Stakeholder perspectives on selecting falls prevention programmes in Brunei Darussalam: A qualitative study

Muhammad Hassan Syaibani Hardifadhillah; Shyh Poh Teo; Nurul Zatil Hidayah Suffian; Asmah Husaini

doi:10.55225/hppa.719

Authors

Muhammad Hassan Syaibani Hardifadhillah Universiti Brunei Darussalam, PAPRSB Institute of Health Sciences, Brunei Darussalam
Shyh Poh Teo Universiti Brunei Darussalam, PAPRSB Institute of Health Sciences, Brunei Darussalam; RIPAS Hospital, Geriatrics and Palliative Medicine, Brunei Darussalam https://orcid.org/0000-0002-6117-5774
Nurul Zatil Hidayah Suffian Universiti Brunei Darussalam, PAPRSB Institute of Health Sciences, Brunei Darussalam; RIPAS Hospital, Physiotherapy Department, Brunei Darussalam https://orcid.org/0009-0002-1463-9094
Asmah Husaini Universiti Brunei Darussalam, PAPRSB Institute of Health Sciences, Brunei Darussalam https://orcid.org/0000-0002-9544-2439

DOI:

https://doi.org/10.55225/hppa.719

Keywords:

allied health professionals, fall prevention, older adults, qualitative research, stakeholder perspectives

Abstract

Background: Falls are a major contributor to morbidity, disability, and loss of independence among older adults. Although several evidence-based falls prevention programmes have demonstrated effectiveness, decisions about which programmes to implement in practice should take into account feasibility, accessibility, and local context. Understanding the perspectives of key stakeholders is necessary to inform programme selection and implementation.

Methods: This qualitative descriptive study explored the perspectives of two key stakeholders, community-dwelling older adults and allied health professionals, regarding falls prevention programmes in Brunei Darussalam. Focus group discussions were conducted with older adults (n = 15), and semi-structured individual interviews with allied health professionals (n = 6). Participants discussed three established falls prevention programmes: the Otago Exercise Programme, Stepping On, and Lifestyle-integrated Functional Exercise. Data were analysed using reflexive thematic analysis.

Results: Four interrelated themes were identified. Older adults expressed agreement regarding the importance of reducing falls risk and supported initiatives to introduce falls prevention programmes, focusing primarily on accessibility rather than differentiating between specific interventions. In contrast, allied health professionals engaged more critically regarding programme delivery and sustainability. They expressed a conceptual preference for Stepping On, while considering how delivery could be adapted to local settings. Across both groups, the need for contextual and cultural adaptation emerged as a shared priority.

Conclusions: Stakeholder perspectives highlighted that programme preference was shaped less by intervention content or evidence base and more by feasibility, accessibility, and system fit. Integrating older adults’ and allied health professionals’ perspectives may enhance uptake, acceptability, and sustainability of fall prevention initiatives

Downloads

Download data is not yet available.

References

Rubenstein LZ. Falls in older people: Epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35(suppl 2):ii37-ii41. doi: 10.1093/ageing/afl084 DOI: https://doi.org/10.1093/ageing/afl084 Google Scholar

Moylan KC, Binder EF. Falls in older adults: Risk assessment, management and prevention. Am J Med. 2007;120(6):493.e1-493.e6. doi: 10.1016/j.amjmed.2006.07.022. DOI: https://doi.org/10.1016/j.amjmed.2006.07.022 Google Scholar

Sherrington C, Tiedemann A, Fairhall N, Close JC, Lord SR. Exercise to prevent falls in older adults: An updated meta-analysis and best practice recommendations. N S W Public Health Bull. 2011;22(4):78. doi: 10.1071/nb10056. DOI: https://doi.org/10.1071/NB10056 Google Scholar

Pillay J, Gaudet LA, Saba S, et al. Falls prevention interventions for community-dwelling older adults: Systematic review and meta-analysis of benefits, harms, and patient values and preferences. Syst Rev. 2024;13(1):289. doi: 10.1186/s13643-024-02681-3. DOI: https://doi.org/10.1186/s13643-024-02681-3 Google Scholar

Gardner MM. Practical implementation of an exercise-based falls prevention programme. Age Ageing. 2001;30(1):77-83. doi: 10.1093/ageing/30.1.77. DOI: https://doi.org/10.1093/ageing/30.1.77 Google Scholar

