RESUMO
Background: Evidence-based falls prevention programs are available in many communities, but participation in such programs remains low. This study aimed to develop community-based referral networks of organizations to facilitate the uptake of evidence-based falls prevention programs through engaging older adults at risk for falls with the RememberingWhen™ program and connecting them to evidence-based programs in Midwestern communities. Methods: Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), referral networks were developed in two Midwestern communities (urban and micropolitan) through a seven-step community engagement plan: establishing and operationalizing the State-level Advisory Board (SAB), identifying falls prevention resources, conducting community assessments, developing Local Advisory Groups (LAG), operationalizing the LAG, developing referral network and protocols, and implementing the network. Semistructured interviews guided by the RE-AIM framework were conducted with members of the SAB, LAG, administrators and staff from organizations that participated in networks, and older adult participants. Results: After participating in the development of referral networks, participants felt they learned important skills that they can use to develop additional collaborations and networks in the future, emphasized the benefits of building community capacity among organizations with common missions. Interview data yielded strategies on enhancing the referral network's reach, impact, adoption, implementation efficiency, and maintenance. Conclusion: Future sustainability studies of such networks should explore identified challenges and strategies to sustain efforts. Results highlight the importance of ongoing funds to support the efforts of organizational networks in communities.
RESUMO
Remembering When™ (RW) is a falls and fire prevention program delivered by fire service personnel and homecare organizations to help older adults live safely at home for as long as possible. This study evaluated changes in falls prevention and fire safety behaviors and perceptions and social support associated with falls and residential fires among older adults following delivery of the RW program by fire service personnel. In a convenience sample of adults 65 + years residing in five Iowa communities, 70 received the RW program during a home visit and 75 received the RW program in a group presentation followed by a home visit. Baseline and follow-up telephone interviews were conducted to assess changes in falls and fire safety behaviors, perceptions and social support. Changes were assessed using McNemar's exact test and paired sample t-tests. To control for dependence of 26 households with two participants, one participant was randomly selected and included in the analysis (n = 119). The RW program improved falls and residential fire prevention behaviors among older adults. Perceived efficacy to prevent falls increased from baseline (p = 0.047). Perceived susceptibility (p = 0.021) and control of fires (p = 0.000) increased while perceived severity (p = 0.025) and fear of residential fires (p = 0.019) decreased when compared to baseline. The proportion of participants reporting discussing falls with friends and family increased (p < 0.001), and more participants reported discussing fire prevention with healthcare professionals (p = 0.039). Fire service personnel can be effective deliverers of falls prevention information to older adults.