**Background:** Fall rates among community-dwelling older adults are rising due to population aging, with over one-third of those aged 65+ falling each year. Multifactorial fall prevention interventions (FPIs) are recommended but often fail due to complex contextual challenges across multiple stakeholders, settings, and sectors. This scoping review aimed to identify contextual determinants (barriers and facilitators) influencing FPI implementation in the community.
**Methods:** The review followed the Arksey and O'Malley framework. Electronic databases (PubMed, CINAHL, SPORTDiscus, PsycINFO) were searched in March 2022, with updates in October 2022 and March 2023. Studies were included if they described barriers/facilitators to FPI implementation for community-dwelling older adults, were conducted in community settings, used (partly) qualitative designs, were published since 2010, and were in English or Dutch. Non-Western studies, eHealth interventions, and studies focusing solely on screening/assessment or on older adults' perceptions only were excluded. To validate and complement literature findings, four consensus meetings (CMs) were held with 35 health and social care professionals (HSCPs) across four districts in Utrecht, the Netherlands. Data were analyzed using directed qualitative content analysis according to the 39 constructs of the Consolidated Framework for Implementation Research (CFIR).
**Key Results:** The search yielded 308 initial studies, plus 34 and 376 additional studies from updates; after removing 302 duplicates and screening, 25 full-text articles were assessed, and 15 studies were included. The 15 studies were conducted in Norway (3), Australia (3), the Netherlands (3), Switzerland (2), Canada (2), and the USA (2). Eleven focused on primary care; four on broader community settings. Ten used qualitative methods only; five used mixed methods. The four CMs involved 35 HSCPs (mean 9 per meeting, range 7–13), including general practitioners, physical therapists, dieticians, community nurses, occupational therapists, pharmacists, and social workers. Directed qualitative content analysis identified determinants within 35 unique CFIR constructs. Twenty-one constructs were identified in both the literature and CMs; 14 constructs were identified only in the literature. The majority of determinants could act as both barriers and facilitators depending on presence or absence. Key determinants consistently identified across both sources included: "networks and communications" (12 studies, all CMs), "cosmopolitanism" (networking with external organizations; 12 studies, all CMs), "available resources" (time, money, staff, training, space; 12 studies, all CMs), "patient needs and resources" (10 studies, all CMs), "external policy and incentives" (funding, policies, guidelines; 11 studies, all CMs), "knowledge and beliefs about the intervention" (11 studies, 2 CMs), "other personal attributes" (enthusiasm, motivation, skills; 10 studies, 3 CMs), "formally appointed internal implementation leaders" (8 studies, all CMs), and "engaging" the right stakeholders (9 studies, 2 CMs). Determinants identified only in the literature included "intervention source," "trialability," "opinion leaders," "champions," "external change agents," and "executing."
**Clinical Implications:** Successful implementation of FPIs in the community requires addressing a broad array of contextual determinants. However, several core determinants appear essential regardless of local context: establishing collaborative cross-sector relationships and clear communication among stakeholders; ensuring adequate time, financing, and staffing; appointing strong, engaged implementation leaders; and accounting for older adults' needs, including their reluctance to acknowledge fall risk and practical barriers such as cost and transportation. The variation in identified determinants across studies and communities underscores that context analysis is always necessary to tailor implementation strategies locally. The next step is to select and design implementation strategies that match the locally identified determinants, which will ultimately support wider and more structural implementation of FPIs to reduce falls among the aging population.