Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-10T16:56:48.260Z Has data issue: false hasContentIssue false
  • English
  • Français

Implementing a Community-Based Falls-Prevention Program: From Drawing Board to Reality*

Published online by Cambridge University Press:  31 March 2010

Johanne Filiatrault ,
Manon Parisien ,
Sophie Laforest ,
Carole Genest ,
Lise Gauvin ,
Michel Fournier ,
Francine Trickey  and
Yvonne Robitaille
Johanne Filiatrault*
Affiliation:
Institut national de santé publique du Québec Programme de doctorat en santé publique, Université de Montréal Groupe de recherche interdisciplinaire en santé (GRIS) École de réadaptation, Université de Montréal
Manon Parisien
Affiliation:
Centre de Santé et de Services sociaux Cavendish—Centre affilié universitaire en gérontologie sociale
Sophie Laforest
Affiliation:
Groupe de recherche interdisciplinaire en santé (GRIS) Centre de Santé et de Services sociaux Cavendish—Centre affilié universitaire en gérontologie sociale Département de kinésiologie, Université de Montréal
Carole Genest
Affiliation:
Institut national de santé publique du Québec
Lise Gauvin
Affiliation:
Groupe de recherche interdisciplinaire en santé (GRIS) Département de médecine sociale et préventive, Université de Montréal Centre de recherche Léa-Roback sur les inégalités sociales de santé de Montréal
Michel Fournier
Affiliation:
Direction de santé publique de Montréal
Francine Trickey
Affiliation:
Direction de santé publique de Montréal
Yvonne Robitaille
Affiliation:
Institut national de santé publique du Québec Département de médecine sociale et préventive, Université de Montréal Department of Epidemiology and Biostatistics, McGill University
*
Requests for offprints should be sent to:/Les demandes de tirés-à-part doivent être adressées à: Johanne Filiatrault, O.T., M.Sc., École de réadaptation, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, Québec, H3C 3J7. (johanne.filiatrault@umontreal.ca)
Get access Rights & Permissions [Opens in a new window]

Abstract

Several studies have demonstrated the efficacy of falls-prevention programs designed for community-dwelling seniors using randomized designs. However, little is known about the feasibility of implementing these programs under natural conditions and about the success of these programs when delivered under such conditions. The objectives of this paper are to (a) describe a multifactorial falls-prevention program (called Stand Up!) designed for independent community-dwelling seniors and (b) present the results of an analysis of the practicability of implementing this program in community-based settings. The program was implemented in the context of an effectiveness study in 10 community-based organizations in the Montreal metropolitan area. Data pertaining to the reach and delivery of the program as well as participation level show that a falls-prevention program addressing multiple risk factors can be successfully implemented in community-based settings.

Résumé

Plusieurs études ont démontré, à l'aide de devis randomisés, l'efficacité de programmes de prévention des chutes destinés aux aînés vivant dans la communauté. Cependant, on connaît peu de choses quant à la faisabilité d'implanter ces programmes dans des conditions naturelles et quant à l'efficacité de ces programmes lorsqu'ils sont offerts dans de telles conditions. Les objectifs de cet article sont de: (a) décrire un programme multifactoriel de prévention des chutes (PIED) destiné à des aînés autonomes vivant dans la communauté et (b) présenter les résultats d'une analyse de la faisabilité d'une implantation du programme dans les organismes communautaires. Le programme a été implanté dans 10 organismes du milieu communautaire situés dans la région métropolitaine de Montréal dans le contexte d'une étude d'efficacité. Les résultats concernant la population recrutée et la façon dont le programme a été offert, ainsi que le niveau de participation au programme montrent qu'un programme de prévention des chutes visant plusieurs facteurs de risque peut être implanté avec succès dans des milieux communautaires.

Keywords

agingfalls preventionprogram implementationcommunity-based organizationscommunity-dwelling seniorsvieillissementprévention des chutesimplantation de programmesorganismes du milieu communautaireaînés vivant dans la communauté
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 26 , Issue 3 , Fall/Automne 2007 , pp. 213 - 225
Copyright
Copyright © Canadian Association on Gerontology 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The study reported in this paper was supported by the Canadian Institutes of Health Research (Grant No. MOP 53123). The study was also supported by the Regional Health and Social Services Boards of Montreal, Laval, and Montérégie, who provided seed monies for program implementation in community-based organizations. Johanne Filiatrault was supported by doctoral fellowships from the Fonds de la recherche en santé du Québec (FRSQ) and the Ordre des ergothérapeutes du Québec (OEQ). The authors would like to thank seniors and collaborators from community-based organizations for their participation in the study.

