A Priority Setting Partnership to Identify Fall-Prevention Research Priorities Among Canadian Knowledge Users: Phase 1 Results

Introduction: Despite well-defined evidence for fall prevention (FP), fall rates and consequences among older adults remain largely unchanged. Historically, knowledge users (KUs; older adults, caregivers, clinicians) have had limited involvement in research informing FP efforts. Identifying consensus-derived priorities to guide future research that are grounded in KUs lived experience may help bridge this evidence–practice gap. Accordingly, we aim to generate national fall-prevention research priorities for community-dwelling older adults.

Methods: A modified James Lind Alliance Priority Setting Partnership exercise was conducted with support from a Steering Group of diverse KUs. The process includes three phases: 1) an initial survey, 2) a follow-up survey, and 3) an in-person workshop. In Phase 1, respondents were asked to complete nine open-ended questions exploring FP concerns in community settings. The survey was distributed via social media, through healthcare champions, and by phone to randomly selected phone numbers. Responses were analysed using content analysis by two independent analysts.

Results: The Steering Group included 12 members (older adults, caregivers, and clinicians). Members cited concerns for a loved one, about fall risk after witnessing a fall, or, among clinicians, observing the distress falls cause for patients and families as motivations for participation. The initial Phase 1 survey was completed by 218 respondents (including 94 older adults, 45 clinicians, and 48 caregivers), generating 1,841 open-ended responses. Responses were grouped into six overarching categories related to fall definition, occurrence, risk, prevention, impact, and cross-cutting themes. The five most common subthemes related to environmental attributes (n=293 coded responses), psychosocial influences (n=284), access to FP initiatives (n=246), physical fitness (n=189), and intrapersonal considerations (n=179).

Conclusions: Phase 1 of our priority-setting process generated a comprehensive and meaningful inventory of FP priorities. Future phases will involve ranking these priorities to identify those most salient to non-research KUs and guide FP research agendas.