title: Fall prevention services for older Aboriginal people: investigating availability and acceptability.
abstract: BACKGROUND
  Falls and fall-related injury are emerging issues for older Aboriginal people. Despite this, it is unknown whether older Aboriginal people access available fall prevention programs, or whether these programs are effective or acceptable to this population.
  
  
  OBJECTIVE
  To investigate the use of available fall prevention services by older Aboriginal people and identify features that are likely to contribute to program acceptability for Aboriginal communities in New South Wales (NSW), Australia.
  
  
  METHODS
  A questionnaire was distributed to Aboriginal and mainstream health and community services across NSW to identify the fall prevention and healthy ageing programs currently used by older Aboriginal people. Services with experience in providing fall prevention interventions for Aboriginal communities, and key Aboriginal health services that delivered programs specifically for older Aboriginal people, were followed up and staff members were nominated from within each service to be interviewed. Service providers offered their suggestions as to how a fall prevention program could be designed and delivered to meet the health and social needs of their older Aboriginal clients.
  
  
  RESULTS
  Of the 131 services that completed the questionnaire, four services (3%) had past experience in providing a mainstream fall prevention program to Aboriginal people; however, there were no programs being offered at the time of data collection. From these four services, and from a further five key Aboriginal health services, 10 staff members experienced in working with older Aboriginal people were interviewed. Barriers preventing services from offering appropriate fall prevention programs to their older Aboriginal clients were identified, including limited funding, a lack of available Aboriginal staff, and communication difficulties between health services and sectors. According to the service providers, an effective and acceptable fall prevention intervention would be evidence based, flexible, community-oriented and social, held in a familiar and culturally safe location and delivered free of cost.
  
  
  CONCLUSIONS
  This study identified a gap in the availability of acceptable fall prevention programs designed for, and delivered to, older Aboriginal people in NSW. Further consultation with older Aboriginal people is necessary to determine how an appropriate and effective program can be designed and delivered. Terminology: The authors recognise the two distinctive Indigenous populations of Australia: Aboriginal and Torres Strait Islander people. Because the vast majority of the NSW Aboriginal and Torres Strait Islander population is Aboriginal (95.4%)1, this population will be referred to as 'Aboriginal' in this manuscript.
authors.affiliation: The George Institute for Global Health, The University of Sydney, NSW, Australia, clukaszyk@georgeinstitute.org.au.
authors.forename: Caroline
authors.initials: C
authors.lastname: Lukaszyk
authors.affiliation: The George Institute for Global Health, The University of Sydney, NSW, Australia.
authors.forename: Julieann
authors.initials: J
authors.lastname: Coombes
authors.affiliation: The George Institute for Global Health, The University of Sydney, NSW, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Keay
authors.affiliation: The George Institute for Global Health, The University of Sydney, NSW, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.affiliation: The George Institute for Global Health, The University of Sydney, NSW, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Tiedemann
authors.affiliation: Neuroscience Research Australia, Sydney, NSW.
authors.forename: Tony
authors.initials: T
authors.lastname: Broe
authors.affiliation: NSW Falls Prevention Program, Clinical Excellence Commission, NSW Ministry of Health, Sydney, Australia.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Lovitt
authors.affiliation: The George Institute for Global Health, The University of Sydney, NSW, Australia, School of Nursing & Midwifery, Flinders University, Adelaide, South Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ivers
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D006297:Health Services Accessibility; D006303:Health Services, Indigenous; D006801:Humans; D007407:Interviews as Topic; D009517:New South Wales; D011795:Surveys and Questionnaires; D000095283:Australian Aboriginal and Torres Strait Islander Peoples