A systems approach to assist policy action to prevent falls among community-dwelling older people in Australia

Nathalia Costa; Meghan Ambrens; Kim Delbaere; Louise Wilson; Ang Li; Catherine Sherrington

doi:10.1071/phrp3412405

RESEARCH ARTICLE (Open Access)

A systems approach to assist policy action to prevent falls among community-dwelling older people in Australia

Nathalia Costa ^A ^B ^* , Meghan Ambrens ^C ^D , Kim Delbaere ^C ^D , Louise Wilson ^E , Ang Li ^F and Catherine Sherrington ^G ^H

+ Author Affiliations

- Author Affiliations

^A Sydney Musculoskeletal Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia

^B University of Queenslandâ€™s Clinical Trial Capability (ULTRA) team, University of Queensland, Brisbane, Australia

^C Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia

^D School of Population Health, UNSW Sydney, Australia

^E NHMRC Centre for Research Excellence on Women and Non-communicable Diseases: Prevention and Detection, School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia

^F NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia

^G Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia

^H Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, NSW, Australia

^* Correspondence to: nathalia.costa@sydney.edu.au

Public Health Research and Practice 34, e3412405 https://doi.org/10.17061/phrp3412405

Published: 4 April 2024

2024 © Costa et al. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.

Abstract

Objectives: While systems thinking has gained recognition as an important approach in health policy and prevention research, its application in the context of fall prevention among community-dwelling older adults has been underutilised. Here, we build on the guiding principles of the systemic lens component of the Prevention System Change Framework to assess and identify potential changes that are required to facilitate policy action in the field of falls prevention. Methods: We conducted a desktop search to identify policy documents encompassing falls prevention among community-dwelling older adults in Australia. Documents were considered eligible if they were published in the last 10 years and were authored or endorsed by federal or state government bodies. We collaboratively examined eligible documents to gain insights into the current policy landscape in falls prevention and to illustrate opportunities for action and the potential for strengthening partnerships. Results: There is no current national policy on preventing falls in older adults in Australia. While we identified eight policy documents, none focused exclusively on falls prevention, indicating that falls are currently not perceived as a public health issue that warrants a dedicated policy framework. We identified a need for a comprehensive national policy that draws upon insights from various disciplines, suggests intersectoral collaboration, addresses health inequities and involves meaningful engagement with key stakeholders. Future falls prevention policies may benefit from clear governance structures and specific targets, along with mechanisms for monitoring and evaluating outcomes. Conclusion: Falls prevention is a pressing public health concern that requires dedicated policy resources. Adopting a systems-oriented approach can help reduce falls and their associated burdens on individuals and the healthcare system. Acknowledging the urgency and complexity of this challenge is a first, essential step toward crafting a comprehensive national falls prevention policy.

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