Training community home care workers to deliver a tailored falls prevention Education and Exercise program to home care clients - TrEdEx an effectiveness-implementation study protocol

Frail, older people receiving supportive care in the home are at high risk of falls and functional decline that leads to either unplanned hospital admissions or permanent residential care, making it difficult to safely remain at home. Community home care organisations are well positioned to deliver high quality falls prevention programs if staff are suitably trained. This research aims to train community home care workers to deliver a fall prevention program to home care clients and evaluate program implementation and effectiveness. A 2-phase hybrid effectiveness-implementation, pre- post design using a realist approach will be undertaken with a home care organisation. Home care workers, comprising community therapy assistants and community support workers, employed by the organisation will be trained to deliver the program by the organisations allied health professional staff using a train the trainer model. A multi-media falls prevention program (education and exercises) will be tailored to the clients falls risk profile to raise falls awareness and promote physical activity and self-management. Clients receiving home care from the organisation will be recruited. Implementation of the program will be guided by the Consolidated Framework for Implementation Research, barriers and enablers will be identified at the client, staff, and organisation levels. Program effectiveness will be determined through client engagement, program satisfaction, knowledge acquisition, attitudes and enactment of falls prevention strategies, changes in functional mobility, falls and falls injuries and a cost-consequence analysis. If successful, home care clients may enhance their functional mobility and reduce their risk of falling, allowing them to stay safely at home. Home care organisations could positively contribute to the sustainable development of a well-trained workforce delivering evidence-based programs.