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Perceptions of Facilitators and Barriers to Implementation of Falls Prevention Programs in Primary Health Care Settings in China

IMPORTANCE: Falls have become a major public health issue in China with population aging. Although falls prevention for older community-dwelling people has been included in the National Essential Public Health Service Package since 2009, there is limited understanding of the implementation of this p...

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Autores principales: Ye, Pengpeng, Jin, Ye, Er, Yuliang, Yin, Xuejun, Yao, Yao, Li, Bingqin, Zhang, Jing, Ivers, Rebecca, Keay, Lisa, Duan, Leilei, Tian, Maoyi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9419020/
https://www.ncbi.nlm.nih.gov/pubmed/36018587
http://dx.doi.org/10.1001/jamanetworkopen.2022.28960
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author Ye, Pengpeng
Jin, Ye
Er, Yuliang
Yin, Xuejun
Yao, Yao
Li, Bingqin
Zhang, Jing
Ivers, Rebecca
Keay, Lisa
Duan, Leilei
Tian, Maoyi
author_facet Ye, Pengpeng
Jin, Ye
Er, Yuliang
Yin, Xuejun
Yao, Yao
Li, Bingqin
Zhang, Jing
Ivers, Rebecca
Keay, Lisa
Duan, Leilei
Tian, Maoyi
author_sort Ye, Pengpeng
collection PubMed
description IMPORTANCE: Falls have become a major public health issue in China with population aging. Although falls prevention for older community-dwelling people has been included in the National Essential Public Health Service Package since 2009, there is limited understanding of the implementation of this program. OBJECTIVE: To identify the associated factors and provide recommendations to inform the better implementation of falls prevention in the Chinese primary health care system. DESIGN, SETTING, AND PARTICIPANTS: This qualitative study was conducted in 3 purposively selected cities in China from March 1 to June 7, 2021. Health administrators from the local health commission or bureau, staff members from local Centers for Disease Control and Prevention and primary health care facilities and community-dwelling older people were recruited, using a combination of purposive sampling and snowball sampling. MAIN OUTCOMES AND MEASURES: In-depth interviews were conducted with health administrators and focus groups with other participants. Data analysis followed the guidance of the Consolidated Framework for Implementation Research. Study outcomes included facilitators and barriers of implementing falls prevention for older people in the Chinese primary health care settings. A framework with recommendations was developed to inform the future intervention implementation. RESULTS: Among a total of 130 participants interviewed, 77 (59.2%) were female and the mean (SD) age was 47.4 (16.7) years. Clear recognition of the challenges and benefits of falls prevention, adaptive regionally tailored guidance plans, and continuous governmental policy and financial support were the major facilitators, whereas the major barriers consisted of insufficient confidence in delivering interventions and poor understanding of the falls burden, low recognition of the importance of falls prevention, limited multisectoral collaboration, and weak financial incentives. A 7-strategy embedded framework—including data-driven surveillance, audit and feedback, implementation strategy, workforce strengthening, community empowerment, internal services integration, and external enabling environment—was developed to foster successful implementation. CONCLUSIONS AND RELEVANCE: This qualitative study identified major facilitators and barriers to the implementation of falls prevention for older people at the primary care level, which have the potential to contribute to better implementation of falls prevention for older people in the Chinese primary health care system.
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spelling pubmed-94190202022-09-12 Perceptions of Facilitators and Barriers to Implementation of Falls Prevention Programs in Primary Health Care Settings in China Ye, Pengpeng Jin, Ye Er, Yuliang Yin, Xuejun Yao, Yao Li, Bingqin Zhang, Jing Ivers, Rebecca Keay, Lisa Duan, Leilei Tian, Maoyi JAMA Netw Open Original Investigation IMPORTANCE: Falls have become a major public health issue in China with population aging. Although falls prevention for older community-dwelling people has been included in the National Essential Public Health Service Package since 2009, there is limited understanding of the implementation of this program. OBJECTIVE: To identify the associated factors and provide recommendations to inform the better implementation of falls prevention in the Chinese primary health care system. DESIGN, SETTING, AND PARTICIPANTS: This qualitative study was conducted in 3 purposively selected cities in China from March 1 to June 7, 2021. Health administrators from the local health commission or bureau, staff members from local Centers for Disease Control and Prevention and primary health care facilities and community-dwelling older people were recruited, using a combination of purposive sampling and snowball sampling. MAIN OUTCOMES AND MEASURES: In-depth interviews were conducted with health administrators and focus groups with other participants. Data analysis followed the guidance of the Consolidated Framework for Implementation Research. Study outcomes included facilitators and barriers of implementing falls prevention for older people in the Chinese primary health care settings. A framework with recommendations was developed to inform the future intervention implementation. RESULTS: Among a total of 130 participants interviewed, 77 (59.2%) were female and the mean (SD) age was 47.4 (16.7) years. Clear recognition of the challenges and benefits of falls prevention, adaptive regionally tailored guidance plans, and continuous governmental policy and financial support were the major facilitators, whereas the major barriers consisted of insufficient confidence in delivering interventions and poor understanding of the falls burden, low recognition of the importance of falls prevention, limited multisectoral collaboration, and weak financial incentives. A 7-strategy embedded framework—including data-driven surveillance, audit and feedback, implementation strategy, workforce strengthening, community empowerment, internal services integration, and external enabling environment—was developed to foster successful implementation. CONCLUSIONS AND RELEVANCE: This qualitative study identified major facilitators and barriers to the implementation of falls prevention for older people at the primary care level, which have the potential to contribute to better implementation of falls prevention for older people in the Chinese primary health care system. American Medical Association 2022-08-26 /pmc/articles/PMC9419020/ /pubmed/36018587 http://dx.doi.org/10.1001/jamanetworkopen.2022.28960 Text en Copyright 2022 Ye P et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Ye, Pengpeng
Jin, Ye
Er, Yuliang
Yin, Xuejun
Yao, Yao
Li, Bingqin
Zhang, Jing
Ivers, Rebecca
Keay, Lisa
Duan, Leilei
Tian, Maoyi
Perceptions of Facilitators and Barriers to Implementation of Falls Prevention Programs in Primary Health Care Settings in China
title Perceptions of Facilitators and Barriers to Implementation of Falls Prevention Programs in Primary Health Care Settings in China
title_full Perceptions of Facilitators and Barriers to Implementation of Falls Prevention Programs in Primary Health Care Settings in China
title_fullStr Perceptions of Facilitators and Barriers to Implementation of Falls Prevention Programs in Primary Health Care Settings in China
title_full_unstemmed Perceptions of Facilitators and Barriers to Implementation of Falls Prevention Programs in Primary Health Care Settings in China
title_short Perceptions of Facilitators and Barriers to Implementation of Falls Prevention Programs in Primary Health Care Settings in China
title_sort perceptions of facilitators and barriers to implementation of falls prevention programs in primary health care settings in china
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9419020/
https://www.ncbi.nlm.nih.gov/pubmed/36018587
http://dx.doi.org/10.1001/jamanetworkopen.2022.28960
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