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Table 2 Conjectured context-mechanism-outcome configurations

From: Evaluating the impact of a falls prevention community of practice in a residential aged care setting: a realist approach

Member Level
 CCMO 1 Members who demonstrated higher levels of falls prevention knowledge and awareness (psychological capability) and felt they needed to action fall prevention strategies enough (reflective motivation), better engaged with other site staff to enable implementation of falls prevention strategies
 CCMO 2 Members who participated more in CoP social learning opportunities, connected to experts, gained confidence and credibility and were motivated to make a greater contribution to falls prevention change at their facility
 CCMO 3 Membership of a CoP enabled new and more frequent interdisciplinary connections to develop serving as a resource for guidance and reduced professional isolation within the organisation, when time to participate was supported by facility managers
RAC facility level
 CCMO 4 Facility visiting GPs who related to RAC staff (particularly CoP members and Nurse Practitioners) as credible peers and advocated for the recommended evidence significantly improved their proportion of residents supplemented with vitamin D
 CCMO 5 Falls prevention programs were best implemented and adopted by frontline staff when the resident’s prevention strategies were prompted in novel ways and documentation of strategy enactment was made accountable by care managers
 CCMO 6 Higher levels of care manager support, through realisation and prioritisation for staff to participate as CoP members and action falls prevention at their facility, enabled the implementation of evidence based practices
RAC organisation level
 CCMO 7 Organisational acknowledgment of gaps in governance and recognition of the consequences of not taking a more preventative approach (reflective motivation) regarding falls management changed the cultural focus towards pro-action, following greater engagement with the CoP
 CCMO 8 Failure to offer opportunity in terms of dedicated time commitment for CoP members to learn and engage in falls prevention activity above existing professional duties, limited implementation of falls prevention activities
 CCMO 9 Receiving regular reports on the CoP’s falls prevention actions created a stronger feedback loop from frontline care to general management and assisted in focussing attention on falls prevention
  1. CCMO conjectured context mechanism outcome, GP General Practitioner