TY  - JOUR
PY  - 2022//
TI  - A realist evaluation of a multifactorial falls prevention programme in care homes
JO  - Age and ageing
A1  - Leighton, Paul A.
A1  - Darby, Janet
A1  - Allen, Frances
A1  - Cook, Marie
A1  - Evley, Rachel
A1  - Fox, Chris
A1  - Godfrey, Maureen
A1  - Gordon, Adam
A1  - Gladman, John
A1  - Horne, Jane
A1  - Robertson, Kate
A1  - Logan, Pip
SP  - afac263
EP  - afac263
VL  - 51
IS  - 12
N2  - BACKGROUND: falls in care homes are common, costly and hard to prevent.Multifactorial falls programmes demonstrate clinical and cost-effectiveness, but the heterogeneity of the care home sector is a barrier to their implementation. A fuller appreciation of the relationship between care home context and falls programme delivery will guide development and support implementation. <br><br>METHODS: this is a multi-method process evaluation informed by a realist approach.Data include fidelity observations, stakeholder interviews, focus groups, documentary review and falls-rate data. Thematic analysis of qualitative data and descriptive statistics are synthesised to generate care home case studies. <br><br>RESULTS: data were collected in six care homes where a falls programme was trialled. Forty-four interviews and 11 focus groups complemented observations and document review.The impact of the programme varied. Five factors were identified: (i) prior practice and (ii) training may inhibit new ways of working; (iii) some staff may be reluctant to take responsibility for falls; (iv) some may feel that residents living with dementia cannot be prevented from falling; and, (v) changes to management may disturb local innovation.In some care homes, training and improved awareness generated a reduction in falls without formal assessments being carried out. <br><br>CONCLUSIONS: different aspects of the falls programme sparked different mechanisms in different settings, with differing impact upon falls.The evaluation has shown that elements of a multifactorial falls programme can work independently of each other and that it is the local context (and local challenges faced), which should shape how a falls programme is implemented.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-0729
UR  - http://dx.doi.org/10.1093/ageing/afac263
ID  - ref1
ER  -