Sustainability Of Fall Prevention Exercise Programmes For Community-Dwelling Older Adults: A Scoping Review

Introduction

Exercise-based fall-prevention programmes effectively reduce falls among community-dwelling older adults; however, sustaining these initiatives remains a persistent challenge. Programme sustainability is critical for optimizing resources, maintaining community trust, and achieving lasting population-level benefits. This scoping review examined factors influencing the sustainability of community-based fall-prevention exercise programmes using the Program Sustainability Assessment Tool (PSAT).

Methods

A scoping review was conducted following Joanna Briggs Institute methodology and the PRISMA-ScR framework. Databases searched included Medline, EMBASE, CINAHL, Academic Search Premier, APA PsycINFO, and SPORTDiscus, with no restrictions on language, publication date, or geographic location. From 4,110 records screened, 75 full texts were reviewed, 24 studies met inclusion criteria, with four additional studies identified through citation searching, resulting in 28 included studies. Data were extracted and synthesised according to PSAT domains.

Results

Across the 28 included studies, most programmes received strong initial support but lacked reported strategies for long-term sustainability. Partnership (28 studies) and Environmental Support (25 studies) were among the strongest domains, typically reflecting collaborations with public health agencies, healthcare systems, and local organizations. Organizational capacity (28 studies) focused mainly on trained instructors and coordination, with less emphasis on workforce continuity or succession planning. While funding stability was reported in 28 studies, it often relied on short-term or pilot funding. Programme evaluation (24 studies) was predominantly research-driven, and strategic planning was rarely addressed (10 studies), with little description of formal planning structures or long-term operational planning.

Conclusions

Studies reported strong environmental support and partnerships but limited attention to long-term funding stability and strategic planning, suggesting programmes are well embedded in communities yet dependent on short-term resources. For practitioners, this highlights the need to integrate sustainability considerations into routine programme delivery; for policymakers and funders, stable funding mechanisms and strategic infrastructure are critical to supporting long-term scale-up and sustainment