Date of Award

2016

Degree Name

Doctor of Philosophy (School of Physiotherapy)

Schools and Centres

Physiotherapy

First Supervisor

Associate Professor Anne-Marie Hill

Second Supervisor

Professor Keith Hill

Third Supervisor

Adjunct Professor Richard Berlach

Abstract

Older adults are not optimally engaged in falls prevention strategies. Peer education may be an approach to improving engagement and uptake of falls prevention strategies by community-dwelling older adults. However, empirical research regarding this approach has been inconclusive. Accordingly, the primary aim of this research was to design a peer-led falls prevention education program and evaluate its impact on community-dwelling older adults’ beliefs, knowledge, motivation, and intention to engage in falls prevention strategies. This research was a mixed methods study conducted in two phases. Phase 1 comprised three concurrent studies. These aimed to elucidate the issues regarding falls prevention education and information from key stakeholders and to inform the research in Phase 2. The aims of Phase 1 were, first; to seek key stakeholders’ perspectives in order to gain a better understanding of the role of peer educators in falls prevention, second; to garner views about community-dwelling older adults’ preferences for seeking and receiving falls prevention information, and third; to seek expert evaluation and opinion about the peer educators’ presentations of falls prevention education for community-dwelling older adults.

Feedback from peer educators and expert reviewers indicated that peer education was a feasible and potentially effective approach to deliver education about falls prevention, but that the education should be presented in a personalised manner and incorporate adult learning principles and behaviour change theory. Older adults also suggested that practical strategies and information should be presented in a positive and respectful manner. Their prior experience of falling was found to be an important mediator to receptivity to falls prevention messages. Based on the findings of Phase 1, Phase 2 involved the design, development, implementation and evaluation of a new contemporary peer-led falls prevention education program. A longitudinal quasi-experimental trial (n=232) was conducted to compare the effectiveness of the presentation with the existing program, using a purpose-developed questionnaire. Peer-led falls prevention education significantly increased older adults’ beliefs that falls prevention measures would be useful, their knowledge about falls prevention strategies and intention to take measures to reduce their risk of falling. Older adults who received the contemporary program were significantly more likely to develop a clear action plan to engage in specific measures to reduce their risk of falling compared to the control group. Future research should investigate how well designed peer education programs contribute to improving older adults’ engagement in falls prevention.

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