Strategies to implement multifactorial falls prevention interventions in community-dwelling older persons: a systematic review
Abstract Background One-third of the community-dwelling older persons fall annually. Guidelines recommend the use of multifactorial falls prevention interventions. However, these interventions are difficult to implement into the community. This systematic review aimed to explore strategies used to i...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-02-01
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| Series: | Implementation Science |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13012-022-01257-w |
| _version_ | 1811165803182030848 |
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| author | Sara Vandervelde Ellen Vlaeyen Bernadette Dierckx de Casterlé Johan Flamaing Sien Valy Julie Meurrens Joris Poels Margot Himpe Goedele Belaen Koen Milisen |
| author_facet | Sara Vandervelde Ellen Vlaeyen Bernadette Dierckx de Casterlé Johan Flamaing Sien Valy Julie Meurrens Joris Poels Margot Himpe Goedele Belaen Koen Milisen |
| author_sort | Sara Vandervelde |
| collection | DOAJ |
| description | Abstract Background One-third of the community-dwelling older persons fall annually. Guidelines recommend the use of multifactorial falls prevention interventions. However, these interventions are difficult to implement into the community. This systematic review aimed to explore strategies used to implement multifactorial falls prevention interventions into the community. Methods A systematic search in PubMed (including MEDLINE), CINAHL (EBSCO), Embase, Web of Science (core collection), and Cochrane Library was performed and updated on the 25th of August, 2022. Studies reporting on the evaluation of implementation strategies for multifactorial falls prevention interventions in the community setting were included. Two reviewers independently performed the search, screening, data extraction, and synthesis process (PRISMA flow diagram). The quality of the included reports was appraised by means of a sensitivity analysis, assessing the relevance to the research question and the methodological quality (Mixed Method Appraisal Tool). Implementation strategies were reported according to Proctor et al.’s (2013) guideline for specifying and reporting implementation strategies and the Taxonomy of Behavioral Change Methods of Kok et al. (2016). Results Twenty-three reports (eighteen studies) met the inclusion criteria, of which fourteen reports scored high and nine moderate on the sensitivity analysis. All studies combined implementation strategies, addressing different determinants. The most frequently used implementation strategies at individual level were “tailoring,” “active learning,” “personalize risk,” “individualization,” “consciousness raising,” and “participation.” At environmental level, the most often described strategies were “technical assistance,” “use of lay health workers, peer education,” “increasing stakeholder influence,” and “forming coalitions.” The included studies did not describe the implementation strategies in detail, and a variety of labels for implementation strategies were used. Twelve studies used implementation theories, models, and frameworks; no studies described neither the use of a determinant framework nor how the implementation strategy targeted influencing factors. Conclusions This review highlights gaps in the detailed description of implementation strategies and the effective use of implementation frameworks, models, and theories. The review found that studies mainly focused on implementation strategies at the level of the older person and healthcare professional, emphasizing the importance of “tailoring,” “consciousness raising,” and “participation” in the implementation process. Studies describing implementation strategies at the level of the organization, community, and policy/society show that “technical assistance,” “actively involving stakeholders,” and “forming coalitions” are important strategies. Trial registration PROSPERO CRD42020187450 |
| first_indexed | 2024-04-10T15:42:32Z |
| format | Article |
| id | doaj.art-e3babc002b4c45c297310b1994415eac |
| institution | Directory Open Access Journal |
| issn | 1748-5908 |
| language | English |
| last_indexed | 2024-04-10T15:42:32Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science |
