The Ironbark program: Implementation and impact of a community-based fall prevention pilot program for older Aboriginal and Torres Strait Islander people

Aim: To document the implementation and investigate within-group impact of The Ironbark Program: a community-based, Aboriginal-specific fall prevention program, in New South Wales, Australia. Methods: The Ironbark Program was trialled in six Aboriginal communities over a three- to six-month period. A mixed methods approach was used for program evaluation: strength, balance and gait were assessed to measure participant physical function and BMI was monitored. Semi-structured participant interviews investigated program suitability, relevance and impact. Results: Ninety-eight Aboriginal people aged 40+ years registered for the pilot program, 77 (79%) of whom were present at all assessment time points. There were significant improvements in participant leg strength (average time to complete five repetition sit-to-stand: 14 seconds to 11 seconds), balance (timed single-leg stance: 5.6 seconds to 7.8 seconds), gait (timed 4 m walk: 0.51 m/s to 0.94 m/s) and a significant decrease in BMI (32.0 to 31.6) was observed. Participants reported enjoying the program and stated they would recommend it to others. Conclusion: The evaluation of the Ironbark Program demonstrated acceptability, and showed significant improvements in physical function. If proven to be effective in a definitive trial, this program could be used widely to prevent falls in older Aboriginal people. Implications: Key features of the Ironbark Program were local Aboriginal management, culturally relevant resources, ongoing availability and enabling program use for people aged less than 65 years. These features should be retained on the program's upscale, and may be incorporated into other healthy ageing programs developed for the Aboriginal population.