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Stay On Your Feet® - Common terms

This section explains commonly used terms in injury prevention, safety promotion and falls prevention.  These terms are used throughout this website.

 collaborative  multi-strategic
 community  primary prevention
 fall  safety
 falls prevention  safety promotion
 health promotion  secondary prevention
 healthy active aging  systematic
 multi-factorial  tertiary prevention

What is a community?

A community can be defined in many ways, including the following:

  • a geographical area considered a unit, such as a country, city, town, suburb, region, local health and hospital network or local government area
  • a group of people bonded by common interests, goals or sense of identity eg. members of a bowling club, women's groups, such as the Country Women's Association, or men's groups
  • a collection of people characterised by membership, common values and culture, language, rituals, ceremonies, needs or shared history
  • a group of people experiencing the same need, regardless of geography 21.

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What is a fall?

A fall is an event that results in a person coming to rest inadvertently on the ground or floor or other lower level 29,31. This definition includes falls where the person inadvertently comes to rest in furniture, against a wall or other objects 29,31 but excludes falls resulting in an intentional change in position. To allow a consistent approach to falls prevention in Queensland and comparisons at a national and international level, it is important to use a standard definition for falls in all settings 29, 30.

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What is falls prevention?

Falls prevention is:

  • preventing and reducing the risk of tripping, slipping, stumbling and then falling, by identifying what causes falls (risk factors) and what can protect people from falling
  • identifying how to minimise the physical and psychological effects that results from falling.

The basis of falls prevention is ‘prevention is better than cure’. Preventing falls costs less in terms of both health care system costs and personal costs compared with the consequences, treatment and rehabilitation following a fall 16,37.

Falls prevention also includes falls injury prevention:

  • reducing the number of people injured from falling
  • preventing and reducing the seriousness of injuries that can result from falling
  • identifying the best way to help an injured person recover (sometimes known as rehabilitation)

Falls prevention, like injury prevention and chronic disease prevention can occur at three levels:

  • primary prevention - works to stop a fall from occurring in the first place, using multiple health promotion strategies such as education, skills development, behavioural change, and environmental and legislative changes.
  • secondary prevention - works to reduce the seriousness of an injury once a fall has occurred by designing and implementing protective mechanisms eg. hip protectors.
  • tertiary prevention - works to reduce disability immediately after an injury by providing adequate medical treatment and commencing an effective rehabilitation process.

The term ‘falls prevention’ is not recommended for use in materials for seniors.6 Research has shown that this term is:

  • unfamiliar and meaningless to many people 6
  • not easily understood by older people, who primarily associate it with changes in the environment 6
  • not associated with improving strength and balance, which is important for reducing falls.

For more information on the appropriate language to use when communicating about falls prevention, see key messages.

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What is safety?

“Safety is a state in which hazards and conditions leading to physical injury, psychological or material harm are controlled in order to preserve the health and wellbeing of individuals and the community. It is an essential resource for everyday life, needed by individuals and communities to realise their aspirations” 35. Safety is a dynamic state rather than just an absence of injuries and threats. Safety encompasses:

  • environmental safety
  • physical security
  • security of employment
  • security of revenues and resources
  • moral security
  • family security
  • security of health
  • security of personal property against crime
  • psychological security.

“Because health and safety are fundamental rights of human beings, safety is a prerequisite for the maintenance and improvement of the health and welfare of any population. It is a basic need of human beings” 35.

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What is health promotion?

Health promotion is defined by the World Health Organisation as the process of enabling people to increase control over and to improve their health. Health promotion represents a comprehensive social and political process, it not only embraces actions directed at strengthening the skills and capabilities of individuals, but also action directed towards changing social, environmental and economic conditions so as to alleviate their impact on public and individual health. Health promotion is the process of enabling people to increase control over the determinants of health and thereby improve their health. Participation is essential to sustain health promotion action. 222

Image of an open book World Health Organisation - Health Promotion Glossary (webpage)
Image of an open book World Health Organisation - 10 New Terms for Health Promotion (PDF)

What is safety promotion?