| spelling | doaj.art-e3babc002b4c45c297310b1994415eac2023-02-12T12:18:36ZengBMCImplementation Science1748-59082023-02-0118112410.1186/s13012-022-01257-wStrategies to implement multifactorial falls prevention interventions in community-dwelling older persons: a systematic reviewSara Vandervelde0Ellen Vlaeyen1Bernadette Dierckx de Casterlé2Johan Flamaing3Sien Valy4Julie Meurrens5Joris Poels6Margot Himpe7Goedele Belaen8Koen Milisen9Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU LeuvenDepartment of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU LeuvenDepartment of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU LeuvenDepartment of Public Health and Primary Care, Gerontology and GeriatricsDepartment of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU LeuvenDepartment of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU LeuvenDepartment of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU LeuvenDepartment of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU LeuvenDepartment of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU LeuvenDepartment of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU LeuvenAbstract Background One-third of the community-dwelling older persons fall annually. Guidelines recommend the use of multifactorial falls prevention interventions. However, these interventions are difficult to implement into the community. This systematic review aimed to explore strategies used to implement multifactorial falls prevention interventions into the community. Methods A systematic search in PubMed (including MEDLINE), CINAHL (EBSCO), Embase, Web of Science (core collection), and Cochrane Library was performed and updated on the 25th of August, 2022. Studies reporting on the evaluation of implementation strategies for multifactorial falls prevention interventions in the community setting were included. Two reviewers independently performed the search, screening, data extraction, and synthesis process (PRISMA flow diagram). The quality of the included reports was appraised by means of a sensitivity analysis, assessing the relevance to the research question and the methodological quality (Mixed Method Appraisal Tool). Implementation strategies were reported according to Proctor et al.’s (2013) guideline for specifying and reporting implementation strategies and the Taxonomy of Behavioral Change Methods of Kok et al. (2016). Results Twenty-three reports (eighteen studies) met the inclusion criteria, of which fourteen reports scored high and nine moderate on the sensitivity analysis. All studies combined implementation strategies, addressing different determinants. The most frequently used implementation strategies at individual level were “tailoring,” “active learning,” “personalize risk,” “individualization,” “consciousness raising,” and “participation.” At environmental level, the most often described strategies were “technical assistance,” “use of lay health workers, peer education,” “increasing stakeholder influence,” and “forming coalitions.” The included studies did not describe the implementation strategies in detail, and a variety of labels for implementation strategies were used. Twelve studies used implementation theories, models, and frameworks; no studies described neither the use of a determinant framework nor how the implementation strategy targeted influencing factors. Conclusions This review highlights gaps in the detailed description of implementation strategies and the effective use of implementation frameworks, models, and theories. The review found that studies mainly focused on implementation strategies at the level of the older person and healthcare professional, emphasizing the importance of “tailoring,” “consciousness raising,” and “participation” in the implementation process. Studies describing implementation strategies at the level of the organization, community, and policy/society show that “technical assistance,” “actively involving stakeholders,” and “forming coalitions” are important strategies. Trial registration PROSPERO CRD42020187450https://doi.org/10.1186/s13012-022-01257-wCommunity settingPrimary health careImplementationPractice guidelinesFalls preventionAged |
| spellingShingle | Sara Vandervelde Ellen Vlaeyen Bernadette Dierckx de Casterlé Johan Flamaing Sien Valy Julie Meurrens Joris Poels Margot Himpe Goedele Belaen Koen Milisen Strategies to implement multifactorial falls prevention interventions in community-dwelling older persons: a systematic review Implementation Science Community setting Primary health care Implementation Practice guidelines Falls prevention Aged |
| title | Strategies to implement multifactorial falls prevention interventions in community-dwelling older persons: a systematic review |
| title_full | Strategies to implement multifactorial falls prevention interventions in community-dwelling older persons: a systematic review |
| title_fullStr | Strategies to implement multifactorial falls prevention interventions in community-dwelling older persons: a systematic review |
| title_full_unstemmed | Strategies to implement multifactorial falls prevention interventions in community-dwelling older persons: a systematic review |
| title_short | Strategies to implement multifactorial falls prevention interventions in community-dwelling older persons: a systematic review |
| title_sort | strategies to implement multifactorial falls prevention interventions in community dwelling older persons a systematic review |
| topic | Community setting Primary health care Implementation Practice guidelines Falls prevention Aged |
| url | https://doi.org/10.1186/s13012-022-01257-w |
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