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Community Based Intervention01:30

Community Based Intervention

Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...

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Implementation of the Ironbark falls prevention program: a mixed methods process evaluation with Aboriginal

Grace McKeon1,2, Zarayn Knight3, Rebecca Ivers3,4

  • 1Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University,  Melbourne, Victoria, Australia.

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The Ironbark program effectively prevents falls in older Aboriginal people through culturally tailored exercises and Yarning circles. High fidelity implementation was achieved, demonstrating the program

Keywords:
Aboriginal and Torres Strait Islander peoplesexercisefalls preventionimplementationolder adultsqualitative research

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Area of Science:

  • Gerontology
  • Public Health
  • Indigenous Health

Background:

  • Falls are a primary cause of injury and loss of independence in older Aboriginal individuals.
  • The Ironbark program is a community-based, culturally co-designed fall prevention initiative.
  • This study evaluates the Ironbark program's implementation fidelity and influencing factors.

Purpose of the Study:

  • To conduct a process evaluation of the Ironbark Standing Strong and Tall program.
  • To examine the fidelity and key factors influencing the implementation of a culturally-grounded fall prevention program.
  • To provide practical guidance for facilitators and inform program sustainability and expansion.

Main Methods:

  • Process data collected from 15 of 16 implementing sites across two Australian states.
  • Quantitative assessment of fidelity and dose using structured observations and checklist scores.
  • Qualitative thematic analysis of semi-structured interviews mapped onto the Consolidated Framework for Implementation Research (CFIR).

Main Results:

  • The program demonstrated high fidelity, with median adherence scores above 80% for 117 participants.
  • Key facilitators included Aboriginal leadership, program flexibility, and supportive structures; challenges involved varying abilities and engagement.
  • Facilitators recommended enhanced training and data access; sustainability hinges on workforce capacity and funding.

Conclusions:

  • Culturally relevant fall prevention programs, like Ironbark, can be successfully implemented with high fidelity in community settings.
  • Findings offer practical insights for facilitators and strategies for sustaining and scaling community-led health initiatives.
  • The study informs the integration of culturally safe, community-led health programs into routine practice.