Reducing Falls Among Community-Dwelling Older Adults From Clinicians' Perspectives: A Systems Modeling Approach

Area of Science:

• Gerontology
• Public Health
• Implementation Science

Background:

• Falls in older adults represent a global health concern.
• Multicomponent fall prevention programs show effectiveness in trials but face implementation challenges in community settings.
• Limited research exists on implementation barriers in Asian contexts.

Purpose of the Study:

• To identify factors facilitating or inhibiting community-based fall prevention programs in Singapore.
• To explore the interrelationships between these implementation factors.
• To address the gap in Asian-centric research on fall prevention implementation.

Main Methods:

• Engaged healthcare professionals familiar with fall prevention programs.
• Utilized Group Model Building (GMB), a systems modeling methodology.
• Developed a Causal Loop Diagram (CLD) to visualize dynamic relationships.

Main Results:

• Implementation is driven by healthcare provider factors (referrals) and patient factors (acceptance, adherence).
• Identified key leverage points for targeted interventions.
• A qualitative conceptual model of barriers and facilitators was created.

Conclusions:

• Emphasized enhanced coordination and collaboration among providers for sustainable programs.
• Recommended a national effort with a multidisciplinary stakeholder advisory group.
• Findings offer guidance for future fall prevention strategies.