Abstract

Fall-related injury amongst older Aboriginal people is a growing health issue yet our recent audit of services identified few Aboriginal-specific fall prevention programs. Informed by stakeholder interviews and Yarning Circles with over 70 older Aboriginal people, a fall prevention program was developed in partnership with Aboriginal community groups. The aim of this study was to evaluate a culturally appropriate fall prevention program for older Aboriginal people. The Ironbark Program is an on-going, weekly, group-based, strength and balance exercise class with an education component held within Yarning Circles. The program was delivered in 6 communities in NSW over a 6 month period from June 2015. A mixed methods approach was used for evaluation; measures of strength and balance were collected to measure changes in physical outcomes, and participants completed questionnaires and interviews to assess program acceptability. Ninety-eight participants (mean age=64, 71% women) registered for the program; 77 (85%) completed baseline and follow-up measurements. Positive ongoing feedback was received, and attendance was good. On average across all sites, there was significant improvement in participant leg strength (time to complete 5 repetition sit-to-stand: 14 s to 11 s, p<0.01), balance (timed single-leg stance: 5.6 s to 7.8 s, p<0.01) and gait speed (timed 4 meter walk: 0.51 m/s to 0.94 m/s, p<0.01), and a significant decrease in BMI (p<0.01). Participants reported both the exercise and yarning components of the program were enjoyable and valuable. The Ironbark program was effective in improving fall-related measures; funding has now been received for a large scale cluster randomized trial to test its effectiveness in preventing falls. Collaboration between Aboriginal community leaders, Aboriginal health and community service providers facilitated development of a unique, culturally appropriate program that addressed a variety of health, social and cultural needs, translating knowledge into action for positive change.