Abstract
BackgroundThe StayBalanced programme has shown positive effects on fall prevention, balance control and fear of falling. Despite convincing evidence on the efficacy and effectiveness of balance training, there is a gap between research findings and what is provided in community-based and clinical health care settings. Therefore, transferring evidence-based balance training into clinical practice is needed.MethodsThis project, designed as a hybrid type 3 trial, is a cluster-randomized study with a mixed-method design, carried out in primary health care settings. The aim is to investigate the effectiveness of two different strategies to facilitate the implementation of an intervention, the StayBalanced balance training programme, in primary health care, including evaluation of relative changes and maintenance in patient outcomes between intervention arms over 24 months. The StayBalanced programme will be launched through a website with information on the balance training and how to use it in clinical practice. One implementation strategy will include close facilitation, i.e. support and close follow-ups initiated by the researchers, in addition to access to the website. The other strategy simply includes access to the StayBalanced website. Outcome measures in the project consist of implementation outcomes, such as acceptability, feasibility, fidelity and sustainability of the StayBalanced programme. Outcomes at an individual level for older adults participating in the training will include fall-related concerns, health-related quality of life, balance performance, gait, physical activity, muscle strength in lower extremities, number of falls and compliance with training.DiscussionThis study will generate new understanding of effective strategies for transferring research to clinical practice and thereby reduce an important knowledge gap, as well as aid decision-making for future implementation of evidence-based methods. Furthermore, it will contribute to improved balance and gait, increased level of physical activity and function, and improved health-related quality of life for the individuals participating in the programme.Trial registrationClinicalTrials.govNCT02909374. Registered on September 21, 2016
Highlights
The StayBalanced programme has shown positive effects on fall prevention, balance control and fear of falling
The purpose of this paper is to describe the design of a clusterrandomized implementation study carried out in primary health care setting evaluated with a mixed-method approach
The project has been registered at ClinicalTrials.gov under the trial registration number NCT02909374. This project focuses on older adults’ health and prevention of falls, which is an important area of research because the older population is increasing
Summary
The StayBalanced programme has shown positive effects on fall prevention, balance control and fear of falling. Despite convincing evidence on the efficacy and effectiveness of balance training, there is a gap between research findings and what is provided in community-based and clinical health care settings. Balance training and physical activity have been found to have positive effects on fall prevention, balance control and fear of falling [1,2,3]. Despite convincing evidence on the efficacy and effectiveness of balance training and physical activity, there is a gap between research findings and what is performed and provided in community-based and clinical settings. Interventions with proven effectiveness should be transferred into routine clinical practice and studied under more realistic conditions as soon as possible, with the evaluation of the implementation being an integral part of the studies. The purpose of this paper is to describe the design of a clusterrandomized implementation study carried out in primary health care setting evaluated with a mixed-method approach
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