L ocal Aboriginal Community MaryAnne De Navi Prince of Wales Community Health Sydney NSW The Prince of Wales Hospital amp Community Health Services Falls Prevention Education with Aboriginal People ID: 685059
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Slide1
Adapting Falls Prevention Education for the Local Aboriginal CommunityMary-Anne De NaviPrince of Wales Community Health, Sydney, NSW
The Prince of Wales Hospital
& Community Health ServicesSlide2
Falls Prevention Education with Aboriginal People
J James, M-A De Navi, C Moran, M Griffith
Prince of Wales Community Health, Sydney, NSW
Contact
Prince of Wales Community Health
Prince of Wales Hospital
Barker Street NSW 2031Telephone 02 9382 8838Jayne.james@healh.nsw.gov.auReferences
Martiniuk A, et al, Effective and Inclusive Intervention Research with Aboriginal populations: an Evidence Check Rapid Review Brokered by the Sax Institute (http://www.saxinstitute.org.au) for NSW Health, 2010.Clinical Excellence Commission Falls Prevention
Kraft PA, Rise J, Sutton S, Røysamb E, Perceived Difficulty in the Theory of Planned Behaviour: Perceived Behavioural Control or Affective Attitude? British Journal of Social Psychology (2005), 44, 479–496Bessarad
D, Yarning a Culturally Safe Method of Indigenous Conversation, Aboriginal Health Education Research Unit, Curtin University of Technology, 2012Yardley L et al, Attitudes and Beliefs That Predict Older Peoples Intention to Undertake Strength and Balance Training, (2007) 62 Journal of Gerontology
p119-p125Staying Active and on Your Feet, NSW Ministry of Health, 2014Steptoe A, Deaton, Stone A, Subjective Wellbeing, Health, and Ageing, Lancet 2015; 385: 640–48
Lukaszyk C et al, Risk Factors, Incidence, Consequences and Prevention Strategies for Falls and Fall-Injury within Older Indigenous Populations: a Systematic Review, Aust NZ J Public Health. 2016; Online;
doi: 10.1111/1753-6405.12585Published November 2016
Acknowledgements
La Perouse Community EldersPOWCH Falls Prevention Working Party
Falls are a major cause of harm to older people.
2
One in three Aboriginal people over the age of 45 will have a fall.
8
Yarning
is an informal conversation that is culturally friendly and recognised by Aboriginal people as
a means
to talk about something, someone or provide and receive information.
4
In Australia, no
other single cause of injury
, including
road trauma
, costs
the health system more than falls.
2
N = 8
The participants told us they would like a weekly exercise class focusing on strength and balance.
This has been implemented and has a good attendance.
These methods
led clients to associate coping appraisal of health related outcomes to lifestyle change.
Background
It is recognised that prevention strategies need to be culturally appropriate for Aboriginal people who may have differing views and priorities of health, community and family.
1
NSW Health 2016 April Falls Day was
used
to launch Prince of Wales Community Health (POWCH) falls awareness month to share information and education with local communities. Education was provided using a variety of validated tools and resources.
A gap was identified in falls prevention education for
the
local Aboriginal community, as a result resources used for April Falls Education were adapted and implemented.
Goals
To take Falls Prevention Education to the local Aboriginal
community
during April Falls
month.
For individuals to identify and take ownership of their own
wellbeing
and to make one change to prevent harm from a
fall.
Planning
Executive sponsorship from Director of Community
Health.
Governance guided by National Quality Health & Safety Standard
10.
Consultation with POWCH Falls Prevention Working
Party.
Implementation as part of NSW
Health
gazetted
2016 April
Falls
month.
Consultation with Aboriginal Health Workers.
Consultation with the local Aboriginal community via Aboriginal Health Workers.
Permission was sought
from elders to have a yarning group.
Search for culturally appropriate falls education resources for the local health district.
Adaptation of existing resources
.
Method
In partnership with Aboriginal Health Workers education resources were adapted to be culturally appropriate.
Aboriginal Elders were invited to attend the yarning circle.
A yarning circle was used for discussion of information, storytelling and learning from each other about
experiences
of risk and self management strategies.
Facilitators set the scene by describing back ground information and three significant facts about falls that demonstrate the extent of the risk of harm from falls (
threat appraisal
).
The theory of coping appraisal was then applied to form the basis of how the
education
was targeted to this particular cohort.
3
Resources
included
the NSW Clinical Excellence Commission (CEC) Staying Active and on Your Feet
booklet.
6
“I will use my stick all the time”
“”I will join an exercise class”
“I will teach my grandkids to pick up their toys in my house”
Coping appraisal
focuses on the many positive benefits of making a change.
There is a greater effect if the multiple benefits of lifestyle change are emphasised, as opposed to messages that instil fear of a negative outcome
.
