Date Presented 03/21/24

The qualitative findings from an efficacy trial for the Stroll Safe outdoor falls prevention program will be presented. Results reveal a number of program benefits, including increased safe community mobility strategy use.

Primary Author and Speaker: Tracy Chippendale

Contributing Authors: Szu-Wei Chen

PURPOSE: Outdoor falls present a significant challenge to the functional independence of community dwelling older adults. There are a number of existing evidence-based falls prevention programs. However, despite the differences in risk factors, none of the existing programs specifically targets outdoor falls. To fill this gap the Stroll Safe program was developed, informed by the Health Belief and Ecological Models and prior research on the epidemiology of outdoor falls. Stroll Safe is a manualized 7-week program that teaches behavioral strategies to increase safe community mobility. The purpose of this study was to examine the qualitative findings from an efficacy trial in eight community program sites.

DESIGN: A qualitative study using thematic data analysis.

PARTICIPANTS: Inclusion criteria were: Age 60 and older, English speaking, community-dwelling, able to ambulate outdoors independently with or without a mobility aid, and must answer ‘yes’ to one of more of the following questions 1) Have you fallen outdoors and hurt yourself in the last year? 2) Have you fallen outdoors two or more times in the past year? 3) Have you had two or more stumbles or trips outdoors in the last month? 3) Are you afraid that you might fall outdoors?

METHOD: Focus groups were conducted at the community program sites with Stroll Safe program participants (N=67). Thematic analysis with deductive and inductive coding was used. Two coders analyzed the data to increase trustworthiness of the findings.

RESULTS: The results revealed four main themes 1) Precipitants of behavioral change, 2) Behavioral change, 3) Program design, and 4) Enjoyment of program experience.

CONCLUSION: Qualitative findings were consistent with quantitative findings but revealed additional program benefits. Results can be used to guide future implementation studies.

IMPACT STATEMENT: Stroll Safe fills a gap in OT practice and addresses the AOTA priority area of community safety.

References

Chippendale, T. & Chen, S.-W. (2023). The Stroll Safe outdoor falls prevention program: Participant experiences in eight community sites. Archives of Gerontology and Geriatrics, Early online.

Chippendale, T., Albert, S. & Mahmood, A. (2022). Efficacy of the Stroll Safe outdoor fall prevention program: A randomized controlled trial. The Gerontologist, Early online.

Chippendale, T. (2019) Feasibility of the Stroll Safe outdoor fall prevention program. American Journal of Occupational Therapy, 73(4). https://doi.org/10.5014/ajot.2019.031294.