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Engaging community-dwelling older adults in fall prevention programs

Introduction: Fall rates and fall-related injuries among community-dwelling older adults (≥65 years) are expected to increase rapidly, due to the aging population worldwide. Fall prevention programs (FPPs), consisting of strength and balance exercises, have been proven effective in reducing fall rates among older adults. However, these FPPs have not reached their full potential as most programs are under-enrolled. Therefore, this study aims to identify promising strategies that promote participation in FPPs among community-dwelling older adults. Methods: This is an exploratory qualitative study. Previously, barriers and facilitators for participation in FPPs by older adults had been identified. Next, six strategies had been designed using the Intervention Mapping approach: (1) reframing; (2) informing about benefits; (3) raising awareness of risks; (4) involving social environment; (5) offering tailored intervention; (6) arranging practicalities. Strategies were validated during semi-structured interviews with communitydwelling older adults (n = 12) at risk of falling. Interviews were audio-recorded, transcribed, and analyzed following a qualitative thematic methodology, with a hybrid approach. Results: All strategies were considered important by at least some of the respondents. However, two strategies stood out: (1) reframing ‘aging’ and ‘fall prevention’: respondents preferred to be approached differently, taking a ‘life course’ perspective about falls, and avoiding confronting words; and (2) ‘informing about benefits’ (e.g., ‘living independently for longer’); which was mentioned to improve the understanding of the relevance of participating in FPPs. Other strategies were considered important to take into account too, but opinions varied more strongly. Discussion: This study provides insight into potential strategies to stimulate older adults to participate in FPPs. Results suggest that reframing ‘aging’ and ‘fall prevention’ may facilitate the dialogue about fall prevention, by communicating differently about the topic, for example ‘staying fit and healthy’, while focusing on the benefits of participating in FPPs. Gaining insight into the strategies’ effectiveness and working mechanisms is an area for future research. This could lead to practical recommendations and help professionals to enhance older adults’ participation in FPPs. Currently, the strategies are further developed to be applied and evaluated for effectiveness in multiple field labs in a central Dutch region (Utrecht).

A Community of cultures

This paper discusses the concepts and social dynamics of fashion imitation and custom imitation as put forth by French sociologist Gabriel Tarde (1843-1904). Specifically his 1903 book The Laws of Imitation will be introduced and used to argue that, and examine how, fashion has, since the turn of the century, increasingly become a global custom rather than the exemplary innovative force Tarde associated with fashion. The second part of the paper therefore suggests turning to custom and tradition may be fruitful to revitalise the current state of fashion and can cause new fashions to come into being. The traditional technique used by the people of the Dutch village of Staphorst to decorate the fabrics for their traditional costumes - Staphorster stippling - which is nominated to be inscribed on UNESCO’s list of intangible cultural heritage, is presented as a case study in which it is shown how cultural traditions may unilaterally contribute to ethical, ecological and innovative fashion design. It is furthermore argued that the reciprocal effect of the dynamics between custom and fashion accounts for the preservation of traditional skills and techniques. The text concludes by examining the chances and opportunities as well as the pitfalls one may associate with the proposed dynamic interaction between fashion and tradition.

Power to the people

Abstract: The transition towards renewable and sustainable energy is being accompanied by a transformation of communities and neighbourhoods. This transition may have huge ramifications throughout society. Many cities, towns and villages are putting together ambitious visions about how to achieve 100% sustainable energy, energy neutrality, zero carbon emission or zero-impact of their communities. We investigate what is happening at the local community level towards realizing these ambitions from a social perspective. We use the case study approach to answer the following question: how do local community energy initiatives contribute to a decentralized sustainable energy system? We find that especially the development of a shared vision, the level of activities and the type of organisation are important factors of the strength of the ‘local network’.

Contextual determinants influencing the implementation of fall prevention in the community: a scoping review

Background: Successful implementation of multifactorial fall prevention interventions (FPIs) is essential to reduce increasing fall rates in communitydwelling older adults. However, implementation often fails due to the complex context of the community involving multiple stakeholders within and across settings, sectors, and organizations. As there is a need for a better understanding of the occurring context-related challenges, the current scoping review purposes to identify what contextual determinants (i.e., barriers and facilitators) influence the implementation of FPIs in the community. Methods: A scoping reviewwas performed using the Arksey andO’Malley framework. First, electronic databases (Pubmed, CINAHL, SPORTDiscus, PsycINFO) were searched. Studies that identified contextual determinants that influence the implementation of FPIs in the community were included. Second, to both validate the findings from the literature and identify complementary determinants, health and social care professionals were consulted during consensus meetings (CMs) in four districts in the region of Utrecht, the Netherlands. Data were analyzed following a directed qualitative content analysis approach, according to the 39 constructs of the Consolidated Framework for Implementation Research. Results: Fourteen relevant studies were included and 35 health and social care professionals (such as general practitioners, practice nurses, and physical therapists) were consulted during four CMs. Directed qualitative content analysis of the included studies yielded determinants within 35 unique constructs operating as barriers and/or facilitators. The majority of the constructs (n = 21) were identified in both the studies and CMs, such as “networks and communications”, “formally appointed internal implementation leaders”, “available resources” and “patient needs and resources”. The other constructs (n = 14) were identified only in the . Discussion: Findings in this review show that awide array of contextual determinants are essential in achieving successful implementation of FPIs in the community. However, some determinants are considered important to address, regardless of the context where the implementation occurs. Such as accounting for time constraints and financial limitations, and considering the needs of older adults. Also, broad cross-sector collaboration and coordination are required in multifactorial FPIs. Additional context analysis is always an essential part of implementation efforts, as contexts may differ greatly, requiring a locally tailored approach.

IANOS Sustainable solutions for islands' decarbonisation

Social innovation and community-focussed civic initiatives in the context of rural depopulation: for every body by everybody?

In this paper, we apply a civic perspective and social innovation theory to examine how residents of a Dutch village experiencing rural depopulation and austerity reforms evaluate a civic initiative aimed at improving liveability, and what explains their evaluation. Using multivariate statistical analysis, we found that most residents were positive about the initiative and its contribution to local liveability. We also discovered that a substantial group knew very little about the initiative and that low-income groups, in particular, lacked the interest to identify and become engaged with it. Voluntary engagement, however, did not necessarily result in a positive evaluation. Above all, tangible outputs explained citizens’ appreciation. A perceived increase in collaboration within the village and novel forms of collaboration with the local government also proved important, but only when they were accompanied by realised tangible outputs.