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Queensland Stay On Your Feet® Toolkit Phase 1

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Step 1A: Find out about falls and what is happening to prevent them

The first step in developing a falls prevention program/project is to investigate the extent of local falls and fall related injuries in older people and what is being done to address risk factors and other contributing issues. You will use this data to form a baseline for evaluating your project in Phase 4: Review.

Look at the contextThe health of individuals and the community is influenced by many factors including genetics, environmental, economic, and social factors and can also be influenced by politics at a local, state and national level [13]. To understand these influences and their interactions, review relevant international, national, state and local key strategy documents. These documents provide evidence-based policies, guidelines, strategies and plans that will help to direct and strengthen your work.

Gather and analyse falls dataYou will need to allow time at the beginning of the project/program to gather and analyse the data you need. Data collection is a valuable but time consuming process. To make this process more efficient, it may be worth forming a small data committee with a representative from each local organisation involved. Each organisation could then be responsible for collating a brief report from the data they collect about local falls and fall related injury. Try to standardise and compare the data as much as possible.

Falls injury data must be collected from a range of falls data sources to provide a full understanding. There is no single data source that will provide all the required information. National and state data will identify which population groups are at increased risk of falls and fall related injury. Local injury data can be found from a range of sources including ambulance attendances, emergency department presentations and hospital admissions. Local data can be compared with interstate and national data to determine how your community is faring in comparison, and the importance of the issue for your community. Collecting and sharing the data may also help to gain the support of key stakeholders.

To get you started, visit our facts on falls section.

Look at why falls occurFalls in older people are caused by a range of interacting risk factors including personal/intrinsic factors (eg. poor balance and loss of strength) and environmental/extrinsic factors (eg. clutter in the home or garden or uneven ground). Studies have shown that certain single risk factors are significantly associated with an increased risk of falls and falls injury (eg. balance). However, individuals with more than one risk factor will have an increased risk of falls compared to individuals with one risk factor [1].

To achieve a holistic view of the causes of falls, you should consider additional contributing factors such as age, gender, economic status, marital status and social, living and working conditions. These factors all influence health and disease, and are known as the social determinants of health. When considering contributing factors, you will need to determine what can and cannot be changed. The ecological model provides a framework for you to consider the social, environmental and behavioral factors when planning your project/program. Fear of falling may also be an issue.

Look at when falls occurFalls can occur at any time or in any place. However, most falls occur during normal activity in and around the home such as walking, changing clothes, showering, gardening and getting out of bed to go to the toilet [28]. Fewer falls occur as a result of hazardous activities. The time, day of week and month combined with the activity undertaken when a fall injury occurred can assist in the planning and targeting of strategies. Health professionals generally collect this information when a person is admitted to hospital or presents at an emergency department due to a fall. Access any available information through relevant falls data sources.

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What does the community think?Understanding your community's knowledge and attitudes towards falls and falls prevention will guide you in how to address the problem. Consultation with the community may raise concerns about other issues apart from falls. For example, in the Queensland Stay on Your Feet® Wide Bay/Burnett trial project, safety for seniors was identified as the key issue for one community. Consequently, this needed to be addressed before addressing falls.

In the next step, you will learn how to conduct a community stocktake.

Tools and templates

Ready for the next step?Go to Step 1B: Identify existing services and stakeholders 

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Last updated: 14 July 2022