Taylor Morag E, Ambrens Meghan, Hawley-Hague Helen, Todd Christopher, Close Jacqueline C T, Lord Stephen R, Clemson Lindy, Lung Thomas, Berlowitz David, Blennerhassett Jannette, Dayhew Julia, Gluchowski Ashley, Hodge Wendy, Johnson Pamela, Lasrado Reena, Merlene Marita, Miles Lillian, O'Rourke Sandra, Said Catherine M, White Leanne, Wilson Nicola, Zask Avigdor, Delbaere Kim
Neuroscience Research Australia, Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia.
Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.
Age Ageing. 2024 Aug 6;53(8). doi: 10.1093/ageing/afae173.
StandingTall uses eHealth to deliver evidence-based balance and functional strength exercises. Clinical trials have demonstrated improved balance, reduced falls and fall-related injuries and high adherence. This study aimed to evaluate the implementation of StandingTall into health services in Australia and the UK.
Two hundred and forty-six participants (Australia, n = 184; UK, n = 62) were recruited and encouraged to use StandingTall for 2 h/week for 6-months. A mixed-methods process evaluation assessed uptake and acceptability of StandingTall. Adherence, measured as % of prescribed dose completed, was the primary outcome.
The study, conducted October 2019 to September 2021 in Australia and November 2020 to April 2022 in the UK, was affected by COVID-19. Participants' mean age was 73 ± 7 years, and 196 (81%) were female. Of 129 implementation partners (e.g. private practice clinicians, community exercise providers, community service agencies) approached, 34% (n = 44) agreed to be implementation partners. Of 41 implementation partners who referred participants, 15 (37%) referred ≥5. Participant uptake was 42% (198/469) with mean adherence over 6 months being 41 ± 39% of the prescribed dose (i.e. 39 ± 41 min/week) of exercise. At 6 months, 120 (76%) participants indicated they liked using StandingTall, 89 (56%) reported their balance improved (moderately to a great deal better) and 125 (80%) rated StandingTall as good to excellent. For ongoing sustainability, health service managers highlighted the need for additional resources.
StandingTall faced challenges in uptake, adoption and sustainability due to COVID-19 and a lack of ongoing funding. Adherence levels were lower than the effectiveness trial, but were higher than other exercise studies. Acceptance was high, indicating promise for future implementation, provided sufficient resources and support are made available.
Australian and New Zealand Clinical Trials Registry ACTRN12619001329156.
“挺拔站立”项目利用电子健康技术提供基于证据的平衡和功能性力量训练。临床试验已证明该项目能改善平衡能力、减少跌倒及与跌倒相关的损伤，且依从性高。本研究旨在评估“挺拔站立”项目在澳大利亚和英国的医疗服务中的实施情况。
招募了246名参与者（澳大利亚184名；英国62名），并鼓励他们每周使用“挺拔站立”项目2小时，为期6个月。采用混合方法进行过程评估，以评估“挺拔站立”项目的接受程度和可接受性。以完成规定剂量的百分比来衡量依从性，这是主要结果。
该研究于2019年10月至2021年9月在澳大利亚进行，于2020年11月至2022年4月在英国进行，受到了新冠疫情的影响。参与者的平均年龄为73±7岁，196名（81%）为女性。在接触的129个实施伙伴（如私人执业临床医生、社区运动提供者、社区服务机构）中，34%（n = 44）同意成为实施伙伴。在41个转介参与者的实施伙伴中，15个（37%）转介了≥5名参与者。参与者的接受率为42%（198/469），6个月内的平均依从性为规定运动量的41±39%（即每周39±41分钟）。6个月时，120名（76%）参与者表示他们喜欢使用“挺拔站立”项目，89名（56%）报告他们的平衡能力有所改善（中等程度到大幅改善），125名（80%）将“挺拔站立”项目评为良好到优秀。为了实现持续的可持续性，医疗服务管理者强调需要额外的资源。
由于新冠疫情和缺乏持续资金，“挺拔站立”项目在接受、采用和可持续性方面面临挑战。依从水平低于有效性试验，但高于其他运动研究。接受度很高，表明如果有足够的资源和支持，该项目在未来实施有望取得成功。
澳大利亚和新西兰临床试验注册中心ACTRN12619001329156
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