Context makes a difference: a qualitative study exploring how to implement a multifactorial falls prevention...

Area of Science:

• Gerontology
• Public Health
• Implementation Science

Background:

• Falls pose a significant risk to community-dwelling older adults.
• Multifactorial falls prevention interventions are recommended but face implementation challenges.
• Contextual factors critically influence intervention implementation and outcomes.

Purpose of the Study:

• To analyze determinants influencing multifactorial falls prevention intervention implementation.
• To describe contextual factors at all levels impacting implementation in Flanders, Belgium.

Main Methods:

• Qualitative study using semi-structured interviews and focus groups with key persons, healthcare professionals, policymakers, and older adults.
• Utilized the Integrated Checklist of Determinants of Practice (TICD) checklist for interview guide development.
• Data analyzed using the Qualitative Analysis Guide of Leuven (QUAGOL) and NVivo 12™ software.

Main Results:

• Identified four key themes for successful implementation: stakeholder involvement, fostering awareness/knowledge/skills, proactive engagement, and coordinated care financing.
• 33 determinants from the TICD checklist were identified, spanning all seven domains.
• Contextual understanding is crucial for tailoring interventions.

Conclusions:

• Understanding community structures, norms, policies, and contextual factors is essential.
• Proactive tailoring of implementation strategies and interventions to the community context enhances effectiveness.
• Successful implementation hinges on a comprehensive approach addressing multiple determinants.