Abstract for: Reducing falls among community-dwelling older adults from clinicians’ perspectives: A systems modelling approach

Falls among older adults are a significant health problem globally. Studies of multicomponent fall prevention programmes demonstrate effectiveness in reducing falls, however, the translation of research into the community remains challenging. While there is an increasing interest to understand the factors contributing to implementation barriers, the dynamic relationships between factors are less well-examined. This study aims to engage stakeholders in uncovering the factors influencing the implementation of community-based fall prevention programmes in Singapore. Healthcare professionals familiar with fall prevention programmes were invited to discuss the enablers and challenges to the implementation. This effort was facilitated using a systems modelling methodology of Group Model Building (GMB), to discuss and develop a shared conceptual of the challenges. This process led to the development of a Causal Loop Diagram (CLD), a qualitative model demonstrating the dynamic relationships between the barriers and facilitators of implementing fall prevention programmes. Results from the CLD show that implementation is influenced by two main drivers: healthcare provider factors that influenced referrals, and patient factors that influenced referral acceptance and long-term adherence. The overall recommendation emphasised closer coordination across providers, supported by a national effort involving multidisciplinary stakeholder advisory groups, to ensure sustainable and effective community-based fall prevention programmes.