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Taking prevention forward: a directory of examples
- Authors:
- LEWIS Helen, MILNE Alisoun
- Publisher:
- Anchor Research
- Publication year:
- 1999
- Place of publication:
- Oxford
This directory is the final part of the work commissioned from the Nuffield Institute of Health, University of Leeds for the National Preventative Task Group. Its aim is to provide some more concrete examples of preventative approaches and services currently in operation around the country. While most of the examples relate to older people, who were the focus of the original work, thre are also examples relating to other adults, in line with the national policy of 'promoting independence'. (need to refer to others in this series)
Who knows best? Older people's contribution to understanding and preventing avoidable hospital admissions
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2016
- Pagination:
- 18 mins 50 secs
- Place of publication:
- London
This video summarises the key findings of a research project conducted by the University of Birmingham’s Health Services Management Centre and the Department of Social Policy and Social Work which interviewed 104 older people about their emergency admissions to hospital. The research looked at how the older people were admitted to hospital, whether they felt this was the best place for them and what alternatives might have been explored. Similar questions were also asked of a GP and / or hospital doctor representing as many of these older people as possible. Overall, the study found that most older people were admitted to hospital appropriately. Only nine of 104 older people (almost 9%) felt that hospital was not the right place for them. Key findings covered in the video include: delays in seeking help; prevention and early intervention; poor communication; proactive initial approaches; working with GPs and paramedics; and the underfunding of social care. (Edited publisher abstract)
New horizons in falls prevention and management for older adults: a global initiative
- Author:
- MONTERO-ODASSO Manuel
- Journal article citation:
- Age and Ageing, 50(5), 2021, pp.1499-1507.
- Publisher:
- Oxford University Press
Background: falls and fall-related injuries are common in older adults, have negative effects both on quality of life and functional independence and are associated with increased morbidity, mortality and health care costs. Current clinical approaches and advice from falls guidelines vary substantially between countries and settings, warranting a standardised approach. At the first World Congress on Falls and Postural Instability in Kuala Lumpur, Malaysia, in December 2019, a worldwide task force of experts in falls in older adults, committed to achieving a global consensus on updating clinical practice guidelines for falls prevention and management by incorporating current and emerging evidence in falls research. Moreover, the importance of taking a person-centred approach and including perspectives from patients, caregivers and other stakeholders was recognised as important components of this endeavour. Finally, the need to specifically include recent developments in e-health was acknowledged, as well as the importance of addressing differences between settings and including developing countries. Methods: a steering committee was assembled and 10 working Groups were created to provide preliminary evidence-based recommendations. A cross-cutting theme on patient’s perspective was also created. In addition, a worldwide multidisciplinary group of experts and stakeholders, to review the proposed recommendations and to participate in a Delphi process to achieve consensus for the final recommendations, was brought together. Conclusion: in this New Horizons article, the global challenges in falls prevention are depicted, the goals of the worldwide task force are summarised and the conceptual framework for development of a global falls prevention and management guideline is presented. (Edited publisher abstract)
Barriers to preventive care utilization among Hong Kong community-dwelling older people and their views on using financial incentives to improve preventive care utilization
- Authors:
- LIAO Qiuyan, et al
- Journal article citation:
- Health Expectations, 24(4), 2021, pp.1242-1253. Online only
- Publisher:
- Wiley
Background: Financial incentive is increasingly used as a mean to promote preventive care utilization (PCU), but the current Elderly Health Care Voucher Scheme (EHCVS) in Hong Kong is ineffective for encouraging PCU. Objective: To explore the older people's barriers to PCU and their views on financial incentive, including EHCVS, for improving private PCU. Design and setting: Focus-group discussions were conducted in community elderly centres located in five districts of Hong Kong. Participants: Community-dwelling older people aged 60 years or above. Results: Lack of understanding about preventive care and low awareness of the need for preventive care were key factors for the low motivation for PCU. Uncertainty over the level of service fee charged and concerns over service quality hindered the choice of using the private service providers under the current EHCVS. Financial incentives specific for preventive care services were thought to be cues to actions and guides for service promotion. However, some flexibility in service coverage and a set time limit of the financial incentives were preferred to accommodate individual needs. Conclusions: Apart from promoting knowledge of preventive care, official monitoring for service fee and quality is important for empowering older people to choose private service providers for preventive care. Financial incentives for preventive care services should be more specific to cue service promotion and uptake of preventive care while maintaining flexibility to accommodate individual needs. Patient or public contribution: Participants were recruited using purposive sampling with the coordination of community elderly centres. Data were analysed using thematic coding. (Edited publisher abstract)
Determinants of fall prevention guideline implementation in the home- and community-based service setting
- Authors:
- JUCKETT Lisa A., et al
- Journal article citation:
- Gerontologist, 61(6), 2021, pp.942-953.