References

Agence de la santé et des services sociaux (2006). Stand up!. Retrieved August 8, 2007 from http://www.santepub-mtl.qc.ca/programmechute/standup.html.Google Scholar
Agence de la santé et des services sociaux (2007). Programme PIED—Se former. Retrieved 8 August 2007 from http://www.santepub-mtl.qc.ca/programmechute/publications.html.Google Scholar
American College of Sports Medicine (2000). ACSM's guidelines for exercise testing and prescription. (6th ed.) Philadelphia, PA: Lippincott, Williams & Wilkins.Google Scholar
Baloh, R.W., Fife, T.D., Zwerling, L., Socotch, T., Jacobson, K., Bell, T., et al. (1994). Comparison of static and dynamic posturography in young and older normal people. Journal of the American Geriatrics Society, 42(4), 405–412.CrossRefGoogle Scholar
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioural change. Psychological Review, 84, 191–215.CrossRefGoogle Scholar
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
Bertakis, K.D., Azari, R., Helms, L.J., Callahan, E.J., & Robbins, J.A. (2000). Gender differences in the utilization of health care services. Journal of Family Practice, 49, 147–152.Google ScholarPubMed
Brauer, S., Burns, Y., & Galley, P. (1999). Lateral reach: A clinical measure of medio-lateral postural stability. Physiotherapy Research International, 4(2), 81–88.CrossRefGoogle Scholar
Chang, J.T., Morton, S.C., Rubenstein, L.Z., Mojica, W.A., Maglione, M., Suttorp, M.J., et al. (2004). Interventions for the prevention of falls in older adults: Systematic review and meta-analysis of randomized clinical trials. British Medical Journal, 328, 680.CrossRefGoogle Scholar
Des Jarlais, D.C., Lyles, C., & Crepaz, N. (2004). Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The TREND statement. American Journal of Public Health, 94(3), 361–366.CrossRefGoogle Scholar
Direction générale de la santé publique (2004). La prévention des chutes dans un continuum de services. Cadre de référence. Quebec, QC: Ministère de la Santé et des Service sociaux.Google Scholar
Dishman, R.K. (1994). Advances in exercise adherence. Champaign, IL: Human Kinetics.Google ScholarPubMed
Duncan, P.W., Chandler, J., Studenski, S., Hughes, M., & Prescott, B. (1993). How do physiological components of balance affect mobility in elderly men? Archives of Physical Medicine and Rehabilitation, 74, 1343–1349.CrossRefGoogle ScholarPubMed
Duncan, P.W., Weiner, D.K., Chandler, J., & Studenski, S. (1990). Functional reach: A new clinical measure of balance. Journal of Gerontology: Medical Sciences, 45A(6), 192–197.CrossRefGoogle Scholar
Filiatrault, J., Gauvin, L., Richard, L., Robitaille, Y., Laforest, S., Fournier, M., et al. . Impact of a multifaceted community-based falls prevention program on psychological factors related to falls. (under review).Google Scholar
Filiatrault, J., Robitaille, Y., Gauvin, L., Laforest, S., Fournier, M., Parisien, M., et al. (2006). Garder PIED sans augmenter sa peur de chuter!. Canadian Journal of Occupational Therapy—Conference Program Supplement, 43.Google Scholar
Franchignoni, F., Tesio, L., Martino, M.T., & Ricupero, C. (1998). Reliability of four simple, quantitative tests of balance and mobility in healthy elderly females. Aging (Milano), 10(1), 26–31.Google ScholarPubMed
Gillespie, L.D., Gillespie, W.J., Robertson, M.C., Lamb, S.E., Cumming, R.G., & Rowe, B.H. (2003). Interventions for preventing falls in elderly people. Cochrane Database of Systematic Reviews, 4 (Art. No. CD000340; DOI 10.1002/14651858).CrossRefGoogle Scholar
Glasgow, R.E., Lichtenstein, E., & Marcus, A.C. (2003). Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261–1267.CrossRefGoogle ScholarPubMed
Green, L., & Kreuter, M.W. (2005). Health promotion planning: An educational and ecological approach.. (4th ed.) New York: McGraw-Hill.Google Scholar
Institut national de santé publique du Québec (2006). Portrait de santé du Québec et de ses régions 2006: Deuxième rapport national sur l'état de santé de la population du Québec—Les statistiques. Quebec, QC: Gouvernement du Québec.Google Scholar
Jette, A.M., Harris, B.A., Sleeper, L., Lachman, M.E., Heislein, D., Giorgetti, M., & Levenson, C. (1996). A home-based exercise program for nondisabled older adults. Journal of the American Geriatrics Society, 44(6), 644–649.CrossRefGoogle ScholarPubMed
Laforest, S., Pelletier, A., Gauvin, L., Fournier, M., Robitaille, Y., & Corriveau, H. (2006). Maintenance of increased involvement in physical activity among older adults participating in a community-based falls prevention and exercise program. International Congress on Physical Activity and Public Health, Atlanta: Congress Program, 135.Google Scholar
