Context makes a difference: a qualitative study exploring how to implement a multifactorial falls prevention intervention in the community

Abstract Background Falls are a major problem in community-dwelling older people. Multifactorial falls prevention interventions are recommended as intervention. However, poor implementation impacts successful outcomes of multifactorial falls prevention interventions. The context is critical to under...

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Main Authors: Sara Vandervelde, Bernadette Dierckx de Casterlé, Ellen Vlaeyen, Johan Flamaing, Sien Valy, Goedele Belaen, Koen Milisen
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-21561-6
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author Sara Vandervelde
Bernadette Dierckx de Casterlé
Ellen Vlaeyen
Johan Flamaing
Sien Valy
Goedele Belaen
Koen Milisen
author_facet Sara Vandervelde
Bernadette Dierckx de Casterlé
Ellen Vlaeyen
Johan Flamaing
Sien Valy
Goedele Belaen
Koen Milisen
author_sort Sara Vandervelde
collection DOAJ
description Abstract Background Falls are a major problem in community-dwelling older people. Multifactorial falls prevention interventions are recommended as intervention. However, poor implementation impacts successful outcomes of multifactorial falls prevention interventions. The context is critical to understand variation in implementation and clinical outcomes. This study aims to analyze and describe determinants at all levels of the context that influence the implementation of a multifactorial falls prevention intervention in the community in Flanders (Belgium). Methods This study consists of semi-structured interviews with 6 key persons, 3 focus group interviews with healthcare professionals (n = 16), 1 focus group with local policy makers (n = 6) and 4 semi-structured interviews and 1 focus group (n = 3) with older people. The Integrated Checklist of Determinants of Practice (TICD checklist) was used to develop the interview guide and to make sure that there was enough understanding of the contextual determinants at the different domains. The interviews and focus groups were verbatim transcribed and analyzed using the Qualitative Analysis Guide of Leuven (QUAGOL). To clarify themes, data were coded in NVivo 12™. Results We identified 4 key themes related to successful implementation of a multifactorial falls prevention intervention in the community setting: (1) stakeholder involvement and participation, (2) Fostering awareness, beliefs, knowledge, and skills for falls prevention, (3) working proactively and (4) communication, collaboration, coordination and financing care. This study identified 33 determinants of the TICD checklist and all 7 domains were represented. Conclusions Understanding the existing structures, norms, policies and contextual factors allows us to proactively tailor the implementation strategies and a multifactorial falls prevention intervention to the community context.
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spelling doaj-art-bb4f2b04b792433e80af04ea13cccd792025-02-09T12:58:43ZengBMCBMC Public Health1471-24582025-02-0125111410.1186/s12889-025-21561-6Context makes a difference: a qualitative study exploring how to implement a multifactorial falls prevention intervention in the communitySara Vandervelde0Bernadette Dierckx de Casterlé1Ellen Vlaeyen2Johan Flamaing3Sien Valy4Goedele Belaen5Koen Milisen6Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU LeuvenDepartment of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU LeuvenDepartment of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU LeuvenDepartment of Public Health and Primary Care, Gerontology and Geriatrics, KU LeuvenDepartment of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU LeuvenDepartment of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU LeuvenDepartment of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU LeuvenAbstract Background Falls are a major problem in community-dwelling older people. Multifactorial falls prevention interventions are recommended as intervention. However, poor implementation impacts successful outcomes of multifactorial falls prevention interventions. The context is critical to understand variation in implementation and clinical outcomes. This study aims to analyze and describe determinants at all levels of the context that influence the implementation of a multifactorial falls prevention intervention in the community in Flanders (Belgium). Methods This study consists of semi-structured interviews with 6 key persons, 3 focus group interviews with healthcare professionals (n = 16), 1 focus group with local policy makers (n = 6) and 4 semi-structured interviews and 1 focus group (n = 3) with older people. The Integrated Checklist of Determinants of Practice (TICD checklist) was used to develop the interview guide and to make sure that there was enough understanding of the contextual determinants at the different domains. The interviews and focus groups were verbatim transcribed and analyzed using the Qualitative Analysis Guide of Leuven (QUAGOL). To clarify themes, data were coded in NVivo 12™. Results We identified 4 key themes related to successful implementation of a multifactorial falls prevention intervention in the community setting: (1) stakeholder involvement and participation, (2) Fostering awareness, beliefs, knowledge, and skills for falls prevention, (3) working proactively and (4) communication, collaboration, coordination and financing care. This study identified 33 determinants of the TICD checklist and all 7 domains were represented. Conclusions Understanding the existing structures, norms, policies and contextual factors allows us to proactively tailor the implementation strategies and a multifactorial falls prevention intervention to the community context.https://doi.org/10.1186/s12889-025-21561-6Community settingImplementationFalls preventionAgedContextual analysis
spellingShingle Sara Vandervelde
Bernadette Dierckx de Casterlé
Ellen Vlaeyen
Johan Flamaing
Sien Valy
Goedele Belaen
Koen Milisen
Context makes a difference: a qualitative study exploring how to implement a multifactorial falls prevention intervention in the community
BMC Public Health
Community setting
Implementation
Falls prevention
Aged
Contextual analysis
title Context makes a difference: a qualitative study exploring how to implement a multifactorial falls prevention intervention in the community
title_full Context makes a difference: a qualitative study exploring how to implement a multifactorial falls prevention intervention in the community
title_fullStr Context makes a difference: a qualitative study exploring how to implement a multifactorial falls prevention intervention in the community
title_full_unstemmed Context makes a difference: a qualitative study exploring how to implement a multifactorial falls prevention intervention in the community
title_short Context makes a difference: a qualitative study exploring how to implement a multifactorial falls prevention intervention in the community
title_sort context makes a difference a qualitative study exploring how to implement a multifactorial falls prevention intervention in the community
topic Community setting
Implementation
Falls prevention
Aged
Contextual analysis
url https://doi.org/10.1186/s12889-025-21561-6
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