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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

Implementation of evidence based fall-prevention programmes in the health care services: Quality, competency and effectiveness (FALLPREVENT)

Alternative title: Implementering av forsknings basert fall forebyggende intervensjoner i helsetjenesten: Kvalitet, kompetanse og effektivitet

Awarded: NOK 12.0 mill.

This year WP2 is well underway and WP3 of FALLPREVENT has started. The tailored implementation intervention is developed in WP2, and the planning of how to further develop this into the larger WP3 study has started. In the PhD project «Implementation of evidence-based fall prevention in primary care with clinical decision support», screening of 3873 papers for the systematic literature review of decision support for fall prevention among older adults have been conducted. After screening of title, abstract and full-text, 17 papers are included for the full-text review. The candidate is now planning a journal review in four city districts in Oslo, to evaluate how health professionals currently uses a fall prevention check list, in terms of both how risk of falls is assessed and how the results are followed up, during home visits in the primary health care system. The Norwegian Directorate of Health confirmed that the study did not need their approval, and the work will start in December 2022. In the second FALLPREVENT PhD project «Reducing the gap between evidence-based knowledge and practice in the field of fall prevention: development of user-centered implementation interventions», the screening of 13908 papers for the systematic literature review on successful implementation strategies for fall prevention among home-dwelling older adults is now completed. After screening, a total of seven papers are included for the full-text review. Part two of this PhD project is co-creation with health personnel, end-users, and researchers. In addition to the two digital workshops and one focus group interview (reported last year), another digital workshop, one focus group interview, and four individual interviews have been conducted, with a total of 28 participants. The results from the co-creation have provided important insight into feasible fall prevention strategies, barriers, and possible strategies for implementation. Based on the work from the two PhD projects, a protocol for a pilot/feasibility trial as part of WP2 has been developed. The aim is to pilot an implementation strategy for fall prevention in three city districts in Oslo, starting in January 2023. Per 1.12.22, several meetings with city districts in Oslo have been conducted, and the protocol is submitted to the Norwegian centre for research data (NSD) for approval. The two PhD candidates have completed their mid-term evaluation. WP3 started 01.09.22. The post-doctoral candidate in FALLPREVENT has started. This period, several collaborative meetings with city districts and municipalities in Norway has been conducted, both to provide information about the upcoming cluster-randomized controlled trial and to get feedback on the planning of the study. A national introduction meeting was held in February 2022. Furthermore, we have had meetings with national and international collaborators to discuss how to design the protocol for this study. As new national guidance on fall prevention is now being developed, we have established a collaboration with the Norwegian Directorate of Health. We aim to implement the national fall prevention guidance in the primary health care services, and thus provide support to the municipalities in terms of increasing the adherence to the national guidance on fall prevention. The FALLPREVENT project leader and post-doctoral candidate is part of the working group and has taken part in several meetings with the Norwegian Directorate of Health. The WP3 leader has presented FALLPREVENT for the Norwegian Directorate of Health’s steering committee for this fall prevention guidance.

The path from research to service innovation and implementation in practice may be long.Health professionals, patients, policymakers, and the public aspire to making healthcare decisions based on the best available research evidence.FALLPREVENT seeks interaction within and between the services and service innovation for ensuring sound and efficient patient and user pathways.The focus of the FALLPREVENT,is to develop an innovative model for implementation of evidence-based fall prevention programmes based on the knowledge,competence and experience of users and other stakeholders.We have designed four work packages of the project to address the challenges we expect to meet in implementing fall-prevention programmes.FALLPREVENT aims to explore the'know-do gap'in fall prevention in Norway and eterminants of practice in fall prevention.We will tailor implementation interventions to address the identified determinants,and assess the effectiveness of the implementation interventions in a cluster randomized trial,where 20 Norwegian municipalities/city districts will be randomized to the intervention and 20 Norwegian municipalities/city districts or the control group in Norway including the 15 city districts of Oslo.We will use a combination of data sources,and a combination of qualitative and quantitative method for the empirical analyses.Users will contribute to the project by involvement in developing the project,in the data collection and sampling of informants,and they will provide feedback on the milestones of the project through a user reference group.The project and its consortium will strengthen implementation research and promote better health by strengthening the foundation for knowledge-based education,knowledge-based health service,professional practice and policymaking.FALLPREVENT fits in with the highest priority areas under HELSEVEL,by developing research and innovation that enhances quality,competency and efficiency in the health care and welfare services.

Funding scheme:

HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester