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.

中文翻译：

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影响社区老年人多因素跌倒风险评估和多领域干预措施实施的决定因素：系统评价


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，了解影响实施的决定因素非常重要。方法 于 2021 年 12 月 3 日对该系统评价进行文献检索，并于 2023 年 4 月 3 日在五个数据库中进行更新：PubMed（包括 MEDLINE）、EMBASE（通过 Embase.com）、Cochrane 对照试验中央注册库（通过 Cochrane 图书馆） ）、Web of Science 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，则研究被纳入。社论、观点论文、系统评论和针对某一人群（例如帕金森病）的研究被排除在外。两名研究人员独立对文章标题、摘要和全文进行筛选。根据敏感性分析评估质量。 “实践决定因素综合清单”用于对决定因素进行分类。结果 纳入了 29 项研究。决定因素分为障碍因素 (n = 40) 和促进因素 (n = 35)。必要资源的可用性是报道最多的决定因素。其他常见的决定因素包括老年人和医疗保健专业人员的知识、意图/信念和动机，以及将干预措施融入当前实践、沟通、团队和转介流程以及财务（非）激励措施。 结论 绘制障碍和促进因素对于选择适合具体情况的实施策略以及提高多因素跌倒风险评估和/或多领域干预措施的采用和有效性至关重要。