Please use this identifier to cite or link to this item: https://doi.org/10.1093/geroni/igad077
Title: Reducing Falls Among Community-Dwelling Older Adults From Clinicians' Perspectives: A Systems Modeling Approach
Authors: Koh, Vanessa Jean Wen
Matchar, David B 
Chan, Angelique Wei-Ming 
Lee, June May-Ling 
Lai, Wei Xuan
Rosario, Dulcie
George, Anne
Ho, Vanda
Ismail, Noor Hafizah Bte
Lien, Christopher Tsung Chien 
Merchant, Reshma A 
Tan, Shuyan Melissa
Wong, Chek Hooi 
Xu, Tianma
Keywords: Science & Technology
Life Sciences & Biomedicine
Geriatrics & Gerontology
Gerontology
Accidental falls
Fall prevention
Group model building
Implementation
Systems dynamics
PREVENTING FALLS
HEALTH
INTERVENTIONS
MANAGEMENT
SINGAPORE
DYNAMICS
PEOPLE
CARE
Issue Date: 1-Sep-2023
Publisher: OXFORD UNIV PRESS
Citation: Koh, Vanessa Jean Wen, Matchar, David B, Chan, Angelique Wei-Ming, Lee, June May-Ling, Lai, Wei Xuan, Rosario, Dulcie, George, Anne, Ho, Vanda, Ismail, Noor Hafizah Bte, Lien, Christopher Tsung Chien, Merchant, Reshma A, Tan, Shuyan Melissa, Wong, Chek Hooi, Xu, Tianma (2023-09-01). Reducing Falls Among Community-Dwelling Older Adults From Clinicians' Perspectives: A Systems Modeling Approach. INNOVATION IN AGING 7 (7). ScholarBank@NUS Repository. https://doi.org/10.1093/geroni/igad077
Abstract: 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. 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. 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. 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.
Source Title: INNOVATION IN AGING
URI: https://scholarbank.nus.edu.sg/handle/10635/248924
ISSN: 2399-5300
DOI: 10.1093/geroni/igad077
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