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Wytske MA Meekes,1,2 Chantal J Leemrijse,2 Joke C Korevaar,2 Emma K Stanmore,3 Lamberdina (Ien) AM van de Goor1 1Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands; 2Nivel, Utrecht, Netherlands; 3School of Health Sciences, University of Manchester, Manchester, UK and Manchester Academic Health Science Centre (MAHSC), Manchester, UKCorrespondence: Wytske MA Meekes, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Postbus 90153, Tilburg, 5000 LE, Netherlands, Tel +31 13 466 4451, Email w.m.a.meekes@tilburguniversity.eduPurpose: Limited information is available concerning primary care providers’ encountered barriers and facilitators when implementing falls prevention and providing interventions in a real-life setting. This study aimed to identify barriers and facilitators when i) implementing a falls risk assessment strategy at GP practices and among community nurses and ii) providing evidence-based falls prevention interventions in a real-life setting to independently living, frail older people.Methods: A researcher’s journal was maintained during the implementation of a falls risk assessment strategy, which entailed notes from informal conversations with GPs, practice nurses and community nurses. After implementation, two online focus groups with GPs, practice and community nurses, physio- and exercise therapists were conducted. Data were thematically analyzed.Results: Data were collected from 32 GPs, 13 practice nurses, eight community nurses, nine physiotherapists, and two exercise therapists. The GPs and nurses acknowledged that falls prevention is part of their job, meaningful, and that they have sufficient knowledge and skills to offer falls prevention. Collaboration, a previously implemented care program for older people, resources, reimbursement for interventions, and patients’ motivation, awareness and health issues were considered to be important factors for the implementation of falls prevention. Physio- and exercise therapists described collaboration with different disciplines, receiving sufficient referrals, reimbursements, intensity and set-up of the interventions, and patients’ motivation, expectations, goals, self-confidence, awareness, and health issues as important factors when providing falls prevention interventions.Conclusion: This study identified care provider-, context-, patient-, and innovation (strategy)-related barriers and facilitators when implementing falls prevention and providing interventions in primary care. Development of a more successful implementation strategy should focus on intensifying collaboration, reimbursement for interventions, availability of resources, and patients’ lack of motivation and health issues. Hence, falls prevention may become more structurally applied, reducing a major threat for the quality of life of independently living older people.Keywords: falls prevention, implementation, barriers and facilitators, frail older people, primary care

WMA Meekes,1 CJ Leemrijse,2 JC Korevaar,2 JMAE Henquet,3 M Nieuwenhuis,4 LAM van de Goor1 1Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Noord-Brabant, Netherlands; 2NIVEL, Utrecht, Netherlands; 3Huisartsenpraktijk de Ypelaer, Hilvarenbeek, Noord-Brabant, Netherlands; 4Fysiotherapie Nieuwenhuis, Best, Noord-Brabant, NetherlandsCorrespondence: WMA MeekesTranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, Postbus 90153, NetherlandsTel +31 13 466 4451Email w.m.a.meekes@tilburguniversity.eduBackground: Falls are an increasing problem among older people. There are several evidence-based interventions available to prevent falls. However, these are not always well implemented in the primary care setting. General practitioners (GPs) are often the first point of contact for health issues, making them the designated professionals for providing falls prevention. Because GPs are often unaware which patients have a high fall risk and patients themselves do not always know they have a high fall risk, this study aims to evaluate the implementation of a targeted fall risk screening strategy among independently living, frail older people in the primary care setting.Materials and Methods: The targeted fall risk screening strategy used in this study consists of tools for screening high fall risk and for identifying the underlying cause(s) of the high fall risk, an accredited training course in falls prevention for professionals, and service provision by certified physio- and exercise therapists who are able to offer evidence-based falls prevention interventions. This targeted fall risk screening strategy will be implemented in the primary care setting and evaluated at the level of the GP practice and at the level of the patient by using the RE-AIM model of Glasgow et al. In a pre-posttest design, data will be collected of the total number of frail older people who are screened, referred and enrolled for fall-preventive care. Furthermore, barriers and facilitators of the implementation of the fall risk screening strategy will be identified by conducting focus groups and interviews with the care providers and frail older patients. Additionally, the influence of the falls prevention interventions on frail older patients will be evaluated by using a pre-posttest design with a 12-month follow-up period during which data are collected regarding patients’ stability, mobility, strength, balance, self-efficacy, health status, and daily activities.Study Registration: This study is approved by the Medical Ethics Committee Brabant, the Netherlands (NL61582.028.17/ P1732) and registered at the Netherlands Trial Register, NL7917.Keywords: preventive medicine, primary care, geriatric medicine, risk management