Our funding will enable the team to undertake research that involves development and testing.
Our funding will enable the team to undertake research that involves the development and testing of new approaches to falls related interventions.
We will focus on solutions that can be implemented within current health, community services or residential care. All strategies will be developed with input from policy makers, health service managers, clinicians, consumers, and carers to maximise their chance of success.
Stream 1. Identify the most effective and cost-effective solutions to preventing fall-related injuries.
We will identify the most effective and cost-effective options for reducing fall-related injuries in different Australian settings and circumstances. This will involve being informed by systematic reviews and new analyses of existing cohort, trial and administrative data as well as system dynamics models of virtual representations of the real world where individuals and communities act and react, develop health conditions, and use health services in the same way as people do in real life.
Stream 2. Co-design fall-injury prevention interventions and implementation strategies.
This program of work will involve the co-design of fall-injury prevention interventions and implementation strategies suitable to be scaled up and embedded into existing health, community services and residential care in conjunction with policy makers, managers, clinicians, consumers and carers using surveys, qualitative studies, discrete choice experiments and co-design workshops.
Studies will obtain input from staff, patients and carers about i) the extent of implementation of evidence-based fall prevention interventions in current practice; ii) potential for change; and iii) suggested strategies for greater implementation.
Settings identified for implementation or improving services for fall-prevention interventions include:
- Osteoporosis re-fracture prevention clinics/fracture liaison services;
- Outpatient endocrinology, geriatric medicine, rehabilitation and/or physiotherapy services;
- Australia and New Zealand Hip Fracture Registry sites;
- Home care settings;
- Residential care.
Input will involve representative surveys of staff as well as focus groups and interviews with relevant staff and patients about potential for change in these contexts. Systematic reviews will be undertaken to ensure that this work builds on previous work undertaken in this area internationally.
Stream 3. Evaluate implementation of evidence-based fall prevention interventions.
We will evaluate the implementation of evidence-based fall-prevention interventions using effectiveness implementation hybrid trials. The choice of settings and strategies to be prioritised will be finalised based on the findings of the research described in Streams 1 and 2.
We will run pragmatic trials of interventions that are integrated with health/community services rather than alongside such services. This contrasts with most previous trials of fall prevention outcomes that have been undertaken with intervention delivered alongside usual health services (with additional funding for interventions). Using effectiveness-implementation hybrid designs, we will simultaneously collect effectiveness and implementation outcomes. As the effectiveness of most of these fall prevention strategies when implemented within usual care settings in Australia is yet to be rigorously evaluated (i.e., in randomised designs) we consider both effectiveness and implementation aspects to be important.
Stream 4. Test new pragmatic fall-injury prevention interventions.
This program of work will test new pragmatic fall-injury prevention interventions that build on previous evidence and offer new approaches to falls prevention. The choice of settings and strategies will again be informed by the research described in Stream projects 1 and 2.
Projects to address this aim will test new interventions developed through the modelling and consultation processes described above. Interventions that are likely to be cost-effective and amenable to scale-up will be prioritised.