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Background
Falls are common in older people. Despite strong evidence for effective falls prevention strategies, there appears to be limited translation of these strategies from research to clinical practice. Use of peers in delivering falls prevention education messages has been proposed to improve uptake of falls prevention strategies and facilita...
Contexts in source publication
Context 1
... peer educators (n = 11) were invited by the com- munity partner's program training coordinator to par- ticipate in focus group interviews and all accepted. The focus group participants' profile and characteristics are presented in Table 1. Eight (73%) of the participants were less than 75 years old and five (46%) had delivered peer education presentations for more than five years. ...
Context 2
... participants' views about training were influenced by their life skills, work and personal experience (Table 1) before retirement. Presentations were viewed as a "com- bination of information and delivery" (Participant 2) and it was perceived that each needed to be optimal if they were to effectively deliver their falls prevention message. ...
Similar publications
Interventions for older people are often not evaluated and, if evaluated, are not proven successful. Based on a systematic literature review and two qualitative studies about the social needs of older people, an intervention has been developed, implemented, and evaluated. Important social needs that emerged from these studies are connectedness, mea...
Citations
... 8,17 This peer-based interaction, characterized by its egalitarian communication nature, created a supportive and empathetic environment. 30 The shared experiences and strategies among peers proved to be both relatable and comforting, significantly reducing anxieties related to falling. 31 This finding is especially important, considering the psychological barriers that often impede physical activity among older adults. ...
Objective: This study assesses the impact of single-player and multiplayer exergaming modes on improving exercise intentions, reduction of fear of falling, and emotional well-being among older adults, primarily from low socioeconomic status (SES) backgrounds-a group often underrepresented in exergame research. Method: We engaged 48 participants, primarily from low-SES communities in Singapore for a 4-week community-based exergaming intervention. Participants were divided into four groups as follows: (1) conventional exercise alone, (2) exergames alone, (3) exergames with a health coach, and (4) exergames with a peer. Using two-way repeated-measures ANOVA, we analyzed the effects of these interventions. Results: The findings revealed that all exergaming modes positively influenced exercise intentions, fear of falling, and emotional well-being to varying extents. Notably, exergaming with a health coach significantly improved participants' exercise intentions and emotional well-being, underscoring the value of expert guidance in motivating and supporting older adults in adopting healthier lifestyles. Exergaming with a peer was most effective in reducing fear of falling, highlighting the importance of social support and peer interaction in addressing physical health concerns among this population. Conclusion: This study emphasizes the potential of tailored exergame interventions incorporating various social interactions to improve health outcomes for older adults, contributing to more inclusive health promotion strategies.
... This is supported in the literature, where the impact of peer-to-peer transmission of educational messages for falls prevention improves acceptance and facilitates the implementation of new practices. Peer participation also improves the transmission of the message, achieving greater perceived credibility and facilitating optimal commitment (Khong et al., 2015). This finding could be further explored in future research. ...
Background
Falls amongst the elderly represent a global public health challenge because of their potential to cause illness, death, and reduce the autonomy of this group. They also impact the emotional, family, social and economic well-being of those involved. Various strategies to prevent falls have been reported in the literature, focusing mainly on addressing individual risk factors, and on the continuous assessment of the risk of falls in older people.
Objective
This study evaluated user satisfaction and acceptability of a comprehensive model, implemented in the community, to prevent falls amongst independent older adults aged 65 years and above. It sought to capture both the perceptions of the individuals who received the intervention and of the interventionists who implemented it. The study protocol was registered at ClinicalTrials.gov in November 2020 (ID: NCT04313062).
Design
Qualitative, exploratory study using a case study design. The evaluation of the intervention followed the recommendations proposed by the Medical Research Council for complex interventions. Methods and participants: In the period between April 2021 to April 2022, 11 semi-structured interviews were conducted with independent older adults between 65 and 80 years of age who participated in the implementation of the comprehensive model in Santiago, Chile. Data were also collected with eight interventionists through: three semi-structured interviews at the beginning of the intervention; and two focus groups with seven interventionists at the end of the implementation of the model. The team members undertook a content analysis of the data collected.
