Health Promotion Report: Falls Prevention in Western Australia

This report focuses on a health promotion program designed to prevent falls among elderly Aboriginal Australians (65+) residing in residential care within the Kimberley region of Western Australia. It addresses the significant health issue of falls, which are a major cause of injury and hospitalization in this demographic. The report highlights the health issue and rationale for intervention, focusing on the increased risk of falls associated with aging, impaired balance, and chronic health conditions. The target group is identified, along with the behavioral theory of self-efficacy, which underpins the program's approach. Risk and contributing factors are analyzed, including behavioral and environmental factors like lack of awareness, poor vision, and unsafe home environments. A detailed project plan is presented, outlining the program's title, goals, objectives, and strategies, including education, environmental modifications, and technological interventions like smart watches. The timeline for implementation is also provided. The program aims to reduce falls through education, environmental improvements, and technological aids, acknowledging the importance of culturally appropriate health services and community involvement to improve the health and wellbeing of the target population.

Running head: HEALTH PROMOTION
Health Promotion
Name of the Student:
Name of the University:
Author Note:

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Contents
Introduction......................................................................................................................................2
Health issue and rationale................................................................................................................2
Health issues................................................................................................................................2
The consequences of falls............................................................................................................3
Target Group....................................................................................................................................3
Behavioral theory.............................................................................................................................4
Risk and contributing factors...........................................................................................................5
Project plan......................................................................................................................................6
Timeline...........................................................................................................................................8
Conclusion.......................................................................................................................................9
Reference.......................................................................................................................................10

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Introduction
The natural process of ageing often places the adults to an increased risk of encountering
and experiencing fall. it is important to mention that falls are one of the most common as well as
most overlooked causes of injury in the elderly people. The various reasons due to which the
elderly people will be experiencing falls are: illnesses that affects the balances of the older
people like infection in the labyrinths (risks arises due to inflammation and infection in the
regulating parts of the ear); impairments like muscle weakness or poor vision; chronic health
conditions like the low blood pressure, dementia, and heart diseases that causes dizziness
(Healthdirect.gov.au, 2019). This study will be based upon the Australian aboriginal people that
are 65 years of age and are living in the residential care. The region which is selected for the
study is the Western Australia.
Health issue and rationale
Health issues
According to the website of Government of Western Australia Department of Health, fall
is defined as the inadvertently coming to rest on the floor, ground and other lower levels. Falls
can occur person of any age but the injury and the increase in falls increases with the frailty and
age. Globally it can be seen that about 28 to 35 percent of the people that are aged 65 and above
fall each year. The rate of fall increases in people that are aged 70 years and above by 32 to 42
percent. Whereas in Australia, everyone in a 3 people that are aged above 65 years and live in a
community falls each year. The number of falls is actually more than once. It is important to
mention that falls are a very significant issue in Western Australia and it is considered as the
fourth major cause of injury death in a community which is 11 percent; falls is considered as the

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second most common reason of injury hospitalizations in community is 31 percent. It is a
highlighting fact that the for the people that are aged 65 years and above, falls related injury is
the leading cause of hospitalizations (health.wa.gov.au, 2019).
The consequences of falls
Falls can lead to a variety of minor or major injury and even to serious injury or death.
The physical injuries include intracranial bleeding, fractures, lacerations, hematomas, superficial
wounds and scratches, bruising and pain. Even if falls that do not result into physical injury can
still instill fear of falling. However, it can result into self- imposed limitation on certain
activities, and later on this fear induces a cycle of reduced functional ability. It is also important
to mention that the as the population grows, there will be a surge in the demand in the health
services. It has been projected that the fall related injuries will lead to the increased cost in
Western Australia healthcare system. The cost will mount to 174 million dollars for the year
2021. This will be caused by the lack of lower treatment costs, and lack of any prevention plan.
Moreover, the falls that occur within the healthcare facilities results into increased rates of
discharge from the nursing homes, increased usage of the health resources and increased length
of stay (health.wa.gov.au, 2019).
Target Group
Studies have indicated that the Kimberley region in the Western Australia have reported
that the aboriginals Australians that are aged above 45 and above have reported that they have
fallen at least once in the previous year and the percentage of such aboriginal Australians is 31
percent. Moreover, 12 percent of the aboriginal Australians have also reported that they have
injuries associated with the falls. Therefore, the target population will be the Australian

