Factors influencing fall prevention programmes: The challenge of implementing the FaME programme in a complex landscape.
Abstract
Introduction The occurrence of falls in adults 65+ years remains a common and costly issue worldwide. Exercise programmes that improve strength and challenge balance have been shown to be the most effective intervention for reducing falls in community-dwelling older adults, such as the 6-month Falls Management Exercise (FaME) programme. Despite the pre-existing evidence base, the adoption of the FaME programme has been limited. Perspectives of multiple key stakeholder groups and providers of the FaME programme could future inform more successful adoption and implementation of fall prevention programmes such as FaME.
Methods Stakeholders and providers involved in local community fall prevention pathways were purposefully recruited from three geographical areas across England. Twenty-five semi-structured interviews were conducted to gain a broad understanding of factors affecting the adoption, implementation and spread of FaME. Data were analysed using an inductive thematic approach and mapped to the Consolidated Framework for Implementation Research (CFIR).
Results Data from 25 participant interviews and document analysis revealed 11 themes organised within five CFIR domains – the innovation (3), outer setting (3), inner setting (1), characteristics of individuals (1) and process (2).
Conclusion(s) The adoption, implementation and spread of FaME into community settings is complex and faces multiple health system challenges. For adoption and implementation to be facilitated, FaME programmes must demonstrate effectiveness and fit the local needs of those receiving the intervention. For spread to occur, influential commissioners must support wider programme roll out, whilst also securing sufficient expert capacity to deliver the programme. Further monitoring of the programme is recommended to determine effectiveness of provision for older adults. The tailoring of future implementation strategies may help to increase the national availability of FaME classes across the UK for those at greatest risk of falls.
Comments
Interesting insights into implementing FaME in practice
Thanks for sharing this poster, I liked that it focused on the real-world challenges of implementing falls programmes, not just whether they’re effective. Strong implementation stratgies are just as, if notmore important than effectiveness. FaME has a strong evidence base, so it was interesting to see the barriers around funding, staffing, sustainability, and system pressures highlighted so clearly.
I also thought the idea of “falls champions” and aligning programmes with local and national priorities was really important. It shows how much successful implementation depends on support across the whole system, not just the intervention itself. It is something we have also indentified in our implementation trials.
It would be interesting to know whether any of the regions involved identified particularly successful strategies for maintaining long-term funding and programme sustainability.
Important discussion around home modifications and falls prevent
Thanks for sharing this poster, The focus on the practical barriers people face when trying to make home modifications for falls prevention, was particularly interesting. It’s easy to recommend changes clinically, but this highlighted how factors like cost, awareness, motivation, and navigating services can really impact whether modifications actually happen.
I also liked that the poster/abstract looked at facilitators as well as barriers, particularly the role of education and support from healthcare professionals and family members.
It would be interesting to know whether there were any differences in attitudes or uptake between younger adults (50–65) and older age groups, and whether tailored approaches might help improve engagement.