Laforest, S., Pelletier, A., Gauvin, L., Robitaille, Y., Fournier, M., Corriveau, H., et al. . Impact of a community-based falls prevention program on maintenance of increased involvement in physical activity among older adults: A quasi-experimental design. Manuscript submitted for publication Submitted for publication (under review).Google Scholar
Lord, S.R., & Castell, S. (1994). Physical activity program for older persons: Effects on balance, strength, neuromuscular control, and reaction time. Archives of Physical Medicine and Rehabilitation, 75, 648–652.CrossRefGoogle ScholarPubMed
Marks, R., & Allegrante, J.P. (2004). Falls-prevention programs for older ambulatory community dwellers: From public health research to health promotion policy. Social and Preventive Medicine, 49, 171–178.CrossRefGoogle ScholarPubMed
Ministère de la Santé et des Services sociaux (2003). Quebec Public Health Program 2003–2012. Quebec, QC: Direction des communications, Ministère de la Santé et des Services sociaux.Google Scholar
Oakley, A., Dawson, M.F., Fullerton, D., Holland, J., Arnold, S., Cryer, C., et al. (1996). Preventing falls and subsequent injury in older people. Effective Health Care Bulletins, 2(4), 1–16.Google Scholar
Prohaska, T., Belansky, E., Belza, B., Buchner, D., Marshall, V., McTigue, K., et al. (2006). Physical activity, public health, and aging: Critical issues and research priorities. Journal of Gerontology: Social Sciences, 61B(5), 267–273.CrossRefGoogle Scholar
Public Health Agency of Canada (2005). Inventory of falls prevention initiatives in Canada. Ottawa: Division of Aging and Seniors, Public Health Agency of Canada.Google Scholar
Robitaille, Y., Fournier, M., Laforest, S., Gauvin, L., Filiatrault, J., & Corriveau, H.. Exploring the impact of a community-based prevention program on falls using a quasi-experimental design in natural settings. (under review).Google Scholar
Robitaille, Y., Laforest, S., Fournier, M., Gauvin, L., Parisien, M., Corriveau, H., et al. (2005). Moving forward in fall prevention: An Intervention to improve balance among older adults in real-world settings. American Journal of Public Health, 95(11), 2049–2056.CrossRefGoogle ScholarPubMed
Rosenstock, I.M. (1990). The health belief model: Explaining health behaviour through expectancies. In Glanz, K., Lewis, F.M., & Rimer, B.K. (Eds.), Health behaviour and health education. (2nd ed. pp. 39–62). San Francisco, CA: Jossey-Bass.Google Scholar
Sherwood, N.E., & Jeffery, R.W. (2000). The behavioural determinants of exercise: Implications for physical activity interventions. Annual Review of Nutrition, 20, 21–44.CrossRefGoogle ScholarPubMed
Statistics Canada (2000). Canadian Community Health Survey. Ottawa, ON: Author.Google Scholar
Topp, R., Mikesky, A., & Bawel, K. (1994). Developing a strength training program for older adults: Planning, programming, and potential outcomes. Rehabilitation Nursing, 19(5), 266–272.CrossRefGoogle ScholarPubMed
Trickey, F., Parisien, M., Laforest, S., Genest, C., & Robitaille, Y. (2003). Stand Up! A fall prevention programme for seniors: Programme Guide. Montreal, QC: Direction de santé publique de Montréal.Google Scholar
Trickey, F., Parisien, M., Laforest, S., Genest, C., & Robitaille, Y. (2002). Programme intégré d'équilibre dynamique—PIED. Guide d'animation. Montreal, QC: Direction de santé publique de Montréal.Google Scholar
Trickey, F., Robitaille, Y., Damestoy, N., Genest, C., Laforest, S., & Parisien, M. (2001). Adoption naturelle du programme PIED de 1997 à 2001. Bilan et perspectives. Montreal, QC: Direction de la santé publique de Montréal-Centre, Régie régionale de la Santé et des Services sociaux.Google Scholar
Trickey, F., Parisien, M., Robitaille, Y., Gosselin, C., & Laforest, S. (1999). Programme intégré d'équilibre dynamique—PIED. Guide d'animation. Montreal, QC: Direction de la santé publique de Montréal, Régie régionale de la Santé et des Services sociaux.Google Scholar
Trickey, F., Robitaille, Y., Laforest, S., Gosselin, C., & Parisien, M. (1999). Évaluation du Programme intégré d'équilibre dynamique (P.I.E.D.) pour la prévention des chutes chez les aînés. Rapport détaillé. Montreal, QC: Direction de la santé publique de Montréal-Centre, Régie régionale de la Santé et des Services sociaux.Google Scholar
Victora, C.G., Habicht, J.-P., & Bryce, J. (2004). Evidence-based public health: Moving beyond randomized trials. American Journal of Public Health, 94(3), 400–405.CrossRefGoogle ScholarPubMed
Weatherall, M. (2004). Prevention of falls and fall-related fractures in community-dwelling older adults: A meta-analysis of estimates of effectiveness based on recent guidelines. Internal Medicine Journal, 34, 102–108.CrossRefGoogle ScholarPubMed