Implementation of a digital exercise programme in health services to prevent falls in older people.
Background StandingTall uses eHealth to deliver evidence-based balance and functional strength exercises. Clinical trials have demonstrated improved balance, reduced falls and fall-related injuries and high adherence. This study aimed to evaluate the implementation of StandingTall into health servic...
| Publicado en: | Age & Ageing Vol. 53; no. 8; pp. 1 - 13 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Aug2024
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=179376091&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 179376091 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Aug2024 vid: 53 iid: 8 pid: 622 pub: Oxford University Press / USA artinfo: ui: 179376091 10.1093/ageing/afae173 ppf: 1 ppct: 12 formats: tig: atl: Implementation of a digital exercise programme in health services to prevent falls in older people. aug: au: Taylor, Morag E Ambrens, Meghan Hawley-Hague, Helen Todd, Christopher Close, Jacqueline C T Lord, Stephen R Clemson, Lindy Lung, Thomas Berlowitz, David Blennerhassett, Jannette Dayhew, Julia Gluchowski, Ashley Hodge, Wendy Johnson, Pamela Lasrado, Reena Merlene, Marita Miles, Lillian O'Rourke, Sandra Said, Catherine M White, Leanne affil: Neuroscience Research Australia , Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia Population Health , Faculty of Medicine and Health, University of New South Wales , Sydney, New South Wales, Australia School of Health Sciences , Faculty of Medicine and Health, University of New South Wales , Sydney, New South Wales, Australia School of Health Sciences , Faculty of Biology, Medicine and Health, The University of Manchester , Manchester, UK National Institute for Health and Care Research , Applied Research Collaboration—Greater Manchester, The University of Manchester , Manchester, UK Manchester Academic Health Science Centre , Manchester, UK Manchester University NHS Foundation Trust , Manchester, UK School of Clinical Medicine , Faculty of Medicine and Health, University of New South Wales , Sydney, New South Wales, Australia Sydney School of Health Sciences , Faculty of Medicine and Health, The University of Sydney , Sydney, New South Wales, Australia Centre of Excellence for Population Ageing Research, The University of Sydney , Sydney, New South Wales, Australia Sydney School of Public Health , Faculty of Medicine and Health, The University of Sydney , Sydney, New South Wales, Australia The George Institute for Global Health, University of New South Wales , Sydney, New South Wales, Australia Austin Health , Heidelberg, Victoria, Australia Physiotherapy, University of Melbourne , Parkville, Australia Health Promotion, Northern NSW Local Health District , Lismore, New South Wales, Australia School of Health & Society, University of Salford , Salford, UK ARTD Consultants , Sydney, New South Wales, Australia Mid North Coast Local Health District , New South Wales, Australia Physiotherapy, Western Health , St Albans, Victoria, Australia Australian Institute of Musculoskeletal Science , St Albans, Victoria, Australia su: United Kingdom Australia Evaluation of human services programs Patient compliance Community health services Medical care Medical practice COVID-19 pandemic Old age Digital technology Research funding Exercise therapy Functional status Telemedicine Research Accidental falls Postural balance sug: subj: Evaluation of human services programs Patient compliance Community health services Medical care Medical practice COVID-19 pandemic Old age United Kingdom Australia Other local, municipal and regional public administration Residential Mental Health and Substance Abuse Facilities All Other Outpatient Care Centers Community health centres Other Individual and Family Services Digital technology Research funding Exercise therapy Functional status Telemedicine Research Accidental falls Postural balance keyword: adherence aged australia exercise fall prevention health behaviour health services implementation science older adult older people postural balance qualitative research telehealth telemedicine adherence aged australia exercise fall prevention health behaviour health services implementation science older adult older people postural balance qualitative research telehealth telemedicine ab: Background StandingTall uses eHealth to deliver evidence-based balance and functional strength exercises. Clinical trials have demonstrated improved balance, reduced falls and fall-related injuries and high adherence. This study aimed to evaluate the implementation of StandingTall into health services in Australia and the UK. Methods Two hundred and forty-six participants (Australia, n = 184; UK, n = 62) were recruited and encouraged to use StandingTall for 2 h/week for 6-months. A mixed-methods process evaluation assessed uptake and acceptability of StandingTall. Adherence, measured as % of prescribed dose completed, was the primary outcome. Results The study, conducted October 2019 to September 2021 in Australia and November 2020 to April 2022 in the UK, was affected by COVID-19. Participants' mean age was 73 ± 7 years, and 196 (81%) were female. Of 129 implementation partners (e.g. private practice clinicians, community exercise providers, community service agencies) approached, 34% (n = 44) agreed to be implementation partners. Of 41 implementation partners who referred participants, 15 (37%) referred ≥5. Participant uptake was 42% (198/469) with mean adherence over 6 months being 41 ± 39% of the prescribed dose (i.e. 39 ± 41 min/week) of exercise. At 6 months, 120 (76%) participants indicated they liked using StandingTall , 89 (56%) reported their balance improved (moderately to a great deal better) and 125 (80%) rated StandingTall as good to excellent. For ongoing sustainability, health service managers highlighted the need for additional resources. Conclusions StandingTall faced challenges in uptake, adoption and sustainability due to COVID-19 and a lack of ongoing funding. Adherence levels were lower than the effectiveness trial, but were higher than other exercise studies. Acceptance was high, indicating promise for future implementation, provided sufficient resources and support are made available. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12619001329156. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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