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aboriginal that are aged 65 and above and are living in residential care. The health promotion
program will be aimed at the elderly Australian aboriginals that are living in Kimberley and are
under the residential care. Fall related hospitalization have highlighted that falls are commonly
related with head injuries and the data from the older Australian aboriginals show that the falls
contributes to about 81.4 percent of the overall injuries. It is important to mention that the in
comparison to the non- indigenous Australians, the indigenous Australians are receiving 1.7
times more head injuries due to falls (Hill et al., 2016). According to the census data it can be
said that there is a total of 4973 aboriginal or the Torres Islander people and the number of males
is 3899, and the number of females is 3828. The number of people that are within the age group
of 65 to 69 is 225. The total number of the people that are 70 years and above is 249. It is
important to mention that the total percentage of the aboriginals in the Kimberley region is 38.2
percent of the entire Kimberley region which is 3487 (Quickstats.censusdata.abs.gov.au, 2019).
Behavioral theory
Self-efficacy is the term which is often used to research on the fall prevention and at the
same time discuss on a person's fear of falling. It is a behavioral aspect that can be used as an
approach that will underpin the overall program (Loft, Jones & Kneebone, 2018). It is important
to mention that falls self-efficacy is a belief of a person that they have the ability to carry out a
certain activity without loosing balance of falling. It is important to mention that the fear of
falling can be considered as a to promote wellbeing while at the same time it can cause
disruption of the health of the elders (Health.qld.gov.au, 2019). It is important to mention that a
study carried out that analyzed the usability of the behavioral model (fall self- efficacy) and it
has been found that the lower self-efficacy is found to be associated with the high incidence of

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falls, more amounts of self- efficacy was associated with the reduction in the incidence of the
falls among the elderly that reside in communities (Loft, Jones & Kneebone, 2018).
Risk and contributing factors
The main risk factors related with the health issue are as follows:
Behavioral-
 Lack of awareness (Low self-perceived risk of falling. Belief that they won’t fall)
 Poor perception of the importance of vision for decreasing falls risk
 Belief they are unable to do normal activities (low falls self-efficacy)
Environmental-
 Lack of awareness of the relative risk of falls in house
Risk factors Behavioural
/
Environmen
tal
Predisposing Enabling Reinforcing
Age and
gender
Behavioural Lack of awareness (Laing et
al., 2011)
Low self-perceived risk of
falling. Belief that they
won’t fall (Haines et al.,
2015)
lack of proper
education
Mass media message:
Western Australia falls
prevention campaign
Poor vision Behavioural Poor perception regarding
vitality of vision in reducing
falls risk (Loft, Jones &
Kneebone, 2018).
Lack of proper
cognitive
behaviour
Physical consequences of
poor vision (Loft, Jones &
Kneebone, 2018)

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Fear of
falling
Behavioural
Belief they are unable to do
normal activities (low falls
self-efficacy)
(Health.qld.gov.au, 2019)
A history of
falls
Feeling
unsteady
No emotional
support from
family or
friends
(Health.qld.go
v.au, 2019)
Mass media message:
the fall prevention
program will carry the
active message like
"Improve your balance
and strength" and "Stay
active"
Home-based
multifactorial falls
prevention program
A community-based Tai
Chai group
(Health.qld.gov.au,
2019)
The risks of
elderly falls
will
increase
due the
lack of
double
handrails
on the
stairs and
the lack of
non-slip
strips on
the edges
of the
stairs
Environmen
tal
Lack of awareness of the
relative risk of falls in
house (Health.qld.gov.au,
2019)
poor safety
environment
in and around
house
Home modification
program
Home risk assessment by
(Health.qld.gov.au, 2019)
Project plan
Project Title
Stay On Your Feet
Health Issue and
Target Group
Risk factors (Prioritised four) Goal

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Health Issue or
Concern: Falls injury
Target Group: The
aboriginal Australians
of Kemberly, Western
Australia that are
aged 65 and above
- Age and gender
- Eyesight
- A history of falls
- Environment hazard (Stair without
double hand rails and non-strips on
stair edge
To reduce the number of falls
presenting to the emergency
department by 10% in Indigenous
people aged 65 and above who
are living independently in the
community of Kimberley,
Western Australia by the end of
the program
(Wacountry.health.wa.gov.au,
2019)
Objectives Strategies
To decrease by 10%
Indigenous females
aged 65+ who are
living in
independently in the
community of
Kimberley, Western
Australia who falls by
the end of the
program
 Education: local Indigenous health session to focus on falls
prevention including alternative ways to prevent falls, information
about effects of falls and discuss the indigenous history of falls
(Hyde et al., 2018)
The number of
elderly living in
Kimberly who have
vision checked each
year by an
optometrist will have
increase by 15% from
the baseline by the
end of the program.
 Health Education: it can be provided to the elderly people that
vision is important for their own wellbeing and their own
development.
 Policy and legislation- The local government can frame a policy
where the older people will be provided with free eye check-ups
and each year so that their vision remains checked.
Reduce by 25% the
death rate for
unintentional falls
among Indigenous
females aged 65+
who are living
independently in the
community of
Kimberley, Western
Australia by the end
of the program
 Advocacy: Negotiate with existing health agencies to increase
opening hours of culturally appropriate health services and to
increase the number of skilled Indigenous staff
 Community development: work with elders in the Indigenous
community to distribute information through flyers to encourage
the use of culturally appropriate and secure health services that
exist in Kimberley
 Environment strategy: ensure there is cultural awareness and
workplace development training given to all health staff especially
for non-indigenous staff (AIHW, 2015)

