Barriers and Facilitators to Secondary Falls Prevention After an ED Fall: Findings From the iSeFallED Focus Groups
Abstract
Introduction
Strength and balance training are effective components of falls prevention. However, primary prevention often fails to reach those at highest risk, partly because individuals may not perceive a need to engage in preventive measures. Secondary prevention may overcome this barrier, as a recent severe fall, such as one requiring emergency department (ED) treatment, can heighten the perceived need for action. Nonetheless, implementing falls prevention into standard care poses challenges, such as adoption and adherence. This study aims to explore barriers and facilitators influencing implementation of secondary falls prevention interventions following an ED-treated fall in older people.
Methods
Data collection involves eight focus groups each with five to seven persons participating in the iSeFallED study or their close relatives. The iSeFallED study enrolls adults aged ≥60 years who experienced a fall requiring an ED visit. Participants are classified as having mild or moderate risk for functional decline. Those at moderate risk are referred to a falls clinic and are offered a six-month training intervention, whereas those at mild risk receive an informational brochure on falls prevention and exercises in line with global recommendations. Focus groups are recorded and subsequently transcribed. Data are being analyzed using content analysis following Kuckartz
Results
The first three focus groups (n=16) were conducted in December 2025. Themes such as direct approach, social support within the training and individual training instructions were identified. Additional focus groups are planned until April 2026, providing further insights into the views of participants with lived experience and their relatives.
Discussion
Limiting barriers and enhancing facilitators within interventions may improve attrition and adherence in falls prevention studies. Hence, results from this study can serve to refine falls prevention interventions tailored to the needs of persons who visited the ED due to a fall, facilitating implementation.