University of Manitoba, Winnipeg, Canada.
University of New Brunswick, Fredricton, Canada.
Age Ageing. 2024 Aug 6;53(8). doi: 10.1093/ageing/afae186.
Exercise that challenges balance is the most effective fall prevention intervention in community-dwelling older adults. Identifying factors influencing implementation of community fall prevention exercise programs is a critical step in developing strategies to support program delivery.
To identify implementation facilitators, barriers, and details reported in peer-reviewed publications on community fall prevention exercise for older adults.
Scoping review.
We searched multiple databases up to July 2023 for English-language publications that reported facilitators and/or barriers to implementing an evidence-based fall prevention exercise program in adults aged 50+ years living independently. At least two reviewers independently identified publications and extracted article, implementation, and exercise program characteristics and coded barriers and facilitators using the Consolidated Framework for Implementation Research (CFIR).
We included 22 publications between 2001 and July 2023 that reported factors influencing implementation of 10 exercise programs. 293 factors were reported: 183 facilitators, 91 barriers, 6 described as both a facilitator and barrier, and 13 unspecified factors. Factors represented 33 CFIR constructs across all five CFIR domains: implementation inner setting (n = 95 factors); innovation (exercise program) characteristics (n = 84); individuals involved (n = 54); implementation process (n = 40) and outer setting (n = 20). Eight publications reported implementation strategies used; 6 reported using a conceptual framework; and 13 reported implementation outcomes.
The high number of factors reflects the complexity of fall prevention exercise implementation. The low reporting of implementation strategies, frameworks and outcomes highlight the ongoing need for work to implement and sustain community fall prevention exercise programs.
挑战平衡的运动是社区中老年人中最有效的预防跌倒干预措施。确定影响社区预防跌倒运动计划实施的因素是制定支持计划实施策略的关键步骤。
确定社区预防老年人跌倒运动计划实施的促进因素、障碍因素和在同行评议文献中报告的细节。
范围综述。
我们搜索了多个数据库，截至 2023 年 7 月，以获取报告 50 岁以上独立生活的成年人实施基于证据的预防跌倒运动计划的促进因素和/或障碍的英文出版物。至少两名评审员独立确定出版物，并提取文章、实施和运动计划特征，并使用实施研究综合框架 (CFIR) 对障碍和促进因素进行编码。
我们纳入了 2001 年至 2023 年 7 月期间报告影响 10 项运动计划实施因素的 22 篇出版物。共报告了 293 个因素：183 个促进因素、91 个障碍因素、6 个被描述为促进因素和障碍因素、13 个未指定因素。这些因素代表了所有五个 CFIR 领域的 33 个 CFIR 结构：实施内部环境（n=95 个因素）；创新（运动计划）特征（n=84）；参与的个体（n=54）；实施过程（n=40）和外部环境（n=20）。有 8 篇出版物报告了实施策略的使用情况；6 篇报告使用了概念框架；13 篇报告了实施结果。
大量的因素反映了预防跌倒运动实施的复杂性。实施策略、框架和结果报告的低水平突出了实施和维持社区预防跌倒运动计划工作的持续需求。
