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

Fay Manning1,2, Jodi P Ventre3, Grace Brough4

  • 1National Institute for Health and Care Research Peninsula Applied Research Collaboration, University of Exeter Medical School, Exeter, EX1 2LU, UK. f.manning2@exeter.ac.uk.

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Summary
This summary is machine-generated.

Implementing community-based exercise programs like Falls Management Exercise (FaME) requires fidelity for consistent results. Insufficient funding, oversight, and understanding of core components hinder program fidelity.

Keywords:
ExerciseFallsFidelityImplementationMixed methodsOlder adults

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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.