Results
Three themes emerged to account for the satisfaction and acceptability of the intervention with the model on the part of the participants and interventionists: (1) Previous experience of older persons and interventionists; (2) The older person-interventionist encounter and its context; and (3) Identification of facilitators, strengths and challenges for the implementation of the model. The results show a positive assessment of the model, highlighting the value of the social contact derived from the intervention by both participants and interventionists. Although the model involved an individual intervention, the participants’ accounts indicate that it reached out to others, including family members and other elderly acquaintances. Moreover, the interventionists helped identify challenges in implementation and made recommendations to strengthen the model.
Conclusion
The evaluation of satisfaction and feasibility of implementing the model showed positive results that will nurture the next phase of development of this model, which involves scaling up the intervention.
... They could also provide their audiences with demonstrations on how to identify and manage simple fall risk factors and persuasive suggestions for seeking specialist services for more complex risk factors. Previous studies demonstrated the positive impacts of lay health workers in alleviating the shortage and disproportionally distribution of professional health workers and improving primary and community health care [34][35][36]. In addition, effective fall-prevention interventions always require a combination of various skills and knowledge from a multidisciplinary team, rather than simply distributing brochures, to improve safe mobility for older adults [5]. ...
Background
Chinese National Essential Public Health Service Package (NEPHSP) has mandated primary health care providers to provide falls prevention for community-dwelling older people. But no implementation framework is available to guide better integration of falls prevention for older people within the primary health care system.
Methods
This is a two-stage online participatory design study consisting of eight workshops with stakeholders from three purposively selected cities. First, two workshops were organised at each study site to jointly develop the framework prototype. Second, to refine, optimise and finalise the prototype via two workshops with all study participants. Data analysis and synthesis occurred concurrently with data collection, supported by Tencent Cloud Meeting software.
Results
All participants confirmed that the integration of falls prevention for older people within the NEPHSP was weak and reached a consensus on five opportunities to better integrate falls prevention, including workforce training, community health promotion, health check-ups, health education and scheduled follow-up, during the delivery of NEPHSP. Three regional-tailored prototypes were then jointly developed and further synthesised into a generic implementation framework by researchers and end-users. Guided by this framework, 11 implementation strategies were co-developed under five themes.
Conclusions
The current integration of falls prevention in the NEPHSP is weak. Five opportunities for integrating falls prevention in the NEPHSP and a five-themed implementation framework with strategies are co-identified and developed, using a participatory design approach. These findings may also provide other regions or countries, facing similar challenges, with insights for promoting falls prevention for older people.
... The current findings illustrate the positive outcomes of peer support and education with elders. Research demonstrates use of peer support with older populations in terms of issues such as increasing awareness of health issues [59,60], palliative care [40,61,62], successful ageing [63], chronic condition self-management [64] and physical activity and fall-prevention [65][66][67][68]. The current study also further supports the previous research on the tuakana-teina programme to show positive impacts on hauora and mana motuhake outcomes for an elder Indigenous community [32]. ...
Background
There are significant inequities between Māori (Indigenous people) and non-Māori in ageing outcomes. This study used a strengths-based approach based on the key cultural concept of mana motuhake (autonomy and self-actualisation) to develop a tuakana-teina (literally older sibling-younger sibling) peer education programme to assist kaumātua (elders) in addressing health and social needs. The purpose of this study was to test the impact on those receiving the programme. Three aims identify the impact on outcomes, resources received and the cost effectiveness of the programme.
Methods
Five Kaupapa Māori (research and services guided by Māori worldviews) iwi (tribe) and community providers implemented the project using a partnership approach. Tuakana (peer educators) had up to six conversations each with up to six teina (peer learners) and shared information related to social and health services. A pre- and post-test, clustered staggered design was the research design. Participants completed a baseline and post-programme assessment of health and mana motuhake measures consistent with Māori worldviews. Open-ended questions on the assessments, five focus groups, and four individual interviews were used for qualitative evaluation.
Findings
A total of 113 kaumātua were recruited, and 86 completed the programme. The analysis revealed improvements in health-related quality of life, needing more help with daily tasks, life satisfaction, paying bills and housing problems. Qualitative results supported impacts of the programme on mana motuhake and hauora (holistic health) through providing intangible and tangible resources. Cost-effectiveness analysis showed that the intervention is cost effective, with a cost per QALY of less than the conventional threshold of three times GDP per capita.
Conclusions
A culturally-resonant, strengths-based programme developed through a participatory approach can significantly improve health and social outcomes in a cost-effective way.
Trial Registry
Clinical trial registry: Trial registration: (ACTRN12620000316909). Prospectively registered 06/03/2020, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379302&isClinicalTrial=False.