Davis JC, Robertson MC, Ashe MC, Liu-Ambrose T, Khan KM, Marra CA. Does a home-based strength and balance programme in people aged ≥80 years provide the best value for money to prevent falls? A systematic review of economic evaluations of falls prevention interventions. Br J Sports Med. 2010;44(2):80-89. doi: 10.1136/bjsm.2008.060988. DOI: https://doi.org/10.1136/bjsm.2008.060988 Google Scholar

Clemson L, Cumming RG, Kendig H, Swann M, Heard R, Taylor K. The effectiveness of a community-based program for reducing the incidence of falls in the elderly: A randomized trial. J Am Geriatr Soc. 2004;52(9):1487-1494. doi: 10.1111/j.1532-5415.2004.52411.x. DOI: https://doi.org/10.1111/j.1532-5415.2004.52411.x Google Scholar

Clemson L, Singh MAF, Bundy A, et al. Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): Randomized parallel trial. BMJ. 2012;345:e4547. doi: 10.1136/bmj.e4547. DOI: https://doi.org/10.1136/bmj.e4547 Google Scholar

Hanson H, Salmoni A. Stakeholders’ perceptions of programme sustainability: Findings from a community-based fall prevention programme. Public Health. 2011;125(8):525-532. doi: 10.1016/j.puhe.2011.03.003. DOI: https://doi.org/10.1016/j.puhe.2011.03.003 Google Scholar

Teo SP. Geriatrics inpatients in RIPAS Hospital, Brunei: Patient characteristics and rehabilitation needs. J Clin Gerontol Geriatr. 2018;9(2):52-59. doi: 10.24816/jcgg.2018.v9i2.04. DOI: https://doi.org/10.24816/jcgg.2018.v9i2.04 Google Scholar

Asrul Azmi MAW, Husaini A, Teo SP, Abdul Rahman H, Idris F. Physical and balance activity, mobility status and risk of falls among older people in Brunei Darussalam. Asian J Med Health Sci. 2026;9(1):277-290. doi: 10.70672/vkx0k048. DOI: https://doi.org/10.70672/vkx0k048 Google Scholar

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101. doi: 10.1191/1478088706qp063oa. DOI: https://doi.org/10.1191/1478088706qp063oa Google Scholar

Lovarini M, Clemson L, Dean C. Sustainability of community-based fall prevention programs: A systematic review. J Safety Res. 2013;47:9-17. doi: 10.1016/j.jsr.2013.08.004. DOI: https://doi.org/10.1016/j.jsr.2013.08.004 Google Scholar

Yardley L, Bishop FL, Beyer N, et al. Older people’s views of falls prevention interventions in six European countries. Gerontologist. 2006;46(5):650-660. doi: 10.1093/geront/46.5.650. DOI: https://doi.org/10.1093/geront/46.5.650 Google Scholar

Van Rhyn B, Barwick A. Health practitioners’ perceptions of falls and fall prevention in older people: A metasynthesis. Qual Health Res. 2018;29(1):69-79. doi: 10.1177/ DOI: https://doi.org/10.1177/1049732318805753 Google Scholar

Marquez-Doren F, Lucchini-Raies C, Alcayaga C, Bustamante C, González-Agüero M. Acceptability and feasibility of a comprehensive fall prevention model for independent older adults: A qualitative evaluation. Int J Nurs Stud Adv. 2024;7:100220. doi: 10.1016/j.ijnsa.2024.100220 DOI: https://doi.org/10.1016/j.ijnsa.2024.100220 Google Scholar

Albornos-Muñoz L, Blanco-Blanco J, Cidoncha-Moreno MÁ, et al. Efficacy of the Otago exercise programme to reduce falls in community-dwelling adults aged 65–80 when delivered as group or individual training: Non-inferiority clinical trial. BMC Nurs. 2024;23(1):705. doi: 10.1186/s12912-024-02310-3. DOI: https://doi.org/10.1186/s12912-024-02310-3 Google Scholar

Johar AA, Husaini A, Teo SP. Effectiveness of the Otago exercise programme in falls reduction among community-dwelling older people in Southeast Asia: A systematic review. Philipp J Intern Med. 2021;59:133-136. DOI: https://doi.org/10.65564/pjim.39483a270b Google Scholar