STAY ON YOUR FEET: An evidence-based framework for falls prevention

Rhonda Lovell RN, BNScPublic Health Nurse, KFL&A Public HealthChair, KFL&A Falls Prevention Coalition

Objectives

•Provide an overview of the Stay On Your Feet framework•Explore the rationale for use of the SOYF framework•Highlight the KFL&A experience with SOYF

An umbrella and multi-factorial falls prevention framework,with a positive brand name, and 5 strategy areas:1. Awareness raising2. Education3. Policy development 4. Hazard Reduction5. Partnerships with health professionals/disciplines

What is Stay On Your Feet?

SOYF Australia underlying principles:• Falls can be prevented

• To reduce the number and severity of falls, a community needs to implement a wide variety of health promotion activities

• Planning and implementation of SOYF based on the Ottawa Charter for Health Promotion

Why Stay On Your Feet?

•Evidence based•Flexibility•Addresses critical issues & priorities•Community capacity approach•Cost effective

The EvidenceAustralian Project Outcomes• Community-wide program that addressed as many

falls risk factors as possible

• 22% reduction in self-reported falls

• 20% reduction in falls-related hospital admissions

Fits with other approaches and interventions Utilizes local knowledge and data Leverages leadership and expertise Enables a mix of strategies Provides a starting point and/or the context to

evaluate existing activities

Flexibility

Addresses Critical Issues & Priorities• Ontario Public Health Standards 2008• MHP Chronic Disease Prevention Priorities• Ontario Injury Prevention Strategy• Integrated Health Service Plan priorities

Community Capacity Approach•Ensures local relevance•Promotes longevity & sustainability•Supports collaboration & integration of services•Fosters community ownership of the program and input into solutions

A role for everyone

10

INDIVIDUALS

Society

Government

LHINs & Other HCPs

PublicHealth

Groups,Coalitions

•Each hip fracture costs the system $21,285 in the 1st year after hospitalization, and $44,156 if the patient is institutionalized. (Osteoporosis Canada)

•SOYF Ontario demonstration project grants received $60,000 per year for two years

•In KFL&A many SOYF elements are sustained through Public Health & through in kind donation of community partners’ time etc – embedded in agency priorities

Cost effective

In 2004, ONF selected three communities (KFL&A, Grey Bruce, and Elliot Lake) to receive a two-year grant to adapt and implement the SOYF program in Ontario and evaluate its effectiveness

Formal evaluation (Corlett & Warren, 2006) found that the program could be sustained by ongoing leadership of lead agencies beyond ONF funding

SOYF approach is still present in some of the pilot communities, albeit in different form

The Ontario Model

South East LHIN KFL&A Public Health

Kingston Frontenac Lennox & Addington

Total population = 190 39965+ = 29 973 = 15.74%

55-64 = 24 519

Addington, North & Central Frontenac 65+ = 23%

Ontario 65+ = 12.8%

Source: South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Addington, North and Central Frontenac

Population Estimates (2008), Provincial Health Planning Database (PHPDB)

Created a locally relevant action planBuilt upon an existing coalition of key local partnersKFL&A Falls Prevention Coalition

Hired a co-ordinatorGathered required information

Implementation in KFL&A

•Awareness & education

•Growth & sustainability

•Building community capacity

•Regional relevance

•Evidence based practice

KFL&A focus moving forward

Rhonda Lovell, RN, BNScPublic Health Nurse, KFL&A Public HealthChair, KFL&A Falls Prevention Coalition 221 Portsmouth AvenueKingston, OntarioCanada K7M 1V5 tel: 613-549-1232 ext. 1181fax: 613-549-7896rlovell@kflapublichealth.ca

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