Richard G. Berlach’s research while affiliated with University of Notre Dame Australia and other places

Peer-led education has been shown to be an effective approach for raising community-dwelling older adults’ beliefs, knowledge and intention to engage in falls prevention strategies in a recent intervention trial. This article outlines the design and development of the intervention, which was a peer-led falls prevention education programme designed to promote older adult’s motivation to change their behaviour in the area of falls prevention. The elements of the programme that contributed to its efficacy are also described. The programme was designed using a four-step approach and was based on the constructs of a theoretical framework (the COM-B model). Feedback from older adults was also incorporated into the programme development. Programme components developed were a workshop to train older adult peer educators to deliver falls prevention education, a one-hour peer-led falls prevention presentation, and supporting resources to aid programme delivery. A questionnaire measuring older adults’ responses to the presentation was concurrently developed and pilot-tested prior to implementation of the education programme. Finally, resources to monitor and evaluate fidelity at five points in the programme were developed. It was found that seeking older adult consumer involvement, and adopting a theoretical framework-driven approach contributes to effective design and delivery of falls prevention education programmes. This ensured that the programme was acceptable to older adults, feasible to deliver and allowed robust measurement of the effect of the education programme on important behavioural change components.

Falls among older adults are a major problem. Despite considerable progress in falls prevention research, older adults often show low motivation to engage in recommended preventive strategies. Peer-led falls prevention education for older adults may have potential for bridging the research evidence-practice gap, thereby promoting the uptake of falls prevention strategies. We evaluated peer educators’ presentations of falls prevention education to community-dwelling older adults in regard to established criteria that were consistent with adult learning principles, the framework of health behaviour change, falls prevention guidelines, and recommendations for providing falls prevention information. We conducted a within-stage mixed model study using purposive and snowball sampling techniques to recruit 10 experts to evaluate video recordings of the delivery of three peer-led falls prevention presentations. Each expert viewed three videos and rated them using a questionnaire containing both open-ended and closed items. There was a good level of expert agreement across the questionnaire domains. Though the experts rated some aspects of the presentations highly, they thought that the presentations were mainly didactic in delivery, not consistently personally relevant to the older adult audience, and did not encourage older adults to engage in the preventive strategies that were presented. Based on the experts’ findings, we developed five key themes and recommendations for the effective delivery of peer-led falls prevention presentations. These included recommending that peer educators share falls prevention messages in a more interactive and experiential manner and that uptake of strategies should be facilitated by encouraging the older adults to develop a personalised action plan. Findings suggest that if peer-led falls prevention presentations capitalise on older adults’ capability, opportunity, and motivation, the older adults may be more receptive to take up falls prevention messages.

The aim of the study was to evaluate the effectiveness of delivering a contemporary peer-led falls prevention education presentation on community-dwelling older adults’ beliefs, knowledge, motivation and intention to engage in falls prevention strategies. A two-group quasi-experimental pre-test–post-test study using a convenience sample was conducted. A new falls prevention training package for peer educators was developed, drawing on contemporary adult learning and behaviour change principles. A 1-h presentation was delivered to community-dwelling older adults by peer educators trained with the new package (intervention group). Control group participants received an existing, 1-h falls prevention presentation by trained peer educators who had not received the adult learning and behaviour change training. Participants in both groups completed a purpose-developed questionnaire at pre-presentation, immediately post-presentation and at one-month follow-up. Participants’ levels of beliefs, knowledge, motivation and intention were compared across these three points of time. Generalised estimating equations models examined associations in the quantitative data, while deductive content analysis was used for qualitative data. Participants (control n = 99; intervention n = 133) in both groups showed significantly increased levels of beliefs and knowledge about falls prevention, and intention to engage in falls prevention strategies over time compared to baseline. The intervention group was significantly more likely to report a clear action plan to undertake falls prevention strategies compared to the control group. Peer-led falls prevention education is an effective approach for raising older adults’ beliefs, knowledge and intention to engage in falls prevention strategies.

Health education is an important means of raising older people’s knowledge and awareness about falls prevention. This study aimed to evaluate the effect of delivering a new peer-led falls prevention education presentation on older community-dwelling peoples’:1) beliefs and knowledge about falls prevention; 2) motivation and intention to engage in falls prevention strategies; compared to delivering an existing presentation. A two-group quasi-experimental pre-test post-test design was used. A new falls prevention education program was designed, which incorporated adult learning and behavior change principles. This new presentation was delivered to intervention groups and the existing presentation was delivered to control groups. Response to the presentation was measured at baseline, immediately post-presentation and at one-month follow-up. Beliefs, knowledge, motivation and intention outcomes were compared across these three points of time, within and between the intervention and control groups, using generalized estimating equation modelling. Participants (control n=99; intervention n=133) in both groups demonstrated significantly increased levels of belief and knowledge about falls prevention, and intention to engage in strategies over time, compared to baseline. The intervention group was significantly more likely to report they had developed an action plan to undertake to reduce their risk of falling compared to the control group [OR=1.69, 95% CI (1.03–2.78)]. Women in both groups were significantly more likely to report increased knowledge, intention to take action and development of an action plan to reduce their risk of falling. Peer led education could form an effective component of health programs that target falls prevention.

Introduction and hypothesisPregnant women benefit from completing pelvic floor muscle exercises (PFMEs). The aims of the study were to evaluate pregnant women’s levels of awareness, knowledge, and beliefs about the pelvic floor muscles (PFMs) and PFMEs. MethodsA cross-sectional survey was conducted. Respondents were pregnant women over the age of 18 years who attended antenatal clinics in Western Australia (WA). Questionnaire items measured awareness and knowledge about PFMs, confidence and beliefs about engaging in PFMEs, and attendance at antenatal education (ANE) classes. Chi-squared tests examined potential associations between questionnaire items and respondent characteristics. ResultsMean gestation of respondents (n = 633 out of 850; 74% response rate) was 28.7 (+7.8) weeks and 50% were giving birth for the first time. Although 76% of respondents knew that PFMs can prevent urinary incontinence, only 27% knew that they prevented faecal incontinence and 41% thought it was normal to leak urine when pregnant. Only n = 72 (11%) were practicing PFMEs. Respondents who had attended ANE (28%) were significantly more knowledgeable about pelvic floor function (p < .001) and significantly less likely to believe that leaking urine during pregnancy was normal (p = 0.02), compared with those who had not attended ANE. Respondents who did not speak English at home (18%) were significantly less knowledgeable about PFMs and PFMEs, and significantly less likely to have attended, or planned to attend, ANE classes. Conclusion Pregnant women require more health education regarding PFMs. Education should be provided using diverse modes, especially for women from migrant backgrounds and women who do not plan to attend formal ANE classes.