SEARCHSYSTEMATIC_REVIEWpublic health, geriatrics

systematic_review·public health, geriatrics, epidemiology, systematic review, family medicine·PMC10210634

Contextual determinants influencing the implementation of fall prevention in the community: a scoping review

Frontiers in Health Services · 5 authors, 3 centres

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TL;DR

The majority of CFIR constructs operated as both barriers and facilitators, with collaborative stakeholder engagement, leadership, available resources, and patient needs emerging as essential determinants regardless of context.

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Additionally, 35 health and social care professionals were consulted during four consensus meetings in the Utrecht region of the Netherlands. Directed qualitative content analysis using the Consolidated Framework for Implementation Research identified determinants within 35 of 39 CFIR constructs. Twenty-one constructs were identified in both studies and consensus meetings, while 14 were found only in studies. Cross-sector collaboration, appropriate leadership, available resources, and consideration of patient needs emerged as frequently identified essential determinants. The authors note that most determinants functioned as both barriers and facilitators depending on their presence or absence.

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systematic_review

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public health

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ORIGINAL PAPER

PMC10210634

Contextual determinants influencing the implementation of fall prevention in the community: a scoping review

Frontiers in Health Services

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ABSTRACT

Abstract Background Successful implementation of multifactorial fall prevention interventions (FPIs) is essential to reduce increasing fall rates in community-dwelling older adults. However, implementation often fails due to the complex context of the community involving multiple stakeholders within and across settings, sectors, and organizations. As there is a need for a better understanding of the occurring context-related challenges, the current scoping review purposes to identify what contextual determinants (i.e., barriers and facilitators) influence the implementation of FPIs in the community. Methods A scoping review was performed using the Arksey and O'Malley framework. First, electronic databases (Pubmed, CINAHL, SPORTDiscus, PsycINFO) were searched. Studies that identified contextual determinants that influence the implementation of FPIs in the community were included. Second, to both validate the findings from the literature and identify complementary determinants, health and social care professionals were consulted during consensus meetings (CMs) in four districts in the region of Utrecht, the Netherlands. Data were analyzed following a directed qualitative content analysis approach, according to the 39 constructs of the Consolidated Framework for Implementation Research. Results Fourteen relevant studies were included and 35 health and social care professionals (such as general practitioners, practice nurses, and physical therapists) were consulted during four CMs. Directed qualitative content analysis of the included studies yielded determinants within 35 unique constructs operating as barriers and/or facilitators. The majority of the constructs ( n = 21) were identified in both the studies and CMs, such as “networks and communications”, “formally appointed internal implementation leaders”, “available resources” and “patient needs and resources”. The other constructs ( n = 14) were identified only in the studies. Discussion Findings in this review show that a wide array of contextual determinants are essential in achieving successful implementation of FPIs in the community. However, some determinants are considered important to address, regardless of the context where the implementation occurs. Such as accounting for time constraints and financial limitations, and considering the needs of older adults. Also, broad cross-sector collaboration and coordination are required in multifactorial FPIs. Additional context analysis is always an essential part of implementation efforts, as contexts may differ greatly, requiring a locally tailored approach. Keywords: fall prevention, implementation, contextual determinants, community-dwelling older adults, scoping review

CITATION EXPORT

M C van Scherpenseel, S J te Velde, C Veenhof et al.. Contextual determinants influencing the implementation of fall prevention in the community: a scoping review. Frontiers in Health Services. (2023). https://doi.org/10.3389/frhs.2023.1138517

AUTHORS

5 · 3 CENTRES

M C van Scherpenseel, S J te Velde, C Veenhof, M H Emmelot-Vonk, J A Barten

1Research Group Innovation of Human Movement Care, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, Netherlands
2Department of Rehabilitation, Physiotherapy Science and Sport, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
3Department of Geriatrics, University Medical Center Utrecht, Utrecht, Netherlands