Background First Nations community prioritised and led programs are known to be most effective in driving better health and wellbeing for First Nations people. In Australia, despite a rising burden of falls there are few community-led programs addressing the needs of older Aboriginal people. The Ironbark Program is an Aboriginal co-designed fall prevention program.

Objective To test program impact on strength and balance, and a range of secondary outcomes including functional mobility, falls, and activities of daily living.

Methods The Ironbark program involves weekly sessions for Aboriginal people aged 45 years and older. It includes a physical activity program, including exercises that target improved strength and balance, and a yarning circle addressing falls risk factors. The study was a controlled pre-post design, with 21 sites engaged in 2020–2023. Sites elected to receive the Ironbark program or The Healthy Community Program (HCP, a social ‘control’ group). Data were collected by Aboriginal research staff at baseline and at 12-months, including measures of health-related quality of life, psychological distress, activities of daily living, functional mobility and falls. Weekly data collection included measures of health care utilisation and falls. A parallel process evaluation was conducted. An Aboriginal steering committee provided cultural governance and the study has strong capacity building elements. Data analysis and reporting involved an iterative community-engaged process with input from researchers, steering committee, staff and participants.

Results Twenty-one sites engaged in the study, of which 8 were in Western Australia and 13 in NSW. Eighteen sites delivered the Ironbark program and 3 delivered the HCP. Final data collection occurred in November 2023. Interviews with participants, program staff and stakeholders showed high acceptability and strong cultural safety. Data analysis is proceeding. This presentation will report on program implementation and changes in primary and secondary outcomes adjusted for a range of factors including site size, location, age and gender of participants.

Conclusion Community engagement and leadership by Aboriginal communities are critical to the design, implementation and scale-up of programs addressing Aboriginal health priorities. The results of this trial will be relevant to First Nations people globally, highlighting the importance of consumer led prevention programs.