Lessons Learned in the Early Adoption of FaME Across Ireland: A Convergent Mixed‐Methods Implementation Study (FaME Ireland)

Résumé fourni par la source

BACKGROUND: Falls are the most common cause of hospitalisation amongst older adults in Ireland. Structured exercise programmes are recommended to manage falls, and the Falls Management Exercise (FaME) programme has been shown to reduce falls and improve physical function. However, FaME delivery within an Irish context needs to be explored to ensure it is implemented effectively and equitably. OBJECTIVE: To explore key stakeholders' experiences and examine key outcomes during the early adoption of the FaME programme across three sites in Ireland. DESIGN: A convergent mixed-methods design was used to explore the early adoption of FaME across three sites in Ireland (Dublin, Kerry, and Sligo/Leitrim). Focus groups and interviews were conducted with key FaME stakeholders (clients, Postural Stability Instructors, service managers) to understand the experiences of local implementation. Baseline and outcome measures of falls and physical function contextualised the qualitative findings. RESULTS: A census sample across the three study sites, 64 FaME Clients, 10 PSIs, and seven Service Managers were included. Themes described the Reach, Effectiveness, Adoption, Implementation, and Maintenance of FaME according to the RE-AIM framework. All groups recorded improvements in physical function following FaME. CONCLUSIONS: This study highlights factors influencing the adoption of FaME within an Irish context and provides recommendations for future implementation. To ensure effective and sustainable delivery, commissioners should consider how FaME can be embedded within exercise and falls management pathways and establish partnerships with local community organisations to support service delivery. PATIENT OR PUBLIC CONTRIBUTION: Public representatives from Age and Opportunity (n = 16), a national organisation that advocates for valuable activities and services as we age, and clients of FaME (n = 4) were involved in the early protocol planning, scheduled meetings, co-design phases, and analysis stages of the study. Their contribution influenced issues such as accessibility and acceptability of strength and balance programmes and options for dissemination. Representatives from Age and Opportunity reviewed the manuscript for readability.