Improving balance in community-dwelling elders using trained volunteers within faith-based institutions: a mixed methods feasibility study

To investigate the feasibility and acceptability of a volunteer-led balance programme for older adults. A feasibility cluster RCT with focus groups were conducted in faith-based institutions. Eligibility criteria were: participants were ≥65 years, able to do five times sit -to-stand, had no falls in the previous six months and had good mental capacity. The intervention included supervised group exercises and exercise booklets for six months, education and a fall poster. Assessments included, TUG, MCTSiB, FTST, FES, mABC, OPQoL and DGLS at baseline, 6 weeks, and 6 months. Feasibility measures included numbers of volunteers, sessions, and volunteers” time commitment, views of participants about sustainability of program using qualitative focus groups and volunteers' ability to deliver programme. Three churches participated with 31 participants in each group. Participants had a mean age of 77.3 years, were 100% British, and 79% female. The sample size estimate for a future trial using TUG, was 79 per group. Focus groups showed perceived social and physical improvements in participants, need to extend the programme to the wider community, and increased confidence, participation and socialisation. The community-based balance training in faith-based institutions, was feasible and acceptable in one geographical area and requires evaluation in cohesive diverse communities.Implications for RehabilitationIf an institution or a community is united through faith, culture, national roots, or tradition, then these groups are ideal for such balance rehabilitation programmes, because of the familiarity of the location and people, cohesive culture or their ideology to help their communities.Participants and volunteers perceived improved participation, confidence and socialisation and were keen to continue programme.It is important to develop community-based falls prevention programmes that the National Health Service (NHS) can partially support using volunteers to reduce the burden of falls in the community and for the NHS. If an institution or a community is united through faith, culture, national roots, or tradition, then these groups are ideal for such balance rehabilitation programmes, because of the familiarity of the location and people, cohesive culture or their ideology to help their communities. Participants and volunteers perceived improved participation, confidence and socialisation and were keen to continue programme. It is important to develop community-based falls prevention programmes that the National Health Service (NHS) can partially support using volunteers to reduce the burden of falls in the community and for the NHS.

本研究旨在探究面向老年群体的志愿者主导式平衡训练项目的可行性与可接受性。本研究采用可行性整群随机对照试验（cluster RCT）结合焦点小组访谈的研究设计，在宗教信仰机构中开展。
纳入标准如下：受试者年龄≥65岁，能够完成5次坐-站动作（sit-to-stand），近6个月内无跌倒史，且精神状态良好。
干预方案为期6个月，包含监督式团体训练、训练手册、健康宣教及跌倒预防海报。
评估内容包括基线、6周及6个月随访时的计时起立行走试验（Timed Up and Go, TUG）、运动控制测试简版（MCTSiB）、功能性伸展测试（FTST）、跌倒效能感量表（FES）、修订版活动平衡信心量表（mABC）、老年生活质量问卷（OPQoL）及德比跌倒可能性量表（DGLS）。
可行性评估指标包括志愿者人数、培训场次、志愿者的时间投入情况，同时通过质性焦点小组访谈收集受试者对项目可持续性的看法，以及志愿者完成项目交付的能力。
本研究共有3所教堂参与，每组纳入31名受试者。受试者平均年龄为77.3岁，全部为英国籍，女性占比79%。
基于TUG指标的未来试验样本量估算结果为每组79例。
焦点小组访谈结果显示，受试者感知到自身社交与躯体状况得到改善，认为有必要将该项目推广至更广泛的社区，且受试者的自信心、参与度及社交互动均有所提升。
在宗教信仰机构中开展的社区式平衡训练项目在单一地理区域内具备可行性与可接受性，但仍需在具有凝聚力的多样化社区中开展进一步评估。
康复领域的启示：若某一机构或社区基于信仰、文化、民族根源或传统形成凝聚力，则此类群体是开展此类平衡康复项目的理想载体：其成员熟悉场地与彼此，拥有凝聚性的文化氛围，且具备助力社区发展的共同理念。
受试者与志愿者均认为自身的参与度、自信心及社交互动得到提升，并乐于继续参与该项目。
开发由英国国家医疗服务体系（National Health Service, NHS）提供部分支持、依托志愿者开展的社区跌倒预防项目具有重要意义，此举可减轻社区及NHS的跌倒相关负担。
若某一机构或社区基于信仰、文化、民族根源或传统形成凝聚力，则此类群体是开展此类平衡康复项目的理想载体：其成员熟悉场地与彼此，拥有凝聚性的文化氛围，且具备助力社区发展的共同理念。
受试者与志愿者均认为自身的参与度、自信心及社交互动得到提升，并乐于继续参与该项目。
开发由英国国家医疗服务体系（National Health Service, NHS）提供部分支持、依托志愿者开展的社区跌倒预防项目具有重要意义，此举可减轻社区及NHS的跌倒相关负担。