of falls, fear of falling and its consequences, neighbourhood environment, and strategies and behaviours of fall prevention. While older adults discussed the risks of falling and held a fear of falling, these beliefs were mixed. In addition to fall prevention strategies (e.g. keep balance), current findings highlighted the importance of establishing protective factors (e.g. flat and even walking paths) and reducing risk factors (e.g. neighbourhood clutter) in neighbourhood environments. For urban-dwelling older adults in high-density cities, current findings highlight the importance of focusing efforts at the built environment level in addition to strategies and behaviours of fall prevention at the individual level.

Type
Article
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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