Exploring barriers and facilitators to fall prevention among older adults in Saudi Arabia: a qualitative study

Falls are a leading cause of injury, disability, and hospitalization among older adults in Saudi Arabia. Despite international advances in fall prevention, local barriers, particularly those related to culture, education, and resource availability, remain insufficiently explored.

This study aimed to explore the key barriers and facilitators to fall prevention among adults aged 65 and older in Saudi Arabia, and to examine how cultural, educational, and socioeconomic factors influence implementation efforts.

A qualitative descriptive design was employed using semi-structured interviews with 16 healthcare professionals, including nurses, physical therapists, occupational therapists, and general practitioners, recruited from governmental and private hospitals. Interviews were conducted in Arabic, transcribed verbatim, and analyzed using a hybrid inductive-deductive approach. Themes were mapped to the Theoretical Domains Framework (TDF) to ensure theoretical rigor and contextual depth.

Participants identified multiple barriers, including patient and caregiver unawareness, cultural stigmas around assistive device use, high workloads, inadequate staff training, and poorly designed environments. Facilitators included comprehensive assessments, tailored education programs, strong family engagement, interdisciplinary teamwork, and availability of assistive technologies. An emergent theme, "person-centered care," emphasized the need for individualized, flexible strategies beyond the TDF structure.

Effective fall prevention in Saudi Arabia requires culturally sensitive, system-wide strategies that address both structural constraints and individual-level beliefs. By enhancing interdisciplinary coordination, improving education, and prioritizing patient-centered approaches, healthcare systems can better support safe aging and reduce fall-related risks among older adults.