A co-designed conceptual model for implementing falls prevention programmes for community-dwelling older adults in Singapore: a systems thinking approach.

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Tác giả: Angelique Wei-Ming Chan, Mimaika Luluina Ginting, Jing Wen Goh, Vanda Wen Teng Ho, Hozaidah Hosain, Noor Hafizah Binte Ismail, Vanessa Jean Wen Koh, Wei Xuan Lai, Christopher Lien, Doris Yanshan Lim, David Bruce Matchar, Reshma Aziz Merchant, Joann Poh, Shawn Leng Hsien Soh, Abhijit Visaria

Ngôn ngữ: eng

Ký hiệu phân loại: 796.158 Kites

Thông tin xuất bản: England : Age and ageing , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 525784

INTRODUCTION: Implementing falls prevention programmes in the community presents numerous challenges. We sought to understand the dynamics between the determinants influencing implementation to develop a common conceptual model describing the complexities of implementing falls prevention programmes in Singapore. METHODS: A full-day group model building workshop with a series of structured activities was organised with 31 multidisciplinary stakeholders. Stakeholders who attended include healthcare professionals of different specialities (i.e. geriatrics, rehabilitation medicine, physiotherapy, nursing), community-based voluntary welfare organisations, researchers and policymakers. RESULTS: A causal loop diagram was developed to illustrate the determinants influencing implementation of community-based fall prevention programmes. It revealed factors driving key implementation and service outcomes in supply and demand of such programmes. Determinants of these outcomes were synthesised into four themes: (i) structural factors affecting the management and resource allocation for community-based falls prevention programmes, (ii) participation in programmes affected by older adults' willingness and ability to participate, (iii) perceived value as a composite of costs and benefits, and (iv) social support and exercise self-efficacy motivating long-term adherence. Furthermore, in our analysis of feedback relationships, two organisational behaviours were identified: unsustainable growth due to resource constraints (Limits to Growth) and tensions between executing symptomatic or fundamental solutions (Eroding Goals). Stakeholders also explored strategies for effective implementation. CONCLUSIONS: A conceptual model describing the dynamics of implementing community-based fall prevention programmes was developed. This informed the formulation of a National Falls Prevention Framework, a priority action step for the effective implementation of these programmes in Singapore.
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