... A recent review of peer support for carers of people living with dementia (Carter et al., 2020) found that more research is required as to how to design and evaluate interventions that provide such peer support, this includes educational as well as other forms of interventions such as befriending. Peer delivered educational interventions are a potentially efficient and effective means of improving health and social care outcomes (Burmeister et al., 2016;Khong et al., 2015;Ogrin et al., 2017). ...
Family caregivers of people with dementia can find the impairments in their relative’s ability to communicate an enormous challenge. Peer facilitated educational interventions are a potentially efficient and effective way to address these complex communication issues. This paper examines the processes required to support the development of peer educators and the impact this has had on facilitators and course attendees. Semi-structured interviews with six participants who facilitated Empowered Conversations (EC) a communication skills educational program for caregivers of people with dementia and 28 participants who attended the program. A qualitative thematic analysis approach identified emergent themes within the data. Three broad findings are reported: first the support that is needed for peer facilitators; second, the impact of the course reported by facilitators and course attendees; and third, suggestions for improvements. The content of the EC program is strong and the reflective cycle encouraged via support mechanisms prior to, during and following the delivery of sessions is effective for supporting facilitators. When upscaling the program it was important to enhance the support structures for new peer facilitators. Introducing a support session focusing on examples of logistical issues experienced and how these could be addressed would be a useful addition to the support mechanisms already devised. Attendees reported positively on participation in the course, particularly valuing the input from facilitators with experience of caregiving. Suggested improvements related to better information about the course and a settling in period, with some specific individual suggestions for content relating to their personal experiences.
... Participants suggested that the development of a peer-led education program would be a desirable method, as it would increase community capacity safely. The peer-educator model suggested by participants has been used successfully in programs designed for older adults [44,45]. Although this is a starting point, these resources will need to be evaluated, augmented, and implemented to support older adults, particularly those with limited technology experience. ...
Background:
Background: The COVID-19 pandemic has resulted in over 2.58 million deaths worldwide with over 500,000 of those in the US, at the time of this writing. Older adults (65 years of age) and people with underlying medical conditions are at higher risk of death. Since March 2020, preventive measures including lockdowns, social isolation, quarantine and social distancing have been implemented to reduce viral spread. These measures, while effective for risk prevention, may contribute to increased social isolation and loneliness among older adults and negatively impact mental and physical health.
Objective:
Our objective was to identify the impact of the "Stay-at-Home" order on older adults living in a Continued Care Senior Housing Community (CCSHC) in Southern California.
Methods:
Methods: Four 90-minute focus groups were convened using the Zoom communications platform during May 2020 with 21 CCSHC residents participating. Participants were asked to describe how they were managing during the "stay-at-home" mandate that was implemented in March 2020, including impact on their physical and mental health. Transcripts of each focus group were analyzed using qualitative methods.
Results:
Four themes emerged from the qualitative data including: 1 - Impact of Quarantine on Health and Well-Being; 2 - Communication Innovation and Technology Use; 3 - Effective Ways of Coping with Quarantine; and 4 - Improving Access to Technology and Training. Participants reported a threat to their mental and physical health directly tied to quarantine and exacerbated by social isolation and decreased physical activity. Technology was identified as a lifeline for many who are socially isolated from friends and family.
Conclusions:
Conclusions: Technology access, connectivity, and literacy are potential game-changers to supporting the mental and physical health of older adults and must be prioritized.
Clinicaltrial:
... Peer education has been used to assist people in managing various life-transitions, including chronic and acute social and health issues [24]. They are primarily employed within younger populations, but elder peer educators have recently featured in palliative care [25][26][27], raising awareness of health [28,29], successful ageing [30], self-management of chronic conditions [31], and physical activity and fall-prevention in older age [32][33][34][35]. These efforts have demonstrated positive effects of peer education on the recipients. ...
... The findings of this study provide further support of the benefit of using peer education with older people. While peer education has been primarily used for younger populations, recent research has found support for its use with older populations in terms of issues such as successful ageing [30], self-management of chronic conditions [31], palliative care [25][26][27], raising awareness of health [28,29], and physical activity and fall-prevention [32][33][34][35]. The current study illustrates that peer education has effects on specific health and social outcomes for an elder Indigenous community, which is a new contribution to the research literature. ...
