Table 2 Summary of identified facilitators and barriers to the falls prevention pathway components
Pathway component [Thematic category #] | Facilitator [Thematic category #] | Barrier [Thematic category #] |
|---|---|---|
Falls risk screening and assessment by professionals [1] | (A) Professional competence | |
• General approachability of professionals [1] | • Lack of proactive professional approach [1–5] • Lack of professional attention to environmental risk factors [1–6] | |
(B) System-level approaches and resources | ||
• Proactive, data-based approach to falls risk screening [1, 2] • Specialist expertise and equipment [1–3] | • Time constraint in routine practice [1–7] | |
(C) Motivation and awareness of older persons | ||
• Older person’s motivation to maintain health [1–4] | • Older person’s lack of falls risk awareness [1–8] | |
Raising awareness of falls risk [2] | • Awareness from earlier life-course stage [2-1] • Awareness of falls risk by informal caregivers [2] | • Lack of awareness of the physical ageing process [2, 3] |
Initial uptake of falls prevention treatments [3] | (A) Motivation and awareness of older persons | |
• Older person’s experience of falling [3-1] • Older person’s experience of the physical ageing process [3-2] • Older person’s motivation to maintain health [3] | • Older person’s lack of falls risk awareness [3–15] • Low motivation of older persons [3–16] | |
(B) Facilitators and barriers in the community | ||
• Community marketing [3, 4] • Peer recommendations [3–5] • Marketing health benefits of interventions [3–6] | • Lack of information in community [3–17] • Barriers related to socioeconomic class [3–18] • Linguistic barriers to information uptake [3–19] | |
(C) Intervention characteristics | ||
• Intervention is free/cheap [3–7] • Intervention is enjoyable [3–8] • Intervention is of suitable difficulty [3–9] • Intervention is safe [3–10] • Intervention is conveniently located [3–11] | • High intervention cost [3–20] • Inconvenient timing of intervention [3–21] • Lack of safe venues for intervention [3–22] • Transport access and cost issues [3–23] | |
(D) Professional competence and funding | ||
• Professional recommendations are more important than peer recommendations [3–12] • Professional awareness of community initiatives [3–13] • Person-centred professional referrals [3–14] | • Lack of professional awareness of community initiatives [3–24] • Commandeering attitude of professionals [3–25] • Reactive professional approach [3–26] • Mismatch between area-based demand and supply [3–27] | |
Adherence and long-term participation in falls prevention treatments [4] | (A) Motivation and health of older persons | |
• Older person’s motivation to maintain health [4-1] | • Older person’s illness and comorbidities [4–10] | |
(B) Positive and negative experiences of intervention characteristics | ||
• Experience of intervention reducing falls risk [4-2] • Experience of wider health benefits of interventions [4-3] • Intervention is enjoyable [4] • Intervention enables high social participation [4, 5] • Intervention is individually tailored [4–6] | • High intervention cost [4–11] • Intervention is of unsuitable difficulty [4–12] • Intervention is not individually tailored [4–13] • Inconvenient timing of intervention [4–14] • Transport access issues [4–15] | |
(C) Professional availability and competence and funding | ||
• Availability of staff [4–7] • Proactive professional approach to sustain adherence [4–8] • Good professional-participant relationship [4–9] | • Lack of professional and volunteer staff [4–16] • Insufficient public sector funding [4–17] | |