Table 3.

Description of included studies

Study	Report	Setting	Design	Multifactorial falls prevention Interventions	Implementation strategy	Actor	Action target	Outcomes	Justification
Study 1	Clemson, 2004 [27] Ballinger, 2006 [28]	Community group Home of older person Australia	Clemson • RCT Ballinger • QUAL	Screening: No Assessment: Yes • Group exercise: strength and balance • Medication • Environment: community safety, home hazards • Risk behavior • Vision • Footwear and clothing hazards • Vitamin D and calcium • Hip protectors Control group: • Two social visits from OT students • Not discussing falls or falls prevention	Stepping On Multifaceted community-based program using a small-group learning environment to improve fall self-efficacy, encourage behavioral change, and reduce falls Older person: • 2h weekly session for 7 weeks + 1 follow-up home visit by an OT (6 weeks after final session) + booster session (after 3 months) Healthcare professional: • Training	Older person: • OT Healthcare professional: • Researcher	Older person (70+) Healthcare professionals	Clemson • Effectiveness • Adherence/compliance Ballinger • Satisfaction • Experiences/perception • Attitude	Adult education principles [56] Enhancement of self-efficacy (Bandura) [57] Decision-making process (Janis and Mann) [58]
Study 2	Mackenzie, 2021 [29]	Medical practices Australia	QUAL	Screening: Yes Assessment: Yes • Exercise • Medication review • Orthostatic hypotension • Environment: home hazards • Incontinence • Vision • Podiatry/footwear • Cognitive decline • Falls prevention in general	Integrated solutions for sustainable falls prevention (iSOLVE) • Decision tool for GPs • Stay independent fall checklist for the older person • Fall-risk assessment • List of recommended individualized and tailored interventions • Training of GPs	Older person: • GP Healthcare professional: • Project coordinator	Older person (65+) GPs	Normalization process theory • Feasibility • Penetration • Adoption • Satisfaction • Experiences/perspective • Beliefs	Knowledge-to-action framework (KAT) [59] Behaviour change wheel [60] Normalization process theory [61]
Study 3	Middlebrook, 2012 [30]	Home of older person Australia	QUAL	Screening: Yes Assessment: Yes • Exercise • Medication • Orthostatic hypotension • Environment • Vitamin D • Vision	Chronic disease management plan To offer preventive and coordinated care for older persons with chronic conditions and complex care needs 5 sessions	Older person: • Australian government trough Medicare • GP, PT, OT Healthcare professional: • Government	Older person Healthcare professional	• Acceptability • Sustainability • Challenges/recommendations	No information
Study 4	Mora-Pinzon, 2019 [31]	Community organizations • Multipurpose facility that organizes community activities year round • Apartment complex USA	Mixed Method	Screening: No Assessment: Yes • Group exercise (strength and balance) • Medication • Environment • Risk behavior • Vision • Shoes • Bone health • How to talk to your doctor	Stepping On = Pisando fuerte Cultural linguistically — tailored multifaceted falls prevention program (Hispanic seniors) Multifaceted community-based program using a small-group learning environment to improve fall self-efficacy, encourage behavioral change, and reduce falls 8 sessions of 2,5h + booster session 3 months	Older person: • Leader (allied health professional, fitness expert, community health worker, health educator, promotor, peer leader Healthcare professionals: Researchers Organization: Researchers	Older persons (65+) Healthcare professional Organization	RE-AIM model • Effectiveness • Fidelity • Cost • Reach • Knowledge • Adherence/compliance • Maintenance	Adult education principles [56] Enhancement of self-efficacy (Bandura) [57] Decision-making process (Janis and Mann) [58]
Study 5	Renehan, 2019 [32]	Home of older person Australia	Mixed method	Screening: No Assessment: Yes • Exercise (based on Otago) • Medication • Environment • Vision • Footwear • Education, recommendations	Posthospital falls prevention intervention Tailored exercise program, medication review, education 20- to 30-min exercise program three to five times per week for 6 months Exercise physiologist visited at 1, 2, 4, and 8 weeks Monthly phone calls	PT, RN, pharmacist	Older person (65+)	• Adoption • Challenges and recommendations • Dose • Experiences/perspective • Adherence/compliance • Effectiveness	No information
Study 6	Garner, 1996 [33] Hahn, 1996 [34] Kempton, 2000 [35] Barnett, 2003 [36] Barnett, 2004 [37]	Community setting Australia	Garner, 1996 Descriptive Hahn, 1996 Non-RCT Kempton, 2000 Non-RCT Barnett, 2003 Descriptive Barnett, 2004 Mixed method	Screening: No Assessment: Yes • Group exercise class: insufficient physical activity, poor balance and gait • Medication • Environment: domestic and public environment • Vision • Shoes • Chronic Illness	Stay On Your Feet (SOYF) • Awareness raising and information dissemination • Community education • Policy development • Home safety • Support for GP and health workers	Research group, older persons, local community health teams, community health education groups, community organizations, councils, access committees	Older person(60+) Healthcare professional Organization Community Policy/society	Garner • Penetration • Reach • Challenges and recommendations Hahn • Reach • Effectiveness • Knowledge • Awareness • Attitude Kempton • Reach • Beliefs • Adherence/compliance • Effectiveness • Knowledge • Attitude • Awareness Barnett, 2003 • Penetration • Sustainability • Reach Barnett, 2004 • Sustainability	Goals of the Ottawa Charter for Health promotion (WHO) provided the framework for strategy development [62]
