Factors influencing fall prevention programmes: The challenge of implementing and spreading the Falls Management Exercise (FaME) programme in a complex landscape

Background: The occurrence of falls in adults 65+ years remains a common and costly issue worldwide. There is current evidence to suggest that falls can be prevented using evidence-based strength and balance interventions, such as the 6 month Falls Management Exercise (FaME) programme. Perspectives of multiple key partners and providers of the FaME programme could inform future implementation and fall prevention strategies. Methods: Partners and providers involved in local community fall prevention pathways were purposefully recruited from three geographical areas across the UK. Semi-structured interviews were conducted to gain a broad understanding Of factors affecting the adoption, implementation and spread Of FaME. Data were analysed using an inductive thematic approach and mapped to the Consolidated Framework for Implementation Research (CFIR). Results: Data from 25 participant interviews and document analysis revealed 11 themes organised within five CFIR domains - the innovation (3), outer setting (3), Inner setting (1), characteristics of individuals (1) and process (2).Conclusion: The adoption, implementation and spread of FaME into community settings is complex and faces multiple health system challenges. For adoption and implementation to be facilitated, FaME programmes must demonstrate effectiveness and fit the local needs of those receiving the intervention. For spread to occur, influential decision makers and funders must support wider programme roll out, whilst also securing sulT1cient expert capacity to deliver the programme and ensure monitoring is in place to determine effectiveness of provision for older adults.