Preparation

Identify potential barriers

Think about the potential barriers that may be encountered along the way and prepare your reaction to these barriers.

Some of the barriers you might encounter:

  • cost – develop a budget and estimate costs of creating, implementing, and enforcing the policy or environmental change;
  • resources – whether your partnership has members experienced in presenting the need for new policy or environmental changes, as well as designing environments, drafting policies, or building on existing relationships with others who can assist in these activities. A substantial amount of personnel time is required for all phases of these types of interventions, including:
  • planning and preparation phases – how to get access to stakeholders to draw attention to policy and environmental change, how to build support for these changes and how to get buy-in from community members to adopt a balanced eating pattern.
  • implementation and evaluation – how to find funds to support broader environmental changes (e.g., adding handrails, signs or fixing broken steps or sidewalks).
  • maintenance – how to keep participants eating healthy and how to allocate resources to sustaining the intervention activities over time;
  • political representatives and key decision makers – be persistent in trying to get the attention of policy-makers and influential community leaders. It may be important for you and your partners to get buy in from various key decision-makers – for example, representatives from pharmacies, businesses, retirement homes, assisted living centers, parks and recreation, transportation, or urban planning. These decision-makers may not understand the importance or want the added work of changing what is already offered or in existence. Others may feel burdened by having educational messages that put their staff in a position to have to respond to questions when they may not be prepared to do so;
  • loss of revenue – some decision-makers may be concerned that either changes in cost or availability of different products or costly changes to land use or the environment will result in an overall decrease in revenue. It may be important to work with decision-makers to develop ways to assess the impact of these changes upfront (e.g., public surveys, gather information from similar communities that have implemented these changes).

Barriers that have been encountered in other injuries from falls environments and policies are summarized below:

  • A substantial amount of personnel time is required for all phases of these types of interventions, including:
    • Planning and preparation phases – how to get access to stakeholders to draw attention to policy and environmental change, how to build support for these changes and how to get buy-in from community members to change environments or policies related to injuries from falls.
    • Implementation and evaluation phases – how to find funds to support broader environmental changes (e.g., pedestrian facilities in the community) and how to get people to use the resources (e.g., window guards, hip protectors).
    • Maintenance phases – how to maintain good habits to prevent injuries from falls and how to allocate resources to sustaining the intervention activities over time.
  • Creative administrators, goal-oriented staff, and funding are very important during start-up phases.
  • Literacy, language or other cultural barriers may get in the way of communicating about injuries from falls.
  • Information provided should be appropriate for the target audience (e.g., children, older adults).
  • Transient populations may be difficult to track over time.
  • Once an older person falls, they may be more likely to fall again, live in fear, and become less active, independent, and confident.
  • Prevention information, education and support may be more challenging with older adult populations at high risk because they may also suffer from impaired concentration, memory, perception and understanding.
  • Interventions targeting safety practices must provide instruction on proper and consistent use of safety precautions (e.g., hip protectors) in addition to information and resources.
  • Policy-based interventions require a coalition to be more thoughtful, strategic, and purposeful and these interventions require a different perspective than do activity-based programs interventions.
  • Coalition meetings can be diverted by groups with their own agendas that may oppose prevention efforts.
  • Other priorities may get in the way of making lifestyle changes (e.g., stress, illness, family, or relationship problems).
  • Social, economic, and environmental factors can have a strong influence on the intervention (e.g., poverty, chronic unemployment, access to health insurance).
  • Parental cooperation is essential for children to avoid use of infant walkers or increase use of safety gates.
  • Other interventions in schools, senior living centers, or other settings may compete with injury from falls environment and policy changes.

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