Background:
Aotearoa/New Zealand has a population that is ageing and there are challenges to health and social outcomes related to related to key life transitions (e.g., retirement, change in health conditions, loss of spouse). Further, there are significant inequities between Māori (Indigenous people) and non-Māori in ageing outcomes. The purpose of this study was to test the impacts and cost effectiveness of a tuakana/teina (peer education) intervention on kaumātua (elders) receiving the intervention. This study was framed by a strengths-based approach based on the key cultural concept of mana motuhake (autonomy and self-actualisation).
Methods:
This study was grounded in principles of Kaupapa Māori and community-based participatory research to bring together a diverse group of stakeholders to co-develop and co-evaluate the intervention. The intervention had tuakana (peer educators) having conversations with up to six teina (recipients) and providing information related to health and social services. The research design was a pre- and post-test, clustered staggered design. Participants completed a baseline assessment of health and mana motuhake measures consistent with Māori worldviews along with two follow-up assessments (one after the first intervention group completed its activities and a second after the second intervention group completed its activities). Additionally, five focus groups and open-ended questions on the assessments were used to provide qualitative evaluation.
Findings:
A total of 180 kaumātua were recruited to the intervention with 121 completing it. The analysis revealed improvements over time in the expected direction on most of the variables. However, only three of the variables had statistically significant intervention effects: received support, tribal identity, and trouble paying bills. Qualitative results supported impacts of the intervention on mana motuhake, social connectedness, and tangible/information support related to services. Cost-effectiveness analysis showed that the intervention is cost effective, with a cost per QALY of less than the conventional threshold of three times gross domestic product per capita.
Conclusions:
The findings support the relevancy and importance of kaumātua knowledge to create a strengths-based approach to improve health and social outcomes. This study demonstrates that a contextually based and culturally safe age-friendly environments can facilitate engagement and participation by kaumātua for kaumātua.
Trial registry:
Australia New Zealand Clinical Trial Registry (ACTRN12617001396314); Date Registered: 3 October 2017 (retrospectively registered); https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373733&isClinicalTrial=False.
... The umbrella term "peer" can describe a multitude of interventions where both the peer educator and their peer "share something that creates and affinity between them" (Shiner, 1999, p. 564). Khong, Farringdon, Hill, and Hill (2015) found that peers had the potential to effectively deliver fall prevention education to other older adults and stimulate a greater acceptance of the presented information, as the peer relationship enhanced older people's engagement in fall prevention programs. Peer volunteers have been shown to increase physical activity levels and effectively deliver education among their peer groups (Pinto, Stein, Dunsiger, & Kazak, 2015). ...
The aim of this qualitative exploratory study was to investigate older adults’ perceptions of having a peer to encourage their participation in resistance training. The participants were recruited from a retirement village to undergo a 6-week resistance training program. Some participants attended a center; others participated in their home. Data were collected via semistructured interviews and analyzed thematically using a six-phase framework to obtain the participants’ perspectives about the peer support they received. The participants ( n = 21) had divergent views about peer support, with some finding it enabling, while others did not find it helpful. Overall, the participants suggested that peer support could be beneficial if offered as a choice. Further research is needed to determine whether peer support assists in sustaining resistance training engagement among older adults when the aspect of choice is included.
... Processes surrounding the education implementation and design A qualitative study of peer education for community dwelling older adults • Khong, L., Farringdon, F., Hill, K. D., & Hill, A.-M. (2015). "We are all one together": peer educators' views about falls prevention education for community-dwelling older adults--a qualitative study. ...
... Some statements have been published on research reporting more generally that can provide some guidance as to how to report education research outcomes, such as the TREND Statement for non-randomised intervention trials (Des Jarlais, Lyles & Crepaz, 2004), and the TIDieR checklist and guide (Hoffmann, Glasziou, Boutron et al 2014). Some recent publications in falls prevention research including education interventions include protocol papers (Williams et al 2016; Tiedemann et al 2014), a systematic review (Lee et al 2014) and numerous clinical trials ranging, for example, from investigations of nurse-led falls prevention education programs (Uymaz & Nahcivan 2016), interprofessional education in falls prevention (McKenzie et al 2016; Sullivan et al 2015; Mercer et al 2014), peer education programs(Khong et al 2015, Vernon 2010, Allen 2004, to hospital based education interventions(Williams, Hadler, Norting 2015;Hill, McPhail, Waldron et al 2015; Hill, McPhail, Francis-Coad 2015;Zavotsky et al 2014) and multi-media education comparisons(Schepens, Panzer & Goldberg 2011; Hill, McPhail, Hoffman 2009). The reporting of interventions and outcomes range from cursory mention and no reporting of education based outcomes (i.e. ...
