Falls Management Exercise programme: Improving reach, effectiveness, value and sustainability in Ireland. Case studies for learning (acronym: FaME Ireland): protocol of an observational evaluation study

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Abstract
Falls and fall-related injuries in older people are common, with negative effects on functional independence, social engagement and quality of life. The estimated cost of falls related injuries in Ireland, including primary, acute and social care costs, is projected to exceed €2 billion by 2030. The COVID-19 pandemic led to an increase in frailty and falls. Falls Management Exercise Programme (FaME) is a 24-week community-based group and home exercise programme led by qualified Postural Stability Instructors. It has been shown to reduce falls, and improve physical activity levels, physical function and wellbeing. FaME was first introduced in Ireland in 2021, and there are 120 specialist instructors trained to deliver FaME. We want to find the best way to get FaME implemented cost effectively in Ireland. How can we best establish FaME, ensuring we reach everyone who may fall, deliver FaME effectively and appropriately, and support people to keep living their best life after the programme? Although much has been learned regarding implementation of FaME in the UK, it is important to consider the implementation of FaME in an Irish context, where systems and cultures are different. By learning from and working with the specialist instructors at the early adopter sites, using mapping, observation, gap analysis, surveys, interviews, focus groups and workshops throughout, aligning our evaluation to the AFFINITY Project logic model and the Health Services Executive Change Guide we will ‘Define, (co-)Design, Deliver and Disseminate’ our findings based on equity and reach, efficiency, appropriateness and sustainability, suitable physical activity options after the programme, and cost analysis for different scenarios of delivery. Working closely with PPI, Knowledge Users and an International Expert Group, we will deliver a FaME Community of Practice with a fit for purpose FaME Toolkit, synthesising the learning for future implementation across Ireland.
Funding Information
  • Health Research Board (APA2022028)

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