Implementation of a Digital Exercise Programme in Health Services to Prevent Falls in Older People

Overview

Journal Age Ageing

Publisher Oxford University Press

Specialty Geriatrics

Date 2024 Aug 8

PMID 39113467

Authors

Morag E Taylor

Meghan Ambrens

Helen Hawley-Hague

Christopher Todd

Jacqueline C T Close

Stephen R Lord

Lindy Clemson

Thomas Lung

David Berlowitz

Jannette Blennerhassett

Julia Dayhew

Ashley Gluchowski

Wendy Hodge

Pamela Johnson

Reena Lasrado

Marita Merlene

Lillian Miles

Sandra ORourke

Catherine M Said

Leanne White

Nicola Wilson

Avigdor Zask

Kim Delbaere

Affiliations

Soon will be listed here.

Abstract

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.

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