Workshop aim:
The aim of this workshop is explore the key features of best practice educational design as applied to falls prevention research.
Workshop objectives
By the end of this workshop participants will be able to:
1. Differentiate research methodology from educational pedagogy
2. Describe the main educational theories that apply to experiential learning
3. Discuss and critique the quality of education interventions reported in falls prevention interventional trials
4. Apply a framework and model of educational design to guide research design
5. Apply a model of educational evaluation to measure both process of learning and translational patient related outcomes within lines of enquiry
6. Describe the key elements of education interventions to report in publications of educational interventions
7. Apply educational principles to own research activities
Target audience
This workshop is targeted at anyone implementing or planning to implement research that includes an education intervention or program.
Description of workshop content and activities
This workshop will equip participants with core knowledge and skills in education development. This will include skills in how to critique, develop, implement, measure and report educational interventions and outcomes. These skills will then be applied to the falls prevention research context to support quality research design. This workshop will use interactive small group methods such as discussions, brainstorm activities, paired exercises, and small group practical hands on activities to explore the stated learning objectives. In addition a comprehensive workbook outlining the workshop learning materials, resources and exercises will be provided. At the conclusion of the workshop participants will be asked to reflect on key learning points and be offered the opportunity to provide verbal and written feedback on what has worked well in the workshop and what could be improved. Opportunities for further electronic correspondence with the facilitators will be offered.
... Peer education/support is used to help people manage various 'age and stage' life-transitions, including acute and chronic situational health and social stressors [30]. Peer educators are mostly used with younger populations, but elder peer educators have recently featured in self-management of chronic conditions [31], raising awareness of health [32,33], physical activity and fall-prevention in older age [34][35][36][37], successful ageing [38], and palliative care [39][40][41]. In addition to improving health outcomes of recipients, peer education/support has also shown positive outcomes for peer educators' own sense of wellbeing and maintenance of health self-management and programme engagement [42][43][44]. ...
Background
The Aotearoa/New Zealand population is ageing and numerous studies demonstrate with this phenomenon comes increases in non-communicable diseases, injuries and healthcare costs among other issues. Further, significant inequities exist between Māori (Indigenous peoples of Aotearoa/New Zealand) and non-Māori around poor ageing and health. Most research addressing these issues is deficit oriented; however, the current research project takes a strengths-based approach that highlights the potential of kaumātua (elders) by asserting mana motuhake (autonomy, identity and self-actualisation). We believe that the esteem of elders in Māori culture signals transformative potential. Specifically, this project utilises a ‘tuakana-teina’ (older sibling/younger sibling) peer-educator model, where kaumātua work with other kaumātua in relation to health and wellbeing. The objectives of the project are (a) to develop the capacity of kaumātua as peer educators, whilst having positive impacts on their sense of purpose, health and wellbeing; and (b) to enhance the social and health outcomes for kaumātua receiving the intervention.
Methods
The research is grounded in principles of Kaupapa Māori and community-based participatory research, and brings together an Indigenous community of kaumātua, community health researchers, and academic researchers working with two advisory boards. The project intervention involves an orientation programme for tuakana peer educators for other kaumātua (teina). The research design is a pre- and post-test, clustered staggered design. All participants will complete a baseline assessment of health and wellbeing consistent with Māori worldviews (i.e., holistic model). The tuakana and teina participants will be divided into two groups with the first group completing the intervention during the first half of the project and the second group during the second half of the project. All participants will complete post-test assessments following both interventions allowing comparison of the two groups along with repeated measures over time.
Discussion
The findings will provide an evidence base for the importance and relevancy of kaumātua knowledge to create contextually based and culturally safe age-friendly environments that facilitate engagement and participation by kaumātua for kaumātua. If the model is effective, we will seek to facilitate the dissemination and scalability of the intervention.
Trial registration
Australia New Zealand Clinical Trial Registry (ACTRN12617001396314); Date Registered: 3 October 2017 (retrospectively registered).
Electronic supplementary material
The online version of this article (10.1186/s12877-019-1041-2) contains supplementary material, which is available to authorized users.
