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. 2021 Oct:32 Suppl 2:391-398.
doi: 10.1002/hpja.413. Epub 2020 Sep 30.

Scale-up of the Stepping On fall prevention program amongst older adults in NSW: Program reach and fall-related health service use

Serene S Paul  1 , Qiang Li  2 , Lara Harvey  3   4 , Therese Carroll  5 , Annabel Priddis  5 , Anne Tiedemann  6 , Lindy Clemson  7 , Stephen R Lord  3 , Jacqueline C T Close  3   8 , Cathie Sherrington  6
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Scale-up of the Stepping On fall prevention program amongst older adults in NSW: Program reach and fall-related health service use

Serene S Paul et al. Health Promot J Austr. 2021 Oct.

Abstract

Issue addressed: We describe the reach of the scale-up of Stepping On, a fall prevention program targeting community-dwellers aged ≥65 years in NSW, along with fall-related ambulance service use and fall-related hospitalisations after scale-up.

Methods: Data on program provision were received from Local Health Districts. Routinely collected fall-related ambulance usage and hospital admissions in NSW residents aged ≥65 years between 2009 and 2015 were compared within Statistical Local Areas prior to and following the implementation of Stepping On using multilevel models.

Results: Between 2009 and 2014 the program was delivered in 1077 sites to 10 096 older adults. Rates of fall-related ambulance use and hospital admissions per 100-person-years were 1-2 in people aged 66-74, 4-5 in people aged 75-84 and 12-13 in people aged ≥85. These rates increased over time (P < .001). The interaction between time and program delivery was not significant for fall-related ambulance use or hospital admissions. The time-related increase in fall-related ambulance usage in people aged 75-84 years may have been moderated by the Stepping On program (rate ratio 0.97, 95% CI 0.93-1.00, P = .045).

Conclusions: There was no indication of a reduced rate of fall-related ambulance use or hospital admissions across the entire sample. Ambulance call-outs for falls in people aged 75-84 years may have reduced following program participation. SO WHAT?: Program scale-ups need to reach a large proportion of the target population with a focus on those groups contributing most to fall-related health service utilisation. Linking individual participants' health data as part of large-scale evaluations may provide better insights into program outcomes.

Keywords: community-based intervention; injury; older people; program evaluation.

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References

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