Mediators implementation and delivery: the falls management exercise programme (FaME).

Area of Science:

• Gerontology
• Public Health
• Exercise Science

Background:

• Implementing multicomponent interventions, such as community-based Falls Management Exercise (FaME) programmes, necessitates high fidelity for reproducible outcomes.
• This study examines factors influencing implementation strategy fidelity and intervention delivery fidelity in FaME programmes across England.

Purpose of the Study:

• To identify key influences on the fidelity of community-based Falls Management Exercise (FaME) programmes.
• To understand challenges impacting the consistent delivery of evidence-based falls prevention interventions.

Main Methods:

• A mixed-methodological approach was employed between 2021 and 2023.
• Data collection included 40 interviews with stakeholders, providers, and attendees, alongside 21 observations of FaME classes, field notes, and recordings of communities of practice.

Main Results:

• Lower fidelity to the FaME programme was observed in sites with limited oversight and funding.
• A lack of clarity regarding essential intervention components negatively impacted both implementation strategy and delivery fidelity.
• Mediators of fidelity include economic and organizational influences, oversight, evaluation, participant responsiveness, and provider knowledge/training.

Conclusions:

• Insufficient funding, formal oversight, and understanding of essential components are linked to reduced fidelity in evidence-based falls prevention programmes.
• Without local monitoring, intervention delivery may drift from the original evidence base.
• Recommendations include clarifying essential components, standardizing fidelity monitoring, and establishing effective local oversight.