TY  - JOUR
PY  - 2023//
TI  - Reducing falls among community-dwelling older adults from clinicians' perspectives: a systems modeling approach
JO  - Innovation in aging
A1  - Koh, Vanessa Jean Wen
A1  - Matchar, David B.
A1  - Chan, Angelique Wei-Ming
A1  - Lee, June May-Ling
A1  - Lai, Wei Xuan
A1  - Rosario, Dulcie
A1  - George, Anne
A1  - Ho, Vanda
A1  - Ismail, Noor Hafizah Bte
A1  - Lien, Christopher Tsung Chien
A1  - Merchant, Reshma A.
A1  - Tan, Shuyan Melissa
A1  - Wong, Chek Hooi
A1  - Xu, Tianma
SP  - igad077
EP  - igad077
VL  - 7
IS  - 7
N2  - BACKGROUND AND OBJECTIVES: Falls among older adults are a significant health problem globally. Studies of multicomponent fall prevention programs in randomized controlled trials demonstrate effectiveness in reducing falls; however, the translation of research into the community remains challenging. Although there is an increasing interest to understand the factors contributing to implementation barriers, the dynamic relationships between factors are less well examined. Furthermore, evidence on implementation barriers from Asia is lacking as most of these studies originate from the West. As such, this study aims to engage stakeholders in uncovering the factors that facilitate or inhibit implementing community-based fall prevention programs in Singapore, with a focus on the interrelationship between those factors. RESEARCH DESIGN AND METHODS: Health care professionals familiar with fall prevention programs were invited to discuss the enablers and challenges to the implementation. This effort was facilitated using a systems modeling methodology of Group Model Building (GMB) to share ideas and create a common conceptual model of the challenges. The GMB employs various engagement techniques to draw on the experiences and perceptions of all stakeholders involved. <br><br>RESULTS: This process led to the development of a Causal Loop Diagram (CLD), a qualitative conceptual model of the dynamic relationships between the barriers and facilitators of implementing fall prevention programs. <br><br>RESULTS from the CLD show that implementation is influenced by two main drivers: health care provider factors that influenced referrals, and patient factors that influenced referral acceptance and long-term adherence. Key leverage points for potential interventions were identified as well. <br><br>DISCUSSION AND IMPLICATIONS: The overall recommendation emphasized closer coordination and collaboration across providers to ensure sustainable and effective community-based fall prevention programs. This has to be supported by a national effort, involving a multidisciplinary stakeholder advisory group. These findings generated would be promising to guide future approaches to fall prevention.<p />  <p>Language: en</p>
LA  - en
SN  - 2399-5300
UR  - http://dx.doi.org/10.1093/geroni/igad077
ID  - ref1
ER  -