Study 7	Milisen, 2006 [38]	Home of older person Belgium	Mixed method	Screening: Yes Assessment: Yes • Exercise (gait, mobility, balance) • Medication • Orthostatic hypotension • Environment • Risk behavior • Incontinence • Vitamin D • Vision • Podiatry/shoes • Cognitive decline Recommendations and referrals Persons not at risk: Falls prevention in general (leaflet)	Nurse-led multifactorial falls prevention intervention (tailored recommendations) Follow-up 1 month after first visit	Two research nurses	Older person(70+)	• Feasibility • Adoption • Adherence/compliance • timeliness • Experiences/perspective • Reach	No information
Study 8	Mackenzie, 2020 [39]	Home of older person Australia	Mixed method	Screening: yes Assessment: Yes • Exercise (Otago) • Medication • Environment (also community)	Chronic Disease Management Plan To offer preventive and coordinated care for older people with chronic conditions and complex care needs 6 weeks	Older person: • Australian government trough Medicare • GP, PT, OT Healthcare professional: • Government	Older person(75+) Healthcare professional	• Fidelity • Acceptability • Sustainability • Cost • Effectiveness • Timeliness • Recommendations/challenges • Equity • Experiences/perspective • Adherence/compliance • Beliefs	No information
Study 9	Fortinsky, 2008 [17]	Home Health Agencies USA	Descriptive	Screening: Unclear Assessment: Yes • Exercise (mobility and balance) • Medication • Orthostatic hypotension • Environment Conform Yale Frailty and Injuries: Co-operative Studies of Intervention Techniques (FICSIT) trial	Support for implementation & education of healthcare professionals • Implementation team • Training • Supportive material • Champion All 26 HHAs were trained (90min)	Older person: • Home health agencies Healthcare professionals + organization: • Research team, CCFP	Older person(65+) Healthcare professional Organization	• Penetration • Reach	Trans-theoretical model [63] Innovation dissemination theory [64] Behaviour-change strategies
Study 10	Gholamzadeh, 2021 [40]	Health Centers Iran	RCT	Screening: No Assessment: Yes • Group exercise: strength and balance • Medication • Environment: community safety, home hazards • Risk behavior • Vision • Footwear and clothing hazards • Vitamin D and calcium Control group: Stepping On program educative materials in the form of DVDs at the end of the study. They also received a booklet.	Stepping On Multifaceted community-based program using a small-group learning environment to improve fall self-efficacy, encourage behavioral change, and reduce falls Older person: 7 training sessions of 30-60 minutes (2 days a week)	Older person: • Unknown	Older person(65+)	• Effectiveness	Adult education principles [56] Enhancement of self-efficacy (Bandura) [57] Decision-making process (Janis and Mann) [58]
Study 11	Mahoney, 2016 [41]	Senior apartment buildings Home of older person USA	QUAL	Screening: No Assessment: Yes • Group exercise: strength and balance • Medication • Environment: community safety, home hazards • Risk behavior • Vision • Footwear and clothing hazards • Vitamin D and calcium • Hip protectors Info from Clemson, 2004	Stepping On Multifaceted community-based program using a small-group learning environment to improve fall self-efficacy, encourage behavioral change, and reduce falls Older person • 2 h weekly session for 7 weeks + 1 follow-up home visit by an occupational therapist (6 weeks after final session) + booster session (after 3 months) Healthcare professional • Training • Training and program manual	Older person: • RN Healthcare professional: Researcher	Older person (65+) Health care professional	Root cause analysis (RCA) • Fidelity • Adherence/compliance • Belief • Challenges/recommendations	Adult education principles [56] Enhancement of self-efficacy (Bandura) [57] Decision-making process (Janis and Mann) [58]
Study 12	Elley, 2008 [42]	Home of older person • New Zealand	RCT	Screening: Yes Assessment: Yes • Exercise (Otago) • Medication • Orthostatic hypotension • Environment • Incontinence • Vitamin D and calcium • Vision • Footwear • Cognitive decline • Cardiovascular • Musculoskeletal examination	Nurse-led multifactorial falls prevention intervention Older persons: Tailored recommendations Healthcare professionals: Training Control group: social visit + pamphlet	Older person(75+): RN, PT, OT, GP Healthcare professional: RN,researchers	Older person(75+) Healthcare professional	• Penetration • Reach • Effectiveness • Adherence/compliance	No information
