Tailored implementation of national recommendations on fall prevention among older adults in municipalities in Norway (FALLPREVENT trial): a study protocol for a cluster-randomised trial

Maria Bjerk, SA Flottorp, A.H. Pripp, H Øien, TM Hansen, Robbie Foy, Jacqueline Close, S Linnerud, Therese Brovold, Rune Solli, Nina Rydland Olsen, Dawn Skelton, Elisabeth Rydwik, Jorunn L Helbostad, Gro Idland, Edgar Vieira, Kristin Taraldsen

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Abstract

Background
Despite substantial research evidence indicating the effectiveness of a range of interventions to prevent falls, uptake into routine clinical practice has been limited by several implementation challenges. The complexity of fall prevention in municipality health care underlines the importance of flexible implementation strategies tailored both to general determinants of fall prevention and to local contexts. This cluster-randomised trial (RCT) investigates the effectiveness of a tailored intervention to implement national recommendations on fall prevention among older home-dwelling adults compared to usual practice on adherence to the recommendations in health professionals.

Methods
Twenty-five municipalities from four regions in Norway will be randomised to intervention or control arms. Each municipality cluster will recruit up to 30 health professionals to participate in the study as responders. The tailored implementation intervention comprises four components: (1) identifying local structures for implementation, (2) establishing a resource team from different professions and levels, (3) promoting knowledge on implementation and fall prevention and (4) supporting the implementation process. Each of these components includes several implementation activities. The Consolidated Framework for Implementation Research (CFIR) will be used to categorise determinants of the implementation process and the Expert Recommendations for Implementing Change (ERIC) will guide the matching of barriers to implementation strategies. The primary outcome measure for the study will be health professionals’ adherence to the national recommendations on fall prevention measured by a questionnaire. Secondary outcomes include injurious falls, the feasibility of the intervention, the experiences of the implementation process and intervention costs. Measurements will be carried out at baseline in August 2023, post-intervention in May 2024 and at a follow-up in November 2024.

Discussion
This study will provide evidence on the effectiveness, intervention costs and underlying processes of change of tailored implementation of evidence-based fall prevention recommendations.

Trial registration
The trial is registered in the Open Science Registry: https://doi.org/10.17605/OSF.IO/JQ9T5. Registered: March 03, 2023.
Original languageEnglish
Article number5
Number of pages11
JournalImplementation Science
Volume19
DOIs
Publication statusPublished - 25 Jan 2024

Keywords

  • protocol
  • effectiveness
  • falls prevention
  • exercise
  • Norway
  • implementation
  • older adults
  • municipalities
  • implementation science
  • implementation strategies
  • municipal health services
  • Guidelines
  • 3–10 Implementation science
  • Cluster-randomised trial
  • National recommendations
  • Implementation intervention

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy
  • Health Informatics

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