- Publisher:
- Oxford University Press
Background and Objectives: Home- and community-based service (HCBS) recipients often possess multiple fall risk factors, suggesting that the implementation of evidence-based fall prevention guidelines may be appropriate for the HCBS setting. The purpose of this exploratory study was to examine the determinants of fall prevention guideline implementation and the potential strategies that can support implementation in HCBS organizations. Research Design and Methods: Semistructured interview and focus group data were collected from 26 HCBS professionals representing the home-delivered meals, personal care, and wellness programs. Qualitative codes were mapped to the Consolidated Framework for Implementation Research by means of directed content analysis. The Consolidated Criteria for Reporting Qualitative research checklist was used to report the findings of this study. Results: We identified 7 major determinants of guideline implementation: recipient needs and resources, cosmopolitanism, external policy and incentives, networks and communication, compatibility, available resources, and knowledge/beliefs. Strategies to support guideline implementation included the involvement of recipient and caregiver feedback, building fall prevention networks, and conducting educational meetings for HCBS staff. Discussion and Implications: Falls and fall-related injuries will continue to plague the older adult community unless innovative approaches to fall prevention are developed and adopted. The implementation of fall prevention guidelines in the HCBS setting can help mitigate fall risk among a highly vulnerable older adult population and may be facilitated through the application of multifaceted implementation strategies. (Edited publisher abstract)
Interventions promoting physical activity among older adults: a systematic review and meta-analysis
- Authors:
- GRANDE Guilherme D., et al
- Journal article citation:
- Gerontologist, 60(8), 2020, pp.e583-e599.
- Publisher:
- Oxford University Press
Background and Objectives: Frequent participation in physical activity (PA) has benefits across the lifespan but is particularly important for older adults. PA levels are either measured by objective or self-reported survey methods. Objective PA measurement is used to increase accuracy. This systematic review investigated the effect of physical activity-based interventions on objectively measured PA levels among community-dwelling adults aged 60 years and older. Research Design and Methods: Literature searches were conducted in five electronic databases and four clinical trial registries. Randomized controlled trials investigating the effect of physical activity–based interventions on objectively measured PA levels (e.g., accelerometers or pedometers) in community-dwelling adults aged 60 years and older compared with no/minimal intervention were considered eligible. Data were pooled using the most conservative estimates reported from each study using the standardized mean difference (SMD). Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the overall quality of the evidence. Results: Fourteen published trials and 3 ongoing trials were identified. There were significant effects favoring physical activity–based interventions compared with minimal intervention at short-term (less than or equal to 3 months) (SMD: 0.30, 95% CI: 0.17 to 0.43) and intermediate-term (more than 3 months and less than 12 months; SMD: 0.27, 95% CI: 0.06 to 0.49) follow-ups. The quality of evidence was moderate according to GRADE (downgraded for risk of bias). Discussion and Implications: Our findings suggest that physical activity–based interventions may increase objectively measured PA levels in community-dwelling older adults. Further studies are still needed to identify the optimal dose, intensity, and mode of delivery of physical activity–based interventions. (Edited publisher abstract)
Wellbeing for life: reducing the risk of falls
- Author:
- MACINTYRE
- Publisher:
- MacIntyre
- Publication year:
- 2018
- Pagination:
- 20
- Place of publication:
- Milton Keynes
Using bullet points, this short publication provides information on reducing the risk of falls in people with learning disabilities. It covers the areas of: the impact of falls, how to reduce the risk of falls, how dementia can affect a person's perception, supporting people after a fall, and accessing Falls Prevention Clinics. It reports there is good evidence that falls are more common in people with learning disabilities throughout their lives, not only as they age. It is part of the Wellbeing for Life toolkit created for the MacIntyre Dementia project in order to promote understanding about getting older with a learning disability and living well with dementia. (Edited publisher abstract)
Who knows best? Top tips for managing the crisis: older people's emergency admissions to hospital
- Authors:
- GLASBY Jon, et al
- Publisher:
- University of Birmingham. School of Social Policy
- Publication year:
- 2016
- Pagination:
- 12
- Place of publication:
- Birmingham
This resource identifies ten key themes, or ‘top tips’, which could help health and social care services to reduce inappropriate hospital admissions. It has been developed from a national research project which involved interviews and focus groups with older people and their families, and front-line health and social care professionals. It is argued that these ‘perceptions’ from older people and front-line staff are important as they can have a significant impact on how people live their life and access services. The themes cover: not making older people feel they are a burden; making community alternatives to hospital easier to access; to distinguish between ‘inappropriate’ and ‘preventable’ admissions; the need for early action; the importance role of adult social care; and the importance of engaging with older people to understand and respond to the increasing number of emergency admissions. Quotations from older people, their families and professionals are included throughout to illustrate key points. (Edited publisher abstract)
Falls in older people with sight loss: a review of emerging research and key action points
- Author:
- THOMAS POCKLINGTON TRUST
- Publisher:
- Thomas Pocklington Trust
- Publication year:
- 2013
- Pagination:
- 20
- Place of publication:
- London
Draws on recent research to summarise what is known about falls and falls prevention amongst older people with sight loss. It explores the implications of research findings for action to address and reduce the risk of falls among older people with sight loss and suggests key issues for health and social care professionals to consider when working with older people, many of whom may have sight loss, and for sight loss specialists to consider when addressing individuals’ risks of falls. (Publisher abstract)
A systematic review of education for the prevention of HIV/AIDS among older adults
- Authors:
- MILASZEWSKI Dorota, et al
- Journal article citation:
- Journal of Evidence-Based Social Work, 9(3), June 2012, pp.213-230.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This literature review examined articles focused on primary prevention of HIV/AIDS for adults aged 50 and over. A total of twenty one English language articles were included. Three major challenges were identified in providing HIV/AIDS education for older adults include health professionals' ageism, older adults' reluctance to discuss sexuality, and their misconception of their HIV risk. Clinical guidelines for social workers, nurses, and physicians identified the importance of sharing information and assessing risk, considering cultural diversity, and devising creative delivery strategies. Three models of HIV/AIDS education include group education programmes delivered by social workers or other health professionals, peer education models, and one-on-one early intervention models including HIV/AIDS testing. The authors concluded that additional outreach and research on HIV/AIDS prevention among older adults is required.