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Implementation fidelity of the Falls Management Exercise Programme: a mixed methods analysis using a conceptual

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The Falls Management Exercise (FaME) program shows good implementation fidelity in community settings, though some elements require improvement to maximize benefits for older adults and reduce falls. Strategies can enhance program quality and effectiveness.

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Area of Science:

  • Gerontology
  • Public Health
  • Exercise Science

Background:

  • Falls in older adults lead to severe health consequences and high healthcare costs.
  • The Falls Management Exercise (FaME) program effectively improves balance and reduces falls in clinical trials.
  • Real-world delivery of FaME shows modest outcomes, necessitating fidelity assessment for optimization.

Purpose of the Study:

  • To assess the implementation fidelity of the FaME program in community settings.
  • To identify deviations from the intended FaME program delivery.
  • To inform quality improvement strategies for maximizing program effectiveness.

Main Methods:

  • A mixed-methods study design was employed to evaluate FaME program delivery.
  • Data were collected through program registers, expert class observations, and instructor interviews.
  • Quantitative data were analyzed using descriptive statistics, and qualitative data underwent thematic analysis.

Main Results:

  • 40% of 356 participants completed at least 75% of FaME classes.
  • 72%-78% of program content was delivered, with 80%-84% quality criteria met.
  • Key omissions included home exercises and strength progression; instructor interviews revealed reasons for deviations.

Conclusions:

  • FaME programs can be implemented with high fidelity in community settings, but specific deviations impact effectiveness.
  • Facilitation strategies are crucial for improving program fidelity and participant outcomes.
  • Targeted quality improvements can enhance the real-world effectiveness of the FaME program.