https://doi.org/10.1177/0733464819874600
Journal of Applied Gerontology
1–10
© The Author(s) 2019
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DOI: 10.1177/0733464819874600
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Original Manuscript
Falls in community-dwelling older adults represent a major
public health concern. According to Statistics Canada, falls
account for 85% of hospitalizations due to injuries, with
financial costs estimated at CAD $2 billion annually (Public
Health Agency of Canada, 2014). The number of fall-related
hospitalizations among community-dwelling older adults is
over five times the number for older adults in residential
care (Public Health Agency of Canada, 2014), and the aver-
age length of time older adults spent in hospitals because of
falls was 10 days more than any other cause of admission
(Public Health Agency of Canada, 2014). These statistics
highlight the increased strain on the health care system that
could potentially be addressed by effective fall prevention
programs. In addition to the monetary costs, falls have unfa-
vorable physical and mental health consequences for older
adults, including fear of falling, reduced mobility and func-
tion, increased dependence, and depression (Li, Fisher,
Harmer, Mcauley, & Wilson, 2003; Ruthig, Chipperfield,
Newall, Perry, & Hall, 2007; Terroso, Rosa, Marques, &
Simoes, 2013). Considering the population is aging (Public
Health Agency of Canada, 2014), addressing falls and fall-
related issues in older adults through effective programs is
imperative.
The World Health Organization’s (WHO) “Active
Ageing” framework outlines a fall prevention strategy for
older adults. The framework posits that various determi-
nants such as access to health services, physical environ-
ment, and personal, social and economic factors influence
older adult’s health and quality of life (WHO, 2008).
Viewing older adults as a heterogeneous population with
varying range of function, the framework suggests public
health policy measures such as age-friendly communities
and health promotion initiatives to enhance participation
(WHO, 2008). Community fall prevention programs are
such initiatives that can promote healthy lifestyles to limit
decline in older adults’ functional capacity. These programs
874600JAG XX X 10.1177/0733464819874600Journal of Applied GerontologyMalik et al.
research-article 2019
Manuscript received: February 14, 2019; final revision received:
June 24, 2019; accepted: August 6, 2019.
1
McMaster University, Hamilton, Ontario, Canada
2
University of Saskatchewan, Saskatoon, Canada
Corresponding Author:
Vanina Dal Bello-Haas, Associate Professor and Assistant Dean
(Physiotherapy), School of Rehabilitation Science, McMaster University,
1400 Main Street West, 403/E, Hamilton, Ontario, Canada L8S 1C7.
Email: vdalbel@mcmaster.ca
Fall Prevention Program Characteristics
and Experiences of Older Adults and
Program Providers in Canada: A
Thematic Content Analysis
Humna Malik
1
, Briana Virag
1
, Fiona Fick
2
, Paulette V. Hunter
2
,
Sharon Kaasalainen
1
, and Vanina Dal Bello-Haas
1
Abstract
Objectives: To document the characteristics of fall prevention programs in specific regions in two Canadian provinces and
to explore older adults’ and program providers’ experiences with these programs. Methods: Semi-structured interviews
were conducted with 16 program providers/managers from 12 different programs. Ten semi-structured focus groups
were conducted with 59 older adults. Data were analyzed using thematic content analysis. Results: Older adults reported
functional and social benefits. Program providers identified barriers to program success, including cognitive impairment,
frailty, and lack of motivation. The need for general attitudinal changes toward older adults’ needs and broader community
changes were identified as important by the older adults. Discussion: Easily accessible information about fall prevention
programs for older adults and no-cost, ongoing initiatives were critical. Health care providers play keys roles in disseminating
information, facilitating referrals, and advocating for initiatives that best meet the needs of older adults in their communities.
Keywords
older adults, program providers, fall prevention programs, perspectives and experiences, thematic content analysis