Safety promotion encourages an optimal level of safety by maintaining the conditions necessary to reach and sustain that level 35. Safety requires:

  • organised efforts by individuals, organisations, communities and nations 35
  • structural and behavioural changes to achieve continued safe and supportive environments 35.

Safety promotion is about achieving a positive culture of safety 24 hours a day, seven days a week. For preventing falls in older people, safety promotion means individuals, families, organisations, workplaces and governments all sharing the belief that falls are preventable and that it is worthwhile to invest time, money, energy and resources into preventing falls and promoting safety. The term ‘safety promotion’ is preferred to ‘injury prevention’ as it is more positive and readily understood and acted on by older people and stakeholders outside the health sector.

For more information on the appropriate language to use when communicating about falls prevention, see key messages.

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What is healthy active aging?

Healthy active ageing is a positive term used to talk about action taken by older people to prevent falls and improve their overall health. Healthy active ageing is defined as "the process of staying healthy and active for as long as possible by promoting health, participation and security, in order to enjoy independence and a good quality of life without discrimination." The term 'healthy active ageing' is used because:

  • the loss of muscle strength and balance from inactivity is a major cause of falls
  • the term is positive and helps to remove the stereotype of frailty and being a burden on society
  • encouraging and supporting older people to stay active every day (particularly in improving balance and strength) helps to focus attention on one of the major components of falls prevention
  • there are broader health benefits from being healthy and active including improved heart health, reduced risk of cancer, depression and a range of other chronic health conditions.

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Falls prevention approaches

Effective falls prevention requires a collaborative, systematic, multi-strategic (also known as multi-faceted), multi-factorial and evidence-based approach across the health continuum. This is reflected throughout the phases of the Queensland Stay On Your Feet® Community Good Practice model. More information is provided below.

Collaborative
Working with another person, group or an agency with which there is not an immediate connection in order to achieve an outcome 74. For example, this could involve local government, non-government-organisations, other businesses and health providers all working together to promote physical activity programs and better transport options for older people.
Systematic
Working in a methodical and organised manner according to a fixed plan or system 75.  For example, planned and managed falls prevention activities that work in line with the National Falls Prevention for Older People Plan: 2004 Onwards, state directions and any local business/organisation plans.
Multi-strategic
Achieving a long-term goal by employing political, economic, psychological, social and environmental actions in a carefully devised, elaborate and systematic plan 75.  For example, a multi-strategic falls prevention program may simultaneously include:
  • political strategies eg. advocating to ensure falls prevention is a priority issue for government
  • economic strategies eg. working with health insurance companies to secure rebates for Tai Chi classes
  • psychological strategies eg. addressing the fear of falling and reframing messages to focus on healthy active ageing
  • social strategies eg. organising group programs
  • environmental strategies eg. working with architects, builders and town planners to promote safe housing and community designs suitable for older people.
Multi-factorial
Interventions that address several falls risk factors at the same time are known as multi-factorial (eg. physical activity, balance, vision and environmental hazards). Multi-factorial strategies have been shown to be highly effective in reducing falls among community-dwelling older persons when they are based on the results of a risk factor assessment 31, 71, 76, 77, 78, 79.   Successful strategies include:
  • environmental risk assessment and modification
  • balance and gait training with appropriate use of assistive devices
  • medication review and modification
  • managing visual concerns
  • addressing orthostatic hypotension and other cardiovascular problems
  • physical activity (strength and balance), this has been shown to be a particularly important component of a multi-factorial intervention.

Currently, there is no conclusive evidence from randomised controlled trials that multi-factorial interventions can reduce falls in older people with cognitive impairment. There have been very few studies that have looked at this important sub-group 78.

Evidence based Evidence based strategies are available in the Queensland Stay On Your Feet® Community Good Practice Guidelines and the National Guidelines for communities, hospitals and residential aged care facilities .

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Last updated: 3 October 2012

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