Abstract：
BACKGROUND: Multifactorial falls risk assessment and multidomain interventions are recommended by the World guidelines for falls prevention and management. To successfully implement these interventions, it is important to understand determinants influencing the implementation.
METHODS: A literature search was conducted for this systematic review on the 3 December 2021 and updated on the 3 April 2023 in five databases: PubMed (including MEDLINE), EMBASE (via Embase.com), Cochrane Central Register of Controlled Trials (via Cochrane Library), Web of Science Core Collection and CINAHL (via EBSCO). Studies were included if they reported on determinants influencing the implementation of a multifactorial falls risk assessment and/or multidomain interventions in community-dwelling older people. Editorials, opinion papers, systematic reviews and studies focusing on one population (e.g. Parkinson) were excluded. Two researchers independently screened the articles on title, abstract and full text. The quality was evaluated based on a sensitivity analysis. \'The Comprehensive Integrated Checklist of Determinants of practice\' was used to categorise the determinants.
RESULTS: Twenty-nine studies were included. Determinants were classified as barriers (n = 40) and facilitators (n = 35). The availability of necessary resources is the most reported determinant. Other commonly reported determinants are knowledge, intention/beliefs and motivation at the levels of older people and healthcare professionals, fitting of the intervention into current practice, communication, team and referral processes and financial (dis)incentives.
CONCLUSIONS: Mapping of the barriers and facilitators is essential to choose implementation strategies tailored to the context, and to enhance the uptake and effectiveness of a multifactorial falls risk assessment and/or multidomain interventions.
METHODS: A literature search was conducted for this systematic review on the 3 December 2021 and updated on the 3 April 2023 in five databases: PubMed (including MEDLINE), EMBASE (via Embase.com), Cochrane Central Register of Controlled Trials (via Cochrane Library), Web of Science Core Collection and CINAHL (via EBSCO). Studies were included if they reported on determinants influencing the implementation of a multifactorial falls risk assessment and/or multidomain interventions in community-dwelling older people. Editorials, opinion papers, systematic reviews and studies focusing on one population (e.g. Parkinson) were excluded. Two researchers independently screened the articles on title, abstract and full text. The quality was evaluated based on a sensitivity analysis. \'The Comprehensive Integrated Checklist of Determinants of practice\' was used to categorise the determinants.
RESULTS: Twenty-nine studies were included. Determinants were classified as barriers (n = 40) and facilitators (n = 35). The availability of necessary resources is the most reported determinant. Other commonly reported determinants are knowledge, intention/beliefs and motivation at the levels of older people and healthcare professionals, fitting of the intervention into current practice, communication, team and referral processes and financial (dis)incentives.
CONCLUSIONS: Mapping of the barriers and facilitators is essential to choose implementation strategies tailored to the context, and to enhance the uptake and effectiveness of a multifactorial falls risk assessment and/or multidomain interventions.
摘要：
背景：《世界跌倒预防和管理指南》推荐多因素跌倒风险评估和多领域干预措施。为了成功实施这些干预措施，重要的是要了解影响实施的决定因素。
方法：在2021年12月3日对该系统综述进行了文献检索，并于2023年4月3日在五个数据库中进行了更新：PubMed（包括MEDLINE），EMBASE（通过Embase.com），Cochrane中央对照试验登记册（通过Cochrane图书馆），WebofScience核心合集和CINAHL（通过EBSCO）。如果研究报告了影响社区老年人实施多因素跌倒风险评估和/或多领域干预措施的决定因素，则包括研究。社论,意见文件,针对一个人群(如帕金森)的系统评价和研究被排除.两名研究人员独立筛选了标题上的文章，摘要和全文。基于敏感性分析评价质量。“实践决定因素综合综合清单”用于对决定因素进行分类。
结果：纳入29项研究。决定因素分为障碍(n=40)和促进因素(n=35)。必要资源的可用性是报告最多的决定因素。其他通常报告的决定因素是知识，老年人和医疗保健专业人员的意图/信念和动机，将干预措施融入当前的实践，通信,团队和推荐流程以及财务(DIS)激励。
结论：确定障碍和促进因素对于选择适合具体情况的实施策略至关重要，并提高多因素跌倒风险评估和/或多领域干预措施的吸收和有效性。
方法：在2021年12月3日对该系统综述进行了文献检索，并于2023年4月3日在五个数据库中进行了更新：PubMed（包括MEDLINE），EMBASE（通过Embase.com），Cochrane中央对照试验登记册（通过Cochrane图书馆），WebofScience核心合集和CINAHL（通过EBSCO）。如果研究报告了影响社区老年人实施多因素跌倒风险评估和/或多领域干预措施的决定因素，则包括研究。社论,意见文件,针对一个人群(如帕金森)的系统评价和研究被排除.两名研究人员独立筛选了标题上的文章，摘要和全文。基于敏感性分析评价质量。“实践决定因素综合综合清单”用于对决定因素进行分类。
结果：纳入29项研究。决定因素分为障碍(n=40)和促进因素(n=35)。必要资源的可用性是报告最多的决定因素。其他通常报告的决定因素是知识，老年人和医疗保健专业人员的意图/信念和动机，将干预措施融入当前的实践，通信,团队和推荐流程以及财务(DIS)激励。
结论：确定障碍和促进因素对于选择适合具体情况的实施策略至关重要，并提高多因素跌倒风险评估和/或多领域干预措施的吸收和有效性。
