5 | Supporting fall prevention strategies

Developing effective fall prevention programs requires an understanding of the incidence and nature of falls among seniors and of the factors associated with falls.¹⁴⁶ Also key to effective programming is community support to maximize program acceptance and sustainability. Programs often build on elements already in place in the community and rely on networks that extend beyond their communities, such as advocates and stakeholders from provincial and national organizations and universities. Programs are most successful when agencies integrate fall prevention projects into their broader organizational structure and goals, so that fall prevention initiatives can, in turn, support the broader missions of the organizations.

The Health Canada/Veterans Affairs Canada Falls Prevention Initiative commissioned a report to examine the factors that contribute to successful fall prevention programs. The study found that programs that build on existing support can create a climate conducive to the success of a fall prevention initiative and that the impetus and support for fall prevention programming can come from a range of sources. The common element that supports an initiative is the development of a shared understanding that falls are a significant health risk and that doing something about injurious falls is possible.¹⁴⁷

Selecting the appropriate prevention strategies is best done through a collaborative process that reflects the risk profiles of individuals and the unique characteristics of their living situation. Different approaches are needed for vigorous seniors as well as for frail seniors and for those living in the community as well as for those in institutions. Specialized approaches may be required when dealing with specific populations. Recognizing client diversity, such as First Nations groups or ethnocultural groups, is important, as these may benefit from specialized approaches to planning for fall prevention. The success of any strategy is dependent on the effective leadership and active involvement of key stakeholders who have the ability to build on the existing strengths and capacities within each setting.

The Health Canada/Veterans Affairs Canada Falls Prevention Initiative funded a number of fall prevention projects and found that the projects that were sustained at the end of the Initiative were those with strong community partnerships, strong leadership, and additional financial support.¹⁴⁸

Sustainability was most likely if fall prevention projects:

• addressed sustainability in the initial planning stages of projects;
• had key champions to show leadership;
• involved a wide range of stakeholders, including local officials, service groups, universities, provincial and national organizations, and particularly seniors;
• focused on specific project components rather than entire programs (e.g., resources, partnerships and volunteer networks);
• supported outcomes such as increased community interest and awareness;
• had communities with previous capacity for and experience in delivering fall prevention initiatives;
• secured funding for a project coordinator;
• had 'train the trainer' initiatives;
• secured funding from multiple partners; and
• integrated falls projects into the broader goals of the organization.

Projects identified challenges for sustainability as follows:

• developing collaborative relationships across jurisdictions;
• identifying sources of sustainable funding;
• defining the most critical components of a multi-component program;
• identifying optimal recruitment strategies to attract and retain at-risk seniors;
• adapting programs to address diversity;
• maintaining volunteers and advisory group members; and
• preparing systematic evaluation plans.

Summary

Strategies for fall prevention should reflect current literature, with consideration for its practical application and the local resources. Programs to prevent falls and injuries tend to focus on raising awareness, changing behaviours to reduce risk factors, and environmental and policy changes. For these programs to be successful over the long term, it is key to understand that sustainability is an ongoing, active process requiring periodic adaptation to conditions and circumstances.¹⁴⁹

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