Introduction: This study examined whether participation in a modified version of the "Stepping On" program was effective in increasing fall self-efficacy, static and dynamic balance, and awareness of fall risks in older adults. Design: A mixed methods, one-group, nonexperimental, pretest-posttest design. Participants: Nineteen women aged 65 and older residing in a senior living facility. Intervention: Participants attended a 7-week fall prevention education program focused on group exercises, home hazards, community safety and footwear, and vision and medication management. The program met for 2 h weekly for 7 weeks. Participants were assessed pre-and postintervention using the Modified Falls-Efficacy Scale, Get Up and Go Test, and Romberg Balance Test. In addition, a focus group was facilitated postintervention to determine participants' awareness of fall risks. Results: While the Modified Falls-Efficacy Scale (MFES) postintervention results were not statistically significant, they did indicate a decreased level of confidence in participants' ability to avoid a fall postintervention. "Get Up and Go" completion time also increased postintervention, but was not statistically significant. No change in static balance was noted in Romberg Balance Test results. Participants did report an overall increase in awareness of fall risks postintervention. Conclusion: Although results did not support the hypotheses regarding increased fall self-efficacy and static and dynamic balance, participation in the modified "Stepping On" program did lead to an overall increase in awareness of fall risks. Modifying the evidence-based program made it feasible to test in a new community and may have empowered older adults with the knowledge to prevent future falls. ). This work was completed by Garcia, Marciniak, McCune, and Smith in partial fulfillment of the requirements for a Master of Occupational Therapy (MSOT) degree from Dominican Falls among community-dwelling older adults are a major public health concern in the United States. Approximately one-third of adults 65 years and older fall every year and 20-30% of those who fall suffer moderate to severe injuries (
Changing health care delivery systems increasingly demand community-focused care; however, little research has been done exploring the experiences of the limited numbers of occupational therapists in community practice. Therefore, the purpose of this exploratory descriptive study was to better understand the challenges and rewards of community-based occupational therapy. Ten occupational therapists in varied practice settings were interviewed and the data were analyzed qualitatively. Findings suggest a need to understand the experience of community-based occupational therapists and to increase educational and professional support for this important practice area.
Aims: To identify characteristics of older adults who contact first responders after a fall, understand experiences of fallers and first responders regarding fall incidents, and explore strategies for fall prevention education and intervention. Method: In this mixed-methods study 471 fall incident reports were quantitatively analyzed for demographic and fall incident information, and qualitative data were collected and analyzed from focus groups and telephone interviews with older adult fallers and first responders. Results: The majority of fallers were female (62%), the average age was 81, and nearly half (47%) were alone during the fall incident. Polypharmacy was present for a majority of the older adult fallers, with 47% taking five or more medications. Mechanical (57%) and medical (29%) factors were primary contributors to falls. Fallers reported feeling increased vulnerability, depression, frustration, and self-blame after falling. First responders reported challenges communicating with older adult fallers and with care facility staff when assisting residents who had fallen. Conclusions: Older adults who fall may benefit from services and supports from first responders and health professionals to help reduce fall risk and maintain independence despite falling. ). Acknowledgements: The authors would like to thank Dominican University of California and the Department of Occupational Therapy for their commitment to academic research. We would also like to acknowledge the Novato Fire Protection District for their collaboration and support throughout this research process. We would like to especially thank Ted Peterson, the Battalion Chief, for his guidance and commitment to this study. Additionally, we acknowledge Patricia Reyes, the evaluation consultant, for her feedback and suggestions regarding our methodology. Lastly, we are very grateful for the time, energy, and unique perspectives our participants offered in order to make this study a possibility.
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