Developing an implementation framework for stair falls interventions

Principal Investigator - Dr Emma Mulliner, Senior Lecturer in Real Estate, Liverpool John Moores University

Stair falls cause many serious injuries in older adults. Improving home stair safety is vital to support healthy ageing.

The Research to Improve Stair Climbing Safety (RISCS) group at Liverpool John Moores University have been leading efforts to improve stair safety. RISCS have designed ways to reduce stair falls in their state-of-the-art laboratory, but it is not yet known how these can be put into practice in real homes. To be effective, potential interventions must be acceptable and adopted by end users and professional stakeholders.

The aim of this pump-priming project was to create a multi-stakeholder framework to guide the implementation of stair fall interventions in older people’s homes. The project engaged with a holistic network of stakeholders - including older adults (i.e. ‘end users’), service providers, housing providers, policy makers and regulatory bodies – to establish their attitudes, priorities and barriers towards the implementation of stair fall interventions in home settings.

Face to face focus groups were held with 8 older adults and 11 professionals from health and built environment disciplines in summer 2023.  These highlighted positive views of behavioural interventions (such as education and skills training), as well as the use of handrails and ambient lighting in homes. Such interventions were generally perceived as highly acceptable to older adults and a priority for implementation. Less agreement existed in opinions of interventions that require physical changes to the home environment (such as step edge highlighters, the use of optical illusions on inconsistent steps, and rebuilding stairs). While older adults and professionals held different views towards a number of interventions, common barriers to the use of interventions and facilitators that could encourage successful adoption have been established.

The project has assisted in determining the acceptability and implementation priority of a number of different stair falls-prevention interventions according to stakeholders. Dr Mulliner has discussed the project at engagement events focusing on age-friendly places and falls prevention.  There are also plans to present the project at conferences and to write up the findings for publication.

Collaborating Institutions - Liverpool John Moores University, Manchester Metropolitan University, Living Well, Sefton, Rise and Going Consultancy and MerseyCare NHS Foundation Trust