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By the end of the
program, 20% of
Indigenous female
aged 65+ who are
living independently
in the community of
Kimberley, Western
Australia will have
installed non-slip
contrast stair edge
and double handrails
on the steps and
stairs in their homes
 Environment strategy: Install non-slip contrast stair edge and
double handrails on the steps and stairs in their home
 Providing support to the elderly giving them the walker that will
hinder to not to slip and stumble.
 Technological- smart watches can be provided to the elderly that
can detect fall and call the emergency number when required
(Casilari & Oviedo-Jiménez, 2015).
Timeline
Activity Janu
ary
Febru
ary
Mar
ch
Ap
ril
M
ay
Ju
ne
Ju
ly
Aug
ust
Septe
mber
Octo
ber
Nove
mber
Dece
mber
Educatio
n
programs
Environ
mental
assistanc
e
communi
ty
develop
ment
Advocac

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y
Health
education
Eye
checkup
Conclusion
From the above discussion it can be concluded that, falls are one of the major issues that
leads to majority of injuries and death among the elderly people. The indigenous people are the
worst effected form this issue and it can be said that the stay on feet is a step towards reduction
and management of the fall among the elderly people. There are issues associated with the falls
in elderly like they often neglect their vision and due to this the local government must take a
step forward and eye health checkup must be organized for free for the elderly so that they can
stay healthy and free from falls.

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Reference
AIHW. (2015). Cultural competency in the delivery of health services for Indigenous people,
Cultural competency in the delivery of health services for Indigenous people - Australian
Institute of Health and Welfare. Retrieved from
https://www.aihw.gov.au/uploadedfiles/closingthegap/content/our_publications/2015/
ctgc-ip13.pdf
Casilari, E., & Oviedo-Jiménez, M. A. (2015). Automatic fall detection system based on the
combined use of a smartphone and a smartwatch. PloS one, 10(11), e0140929. DOI:
https://doi.org/10.1371/journal.pone.0140929
Haines, T. P., Lee, D. C. A., O'connell, B., McDermott, F., & Hoffmann, T. (2015). Why do
hospitalized older adults take risks that may lead to falls?. Health expectations, 18(2),
233-249.
Health.qld.gov.au. (2019). Fear of falling - Stay On Your Feet | Queensland Health. Retrieved
from https://www.health.qld.gov.au/stayonyourfeet/for-professionals/fear-falling
Health.qld.gov.au. (2019). Fear of falling - Stay On Your Feet | Queensland Health. Retrieved
from https://www.health.qld.gov.au/stayonyourfeet/for-professionals/fear-falling
health.wa.gov.au (2019). Consequences of falls. [online] Ww2.health.wa.gov.au. Available at:
https://ww2.health.wa.gov.au/Articles/A_E/Consequences-of-falls [Accessed 15 May
2019].
health.wa.gov.au. (2019). Falls prevention and management in WA. Retrieved from
https://ww2.health.wa.gov.au/Articles/F_I/Falls-prevention-and-management-in-WA

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Healthdirect.gov.au. (2019). What causes falls?. Retrieved from
https://www.healthdirect.gov.au/what-causes-falls
Hill, K. D., Flicker, L., Logiudice, D., Smith, K., Atkinson, D., Hyde, Z., ... & Boyle, E. (2016).
Falls risk assessment outcomes and factors associated with falls for older Indigenous
Australians. Australian and New Zealand journal of public health, 40(6), 553-558. DOI:
10.1111/1753-6405.12569
Hyde, Z., Smith, K., Flicker, L., Atkinson, D., Almeida, O. P., Lautenschlager, N. T., ... &
LoGiudice, D. (2018). Mortality in a cohort of remote-living Aboriginal Australians and
associated factors. PloS one, 13(4), e0195030. DOI:
https://dx.doi.org/10.1371%2Fjournal.pone.0195030
Laing, S. S., Silver, I. F., York, S., & Phelan, E. A. (2011). Fall prevention knowledge, attitude,
and practices of community stakeholders and older adults. Journal of aging
research, 2011. DOI: https://dx.doi.org/10.4061%2F2011%2F395357
Loft, C. C., Jones, F. W., & Kneebone, I. I. (2018). Falls self-efficacy and falls incidence in
community-dwelling older people: the mediating role of coping. International
psychogeriatrics, 30(5), 727-733. DOI: https://doi.org/10.1017/S1041610217002319
Quickstats.censusdata.abs.gov.au. (2019). 2016 Census QuickStats: Derby-West Kimberley (S).
Retrieved from https://quickstats.censusdata.abs.gov.au/census_services/getproduct/
census/2016/quickstat/LGA52800
Wacountry.health.wa.gov.au. (2019). Kimberley Health Profile Planning and Evaluation Unit
January 2018. Retrieved from
http://www.wacountry.health.wa.gov.au/fileadmin/sections/publications/

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Publications_by_topic_type/Reports_and_Profiles/eDoc_-_CO_-
_Kimberley_Health_Profile_2018.pdf