Cross-cultural Educational Intervention and Fall Risk Awareness

ABSTRACT

Aims: To determine if a two-visit, personalized falls prevention educational intervention affected awareness of fall risk in community-dwelling older adults in Belize. Secondary aim: to assess new learning in a cross-cultural context and willingness to make lifestyle changes to reduce fall risk. Methods: A US-based team completed fall risk assessments (Short FES-I, mCTSIB, TUG, and 30-s Chair Stand Test), pre- and postintervention questionnaires, and an original postintervention semi-structured interview with eighteen participants. Investigators employed the Fall Risk Awareness Questionnaire (FRAQ) to assess awareness of fall risk. Intervention consisted of an educational class regarding fall risks that took place in a day centre, and a home visit. Questionnaire results were analyzed for statistical significance. Investigators completed thematic analysis of interviews. Results: Mean scores of the FRAQ rose slightly at posttest, but results were not statistically significant. Qualitative analyses revealed themes regarding specific fall risk awareness, barriers to change, and willingness to change. Conclusions: Participants in this sample demonstrated an increase in falls risk awareness after a brief falls prevention program. The sample size and prepost design limited generalizability of the results. Therapists should be aware of cultural competence, health literacy, and personal narrative of participants.

KEYWORDS:

• Falls prevention
• fall risk
• occupational therapy
• cross-cultural
• underserved
• older adults

Declaration of interest

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

Acknowledgments

The authors gratefully acknowledge the support of Ms. Rhondine Petrof, Executive Director, Toucan Education Programs, and Ms. Ivorine Bulwer, Executive Director, HelpAge Belize. The authors also gratefully acknowledge the assistance of Nicole Bies, Brianna Hursey, Beth Stratton, and Erin Velpel in data collection and assisting with providing the intervention in this study. Special thanks and acknowledgement are due to the primary authors of the Falls Risk Awareness Questionnaire (FRAQ) instrument, Cheryl Sadowski and Allyson Jones, for granting the investigators permission to use the FRAQ in this study.

This project was completed in partial fulfillment for the requirement of the degree of Doctor of Health Sciences at the University of Indianapolis by the primary investigator, Brenda S. Howard.