Evidence map›Paper›PMID 42328810›Full record

ArticleAge and ageing2026

Implementation of the Ironbark falls prevention program: a mixed methods process evaluation with Aboriginal communities.

Grace McKeon, Zarayn Knight, Rebecca Ivers, Julieann Coombes, Vanessa Jessup, Kim Delbaere, Catherine Sherrington, Anne Tiedemann, Anne-Marie Hill, Leanne McCarthy and 4 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Age and ageing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Grace McKeonInstitute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University,  Melbourne, Victoria, Australia.ORCID 0000-0003-4722-1639
Zarayn KnightSchool of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
Rebecca IversSchool of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
Julieann CoombesThe George Institute for Global Health, Sydney, New South Wales, Australia.
Vanessa JessupWA Centre for Health and Ageing, The University of Western Australia, Perth, Australia.
Kim DelbaereSchool of Health Sciences, Health Translation Hub, University of New South Wales, Randwick, New South Wales 2031, Australia.ORCID 0000-0002-5655-0234
Catherine SherringtonInstitute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia.
Anne TiedemannInstitute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia.
Anne-Marie HillSchool of Allied Health, The University of Western Australia, 35 Stirling Hwy, Crawley, Perth, Western Australia 6009, Australia.ORCID 0000-0003-1411-6752
Leanne McCarthySchool of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
Bronte HaynesNgarruwan Ngadju First Peoples Health and Wellbeing Research Center, University of Wollongong, Wollongong, New South Wales, Australia.
Courtney RyderSchool of Population Health, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0001-6511-1965
Rona MacnivenSchool of Population Health, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0002-2967-7977
Ironbark Investigator Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFalls are a leading cause of injury and loss of independence among older Aboriginal people. The Ironbark program is a culturally co-designed, community-based fall prevention initiative, incorporating exercises and Yarning circles, a culturally grounded form of group discussion. This paper presents a process evaluation of the program, examining fidelity and key factors influencing implementation across settings.

methodsSixteen sites across two Australian states implemented the Ironbark Standing Strong and Tall program. Process data were collected from 15 sites through structured session observations and semi-structured interviews with exercise facilitators. Fidelity and dose were assessed quantitatively, with adherence scored using a summative checklist score. Qualitative data were thematically analysed and mapped onto the Consolidated Framework for Implementation Research (CFIR).

resultsThe program was delivered with high fidelity to 117 participants with median adherence scores consistently above 80%. Sessions were implemented as planned, with strong participant engagement in both exercise and Yarning components. Key facilitators included Aboriginal leadership, trusted site managers, program flexibility and supportive service structures. Challenges included managing varying physical abilities, maintaining engagement over time and external disruptions (e.g. Coronavirus -19 pandemic, weather). Content repetition was noted as a barrier to sustained attendance by participants in later stages. Facilitators recommended additional training, mid-program assessments and access to site-collected data. Sustainability was linked to workforce capacity and securing ongoing funding, particularly to support Aboriginal staff and transport.

conclusionThis process evaluation indicated that a culturally-relevant fall prevention program for older Aboriginal people can be implemented with fidelity across community settings. Findings provide practical guidance for exercise facilitators and on sustaining and expanding the Ironbark program and inform broader efforts to embed culturally safe, community-led health programs in routine practice.

Indexed as

Accidental FallsExercise TherapyHealth Services, IndigenousAgedAustraliaCulturally Competent CareHumansProcess Assessment, Health CareProgram EvaluationQualitative ResearchAboriginal and Torres Strait Islander peoplesexercisefalls preventionimplementationolder adultsqualitative research

Identifiers

PMID42328810
PMCPMC13284708

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.