5
Prompts were used to guide the Yarning. This
included a locally developed tool the ‘Five Falls Factors
’ that contains multifactorial elements of evidence based falls prevention; and a
personal affirmation record to write one intended change to help prevent them from falling
.
N=8
Results
Conclusion
The chosen method maximised the benefit of
eudaimonic
wellbeing for the participants, who expressed attitudes and intentions to make a behavioural change related to falls prevention.
The results of the personal action plan show only conveyed intentions to change. A follow up study would be informative
.
Sustaining the change
Further Yarning Groups focusing on
“How can
I walk safely on my
own?”
are planned.
Further develop the exercise program
with
the
‘Older People Respite Group’.
Work with our local ‘Step U
p
and B
eat
the
Odds
’
group.
Further engagement with the community and follow up throughout April Falls 2017
.
Eudaimonic
Wellbeing
– a sense of autonomy, sense of control, and purpose in life which results in life enhancement.
7
The Prince of Wales Hospital
& Community Health ServicesSlide3
BackgroundIt is recognised that prevention strategies need to be culturally appropriate for Aboriginal people who may have differing views and priorities of health, community and family.1 NSW Health 2016 April Falls Day was used to launch Prince of Wales Community Health (POWCH) falls awareness month to share information and education with local communities. Education was provided using a variety of validated tools and resources. A gap was identified in falls prevention education for the local Aboriginal community, as a result resources used for April Falls Education were adapted and implemented. GoalsTo take Falls Prevention Education to the local Aboriginal community during April Falls month.For individuals to identify and take ownership of their own wellbeing and to make one change to prevent harm from a fall.Slide4
Planning Executive sponsorship from Director of Community Health.Governance guided by National Quality Health & Safety Standard 10. Consultation with POWCH Falls Prevention Working Party. Implementation as part of NSW Health gazetted 2016 April Falls month.Consultation with Aboriginal Health Workers.Consultation with the local Aboriginal community via Aboriginal Health Workers. Permission was sought from elders to have a yarning group.Search for culturally appropriate falls education resources for the local health district. Adaptation of existing resources.Slide5
In partnership with Aboriginal Health Workers education resources were adapted to be culturally appropriate.Aboriginal Elders were invited to attend the yarning circle.A yarning circle was used for discussion of information, storytelling and learning from each other about experiences of risk and self management strategies.Yarning is an informal conversation that is culturally friendly and recognised by Aboriginal people as a means to talk about something, someone or provide and receive information.4 METHODSlide6
Facilitators set the scene by describing back ground information and three significant facts about falls that demonstrate the extent of the risk of harm from falls (threat appraisal).Falls are a major cause of harm to older people.2In Australia, no other single cause of injury, including road trauma, costs the health system more than falls.2One in three Aboriginal people over the age of 45 will have a fall.
8Slide7
Coping appraisal focuses on the many positive benefits of making a change.There is a greater effect if the multiple benefits of lifestyle change are emphasised, as opposed to messages that instil fear of a negative outcome.5The theory of coping appraisal was then applied to form the basis of how the education was targeted to this particular cohort.3Slide8
Prompts were used to guide the Yarning. This included a locally developed tool the ‘Five Falls Factors’ that contains multifactorial elements of evidence based falls prevention; and a personal affirmation record to write one intended change to help prevent them from falling. “I will teach my grandkids to pick up their toys in my house”Resources included the NSW Clinical Excellence Commission (CEC) Staying Active and on Your Feet booklet.6
RESOURCESSlide9
FALLSMEDICATIONSCOMPREHENSIONMEDICALPHYSICAL
Fear of Falling
Falls History
Near Miss
Inactivity
Mobility and transfersFeet & Footwear Clothing
VisionEnvironment
Acute infection Depression
Dizziness Neurological disorders Arthritis -lower limb
Cognitive Decline
Disorientation Impaired judgement Impulsiveness
Disability
Sleeping agent Anxiety agent
Antipsychotic Antidepressant
4 or more regular medications
ContinenceNocturia
Frequency,Urgency
Can your client walk safely on their own?
Five F
alls Factors
Prince of Wales Community Health Falls Prevention Working Party 2017Slide10
Five Falls Factor Tool modified for Aboriginal Falls EducationSlide11
I will teach my grandkids to pick up their toys in my house”Slide12
The chosen methods led clients to associate coping appraisal of health related outcomes to lifestyle change. Eudaimonic Wellbeing – a sense of autonomy, sense of control, and purpose in life which results in life enhancement.7ConclusionThe chosen method maximised the benefit of eudaimonic wellbeing for the participants, who expressed attitudes and intentions to make a behavioural change related to falls prevention.
The results of the personal action plan show only conveyed intentions to change. A follow up study would be informative
.
The participants told us they would like a weekly exercise class focusing on strength and balance.
This has been implemented and has a good attendance.