Study 13	Kramer, 2011 [43]	Community and senior centers • USA	QUAL	Screening: No Assessment: Yes • Group exercise • Medication • Environment • Cognitive decline	InSTEP A set of three model pilot projects at varying levels of intensity — two each at “high,” “medium,” and “low” Older person: Each model program enrolled small classes for a 12-week program of (a) progressive physical activity classes to improve strength, balance, and gait, (b) home safety evaluation and recommendations for modification, and (c) medical risk assessment and recommendations to discuss any identified risks with a healthcare professional Healthcare professional: • Support implementation • Training Organization: • Training • Support implementation • Collaborations	Older person: Exercise instructor, OT, volunteers, senior center staff, physician, social worker Healthcare professional: Fall Prevention Center of Excellence Organization: Fall Prevention Center of Excellence	Older person Healthcare professional Organization	• Feasibility • Penetration • Awareness • Knowledge • Acceptability • Sustainability • Adoption • Cost • Dose • Challenges/recommendations	Theoretical model based on the extended parallel process model [65]
Study 14	Zimmerman, 2017 [44]	Assisted living communities USA	Mixed method	Screening: Yes Assessment: Yes • Exercise • Medication • Environment • footwear	Assisted Living Falls Prevention and Monitoring Program • Tailored implementation • Support for implementation Control group:In service education session	Researchers	Healthcare professional Organization	• Fidelity • Penetration • Reach • Challenges/recommendations • Effectiveness	No information
Study 15	Schlotthauer, 2017 [45]	Home of older person Independent Living Retirement Community (ILRC) Parks and Recreation Center Parish Nurse Program USA	Mixed method	Screening: No Assessment: Yes • Group exercise: strength and balance • Medication • Environment: community safety, home hazards • Risk behavior • Vision • Footwear and clothing hazards • Vitamin D and calcium • Hip protectors Info from Clemson, 2004	Stepping On Multifaceted community-based program using a small-group learning environment to improve fall self-efficacy, encourage behavioral change, and reduce falls • Independent Living Retirement Community: leader health background versus nonhealth background • Parks and Recreation Center: home visits versus phone calls (follow-up) • Parish Nurse Program: home visits versus phone calls (follow-up)	Older person: Healthcare professional and non healthcare professional Healthcare professional: Researchers	Older person Healthcare professional	• Feasibility • Fidelity • Penetration • Sustainability • Acceptability • Reach • Challenges/recommendations • Experiences/perspectives	Adult education principles [56] Enhancement of self-efficacy (Bandura) [57] Decision-making process (Janis and Mann) [58]
Study 16	Baker, 2007 [46]	Senior center USA	QUAL	Screening: Yes Assessment: Yes • Exercise • Medication • Orthostatic hypotension • Environment • Vision Based on the Yale Frailty and Injury Cooperative Studies of Intervention Trials (known as the Yale FICSIT)	Step by step Support for implementation & education of healthcare professionals • Implementation team • Training • Supportive material • Champion	Older person: Senior center staff Healthcare professional: Investigators who had conducted Yale FICSIT (CCFP) Organization: Research team: CCFP investigators	Older person Healthcare professional Organization	• Penetration • Sustainability • Reach • Challenges and recommendations	Trans-theoretical model [63] PDSA cycle[66]
Study 17	Kittipimpanon, 2012 [47]	Community Home of older person Thailand	Mixed method (action research)	Screening: No Assessment: Yes • Group exercise • Medication • Orthostatic hypotension • Environment • Risk behavior • Vision check • Education	Community-based falls prevention program Community development approach • Falls prevention campaign • Fall management system (surveillance fall notification center and environmental hazards management) • Multifactorial risk assessment • Exercise • Home visits	Public health center, public health nurse, identified leaders of the falls prevention teams, zone team leader, the crown property bureau provided support, researchers	Older person (60+) Organization Community	• Sustainability • Satisfaction • Adherence/compliance • Effectiveness	Appreciation-Influence-Control Technique [67] PRECEDE–PROCEED model Community participation [68]
Study 18	Tiedemann, 2021 [48]	Local health districts New South Wales Australia	Non-RCT	Screening: No Assessment: Yes • Group exercise: strength and balance • Medication • Environment: community safety, home hazards • Risk behavior • Vision • Footwear and clothing hazards • Vitamin D and calcium • Hip protectors Info from Clemson, 2004	Stepping On Multifaceted community-based program using a small-group learning environment to improve fall self-efficacy, encourage behavioral change, and reduce falls Older person • 2h weekly session for 7 weeks + booster session (after 3 months) Healthcare professional • Training	Older person: • OT Healthcare professional: • Stepping On trainer	Older person (65+) Healthcare professional	• Challenges/recommendations • Effectiveness • Satisfaction • Experiences • Motivation • Adherence/compliance • Beliefs	Adult education principles [56] Enhancement of self-efficacy (Bandura) [57] Decision-making process (Janis and Mann) [58]

GP General practitioner, PT Physiotherapist, OT Occupational therapist, RN Registered nurse, HHA Home health agencies, CCFP Connecticut Collaboration for Fall Prevention, PDSA cycle Plan, do, study, act cycle, QUAL Qualitative study, RCT Randomized controlled trial, Mixed Method mixed-method study, Descriptive, quantitative descriptive study, Non-RCT Nonrandomized controlled trial