背景:每年有三分之一的社区老年人跌倒。指南建议使用多因素跌倒预防干预措施。然而,这些干预措施很难在社区中实施。本系统综述旨在探索用于在社区中实施多因素跌倒预防干预措施的策略。
方法:在PubMed(包括MEDLINE)中进行系统搜索,CINAHL(EBSCO),Embase,WebofScience(核心收藏),Cochrane图书馆于8月25日进行了演出和更新,2022年。包括报告评估社区环境中多因素跌倒预防干预措施实施策略的研究。两名审阅者独立进行了搜索,筛选,数据提取,和合成过程(PRISMA流程图)。通过敏感性分析对纳入报告的质量进行了评估,评估与研究问题和方法论质量的相关性(混合方法评估工具)。根据Proctor等人的报告,实施策略。(2013)Kok等人指定和报告实施策略和行为改变方法分类的指南。(2016)。
结果:23份报告(18项研究)符合纳入标准,其中14份报告在敏感性分析中得分高,9份得分中等。所有研究都结合了实施策略,解决不同的决定因素。个人层面最常用的实施策略是“剪裁”,\"\"主动学习,\"\"个性化风险,\"\"个性化,“\”意识的提高,“和”参与。“在环境层面,最常描述的策略是“技术援助,使用非专业卫生工作者,同伴教育,“\”增加利益相关者的影响力,“和”组成联盟。“纳入的研究没有详细描述实施策略,并使用了各种实施策略的标签。十二项研究使用了实施理论,模型,和框架;没有研究既没有描述决定性框架的使用,也没有描述实施策略如何针对影响因素。
结论:本综述强调了在详细说明实施策略和有效使用实施框架方面的差距,模型,和理论。审查发现,研究主要集中在老年人和医疗保健专业人员层面的实施策略上,强调“剪裁”的重要性,“\”意识的提高,执行过程中的\"和\"参与\"。描述组织层面实施战略的研究,社区,和政策/社会表明,“技术援助,“”积极参与利益相关者,“”和“组建联盟”是重要的策略。
背景:PROSPEROCRD42020187450.
One-third of the community-dwelling older persons fall annually. Guidelines recommend the use of multifactorial falls prevention interventions. However, these interventions are difficult to implement into the community. This systematic
review aimed to explore strategies used to implement multifactorial falls prevention interventions into the community.
A systematic search in PubMed (including MEDLINE), CINAHL (EBSCO), Embase, Web of Science (core collection), and Cochrane Library was performed and updated on the 25th of August, 2022. Studies reporting on the evaluation of implementation strategies for multifactorial falls prevention interventions in the community setting were included. Two reviewers independently performed the search, screening, data extraction, and synthesis process (PRISMA flow diagram). The quality of the included reports was appraised by means of a sensitivity analysis, assessing the relevance to the research question and the methodological quality (Mixed Method Appraisal Tool). Implementation strategies were reported according to Proctor et al.\'s (2013) guideline for specifying and reporting implementation strategies and the Taxonomy of Behavioral Change Methods of Kok et al. (2016).
Twenty-three reports (eighteen studies) met the inclusion criteria, of which fourteen reports scored high and nine moderate on the sensitivity analysis. All studies combined implementation strategies, addressing different determinants. The most frequently used implementation strategies at individual level were \"tailoring,\" \"active learning,\" \"personalize risk,\" \"individualization,\" \"consciousness raising,\" and \"participation.\" At environmental level, the most often described strategies were \"technical assistance,\" \"use of lay health workers, peer education,\" \"increasing stakeholder influence,\" and \"forming coalitions.\" The included studies did not describe the implementation strategies in detail, and a variety of labels for implementation strategies were used. Twelve studies used implementation theories, models, and frameworks; no studies described neither the use of a determinant framework nor how the implementation strategy targeted influencing factors.
This
review highlights gaps in the detailed description of implementation strategies and the effective use of implementation frameworks, models, and theories. The
review found that studies mainly focused on implementation strategies at the level of the older person and healthcare professional, emphasizing the importance of \"tailoring,\" \"consciousness raising,\" and \"participation\" in the implementation process. Studies describing implementation strategies at the level of the organization, community, and policy/society show that \"technical assistance,\" \"actively involving stakeholders,\" and \"forming coalitions\" are important strategies.
PROSPERO CRD42020187450.