Date Presented 4/7/2016
Given the large need for a culturally relevant fall prevention program for medically underserved older adults, this study explores the necessary elements to successfully adapt an evidence-based fall prevention and home modification program using qualitative research design.
Primary Author and Speaker: Yi-Ling Hu
Contributing Authors: Kristina Vance, Susy Strak
PURPOSE: The purpose of this study is to explore the essential elements needed to adapt a fall prevention and home modification program to become culturally relevant for medically underserved older adults. Necessary elements will be determined by the population itself as well as community-based occupational therapists.
BACKGROUND: Despite the fact that medically underserved older adults are at a high risk for falls, this population is seldom the target of fall prevention research. As a result, current fall prevention programs do not contain geographic, social, economic, and politically relevant elements for this population. The lack of culturally adapted fall prevention programs further increases the disparity medically underserved older adults face and creates additional barriers for community-based occupational therapists seeking to implement evidence-based fall prevention programs.
DESIGN: This study is an exploratory qualitative study. Focus groups consisting of medically underserved older adults were conducted to identify necessary, culturally relevant elements to be included in a fall prevention and home modification program. Delphi technique was used to collect similar information from community-based occupational therapists who work with noninstitutionalized, medically underserved older adults.
PARTICIPANTS: Participants for the focus groups were included if they were ≥65 yr and resided in a medically underserved area. Community-based occupational therapists were included if they had worked in a community-based setting with older adults for ≥1 yr and held a current certification as an occupational therapist (OT) or certified occupational therapy assistant.
METHOD: Audio recordings from the focus groups were transcribed verbatim. Results from the first round of online surveys were coded for data analysis.
ANALYSIS: The data were analyzed using constant comparison to launch the themes of the perspectives of older adults and OTs.
RESULTS: Themes including trust, autonomy, and cost emerged from results of the focus groups. Older adults also suggested that health literacy, adapting images of older adults to be more representative of the population, and readiness for change were all important elements to include in the adapted fall prevention program. Similar themes including trust and readiness have been identified in the initial results of online survey from OTs.
DISCUSSION: The results of this study showed that the adapted version of the fall prevention and home modification program needs to contain elements related to trust, autonomy, cost, and health literacy in order to be culturally sensitive and relevant. Additionally, both medically underserved older adults and community-based OTs had similar views about the essential elements of a culturally relevant fall prevention program. Additional in-depth exploration of community OTs’ perspective on fall prevention program will be compiled after the completion of the Delphi process.
IMPACT STATEMENT: To successfully implement fall prevention programs, OTs must use material that is evidence based and culturally relevant. This study provides OTs with the essential elements needed to incorporate into a fall prevention and home modification program for medically underserved older adults.
