Standing strong and tall-improving mobility and balance in older Aboriginal people through the Ironbark program.

BACKGROUND: Prevention of falls aids healthy ageing, but there are few Aboriginal-led and designed programs. OBJECTIVES: This study aimed to evaluate the effect of Ironbark, an Aboriginal co-designed fall prevention program, on functional mobility, a key indicator of falls. METHODS: This controlled pre-post study was conducted in organisations delivering services to Aboriginal people aged 45 years and older in New South Wales and Western Australia. A co-designed fall prevention program incorporating exercises and yarning circles targeting fall risk factors ('Ironbark Standing Strong and Tall') was compared to a social program ('Ironbark Healthy Community'). Data were collected at baseline and after 12 months of follow-up. RESULTS: The 'Ironbark Standing Strong and Tall' program was delivered at 16 sites and the 'Healthy Community' program at three. Due to lower recruitment than anticipated, combined analysis was not possible. There were significant improvements in the 'Ironbark Standing Strong and Tall' participants for the primary outcome of functional mobility (Short Performance Physical Battery; a change of 0.8 points, 95% CI: 0.4-1.1), reductions in stepping times, improvements in leg stance and increased incidental and planned exercise. There were no significant changes in falls, health-related quality of life (HRQoL) or psychological distress. Participants in the 'Healthy Community' sites had no change in functional mobility but saw declines in HRQoL, physical activity and stepping time. CONCLUSIONS: A co-designed and delivered program for older Aboriginal people, implemented in community settings aligned with stated priorities of Aboriginal older people, improved functional mobility.