Implementation of the Ironbark falls prevention program: a mixed methods process evaluation with Aboriginal communities.

Background Falls are a leading cause of injury and loss of independence among older Aboriginal people. The Ironbark program is a culturally co-designed, community-based fall prevention initiative, incorporating exercises and Yarning circles, a culturally grounded form of group discussion. This paper...

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Publicado en:Age & Ageing Vol. 55; no. 6; pp. 1 - 12
Autores principales: McKeon, Grace, Knight, Zarayn, Ivers, Rebecca, Coombes, Julieann, Jessup, Vanessa, Delbaere, Kim, Sherrington, Catherine, Tiedemann, Anne, Hill, Anne-Marie, McCarthy, Leanne
Formato: Artículo
Publicado: Oxford University Press / USA Jun2026
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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        10.1093/ageing/afag184
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        atl: Implementation of the Ironbark falls prevention program: a mixed methods process evaluation with Aboriginal communities.
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          McKeon, Grace
          Knight, Zarayn
          Ivers, Rebecca
          Coombes, Julieann
          Jessup, Vanessa
          Delbaere, Kim
          Sherrington, Catherine
          Tiedemann, Anne
          Hill, Anne-Marie
          McCarthy, Leanne
        affil:
          Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University,  Melbourne, Victoria, AustraliaDiscipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
          School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
          School of Population Health, University of New South Wales, Sydney, New South Wales, AustraliaThe George Institute for Global Health, Sydney, New South Wales, Australia
          The George Institute for Global Health, Sydney, New South Wales, Australia
          WA Centre for Health and Ageing, The University of Western Australia, Perth, Australia
          School of Health Sciences, Health Translation Hub, University of New South Wales, Randwick, New South Wales 2031, AustraliaFalls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales 2031, Australia
          Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, AustraliaSchool of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
          School of Allied Health, The University of Western Australia, 35 Stirling Hwy, Crawley, Perth, Western Australia 6009, AustraliaWA Centre for Health and Ageing, Perth 6009, Australia
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        Australia
        Human services programs
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        Descriptive statistics
        Research methodology
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        Data analysis software
        Accidental falls
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          Interviewing
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          Research methodology
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          Data analysis software
          Accidental falls
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        Aboriginal and Torres Strait Islander peoples
        aged
        community
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        exercise
        fall prevention
        falls prevention
        https://dx.doi.org/10.1093/ageing/afag184
        implementation
        implementation science
        inLanguage:en
        older adults
        publisher:Oxford University Press
        qualitative research
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42328810/
        Aboriginal and Torres Strait Islander peoples
        aged
        community
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        exercise
        fall prevention
        falls prevention
        https://dx.doi.org/10.1093/ageing/afag184
        implementation
        implementation science
        inLanguage:en
        older adults
        publisher:Oxford University Press
        qualitative research
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42328810/
      ab: Background Falls are a leading cause of injury and loss of independence among older Aboriginal people. The Ironbark program is a culturally co-designed, community-based fall prevention initiative, incorporating exercises and Yarning circles, a culturally grounded form of group discussion. This paper presents a process evaluation of the program, examining fidelity and key factors influencing implementation across settings. Methods Sixteen sites across two Australian states implemented the Ironbark Standing Strong and Tall program. Process data were collected from 15 sites through structured session observations and semi-structured interviews with exercise facilitators. Fidelity and dose were assessed quantitatively, with adherence scored using a summative checklist score. Qualitative data were thematically analysed and mapped onto the Consolidated Framework for Implementation Research (CFIR). Results The program was delivered with high fidelity to 117 participants with median adherence scores consistently above 80%. Sessions were implemented as planned, with strong participant engagement in both exercise and Yarning components. Key facilitators included Aboriginal leadership, trusted site managers, program flexibility and supportive service structures. Challenges included managing varying physical abilities, maintaining engagement over time and external disruptions (e.g. Coronavirus -19 pandemic, weather). Content repetition was noted as a barrier to sustained attendance by participants in later stages. Facilitators recommended additional training, mid-program assessments and access to site-collected data. Sustainability was linked to workforce capacity and securing ongoing funding, particularly to support Aboriginal staff and transport. Conclusion This process evaluation indicated that a culturally-relevant fall prevention program for older Aboriginal people can be implemented with fidelity across community settings. Findings provide practical guidance for exercise facilitators and on sustaining and expanding the Ironbark program and inform broader efforts to embed culturally safe, community-led health programs in routine practice.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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