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A Qualitative Assessment of the Stay Well At Home Fall Risk Reduction Program.
The population of older adults in the United States is rapidly increasing. Falls are a major health concern among the older adult population, and there is an increasing need for more theory-driven fall risk reduction programs that are multifactorial, effective, and inexpensive. The Stay Well At Home (SWAH) program was a 16-week, in-home multifactorial fall risk reduction program that was implemented by trained lay facilitators. The development of this intervention was guided by the Health Action Process Approach (HAPA). The purpose of this study was to qualitatively examine the efficacy of SWAH program as a multifactorial program, to determine its effectiveness as a HAPA-guided intervention, and also to inform further program development of the SWAH program. Semi-structured interviews were conducted with a sample of SWAH recipients (N=15) at the conclusion of the 8-week in-home phase of the program. The purpose of the interviews was to learn about participant experiences with the program and changes they may have observed in themselves. All interviews were recorded, transcribed verbatim, and then thematically analyzed. Themes were also related back to HAPA constructs. The major themes reported by SWAH recipients included an overall increase in fall protective behaviors (100%) as well as improvement in gait (80%), balance (73%), and physical performance (53%). Recipients also responded positively to the SWAH program content and structure. Common barriers for SWAH recipients were health and motivation barriers (73%) and taking the time to exercise (67%). Analysis of the main themes in this study suggest that SWAH was effective at implementing the HAPA model with the exception of successfully implementing action planning activities. The SWAH program was perceived by the interviewed participants as effective in reducing overall fall risk and was fairly successful as a HAPA-guided intervention. Further, it was well received and viewed as beneficial by many SWAH recipients.
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