Implementing a Belgian program to enhance the uptake and effectiveness of a multifactorial falls prevention intervention in community-dwelling older adults: A mixed-methods process and implementation evaluation.

Authors

Sara Vandervelde, Goedele Belaen, Bernadette Dierckx de Casterlé, Ellen Vlaeyen, Johan Flamaing, Kim Delbaere, Alexandre Bohyn, Dirk Cambier, Koen Milisen

Published in

Age and ageing. Volume 55. Issue 11. Oct 31, 2026.

Abstract

To improve the implementation and uptake of a multifactorial falls prevention intervention, the Belgian Program to Enhance the Uptake and Effectiveness of a Multifactorial Falls Prevention Intervention in Community-Dwelling Older people (BE-EMPOWERed) program was systematically developed. It includes a 7-week group program for older people, workshops for healthcare professionals and an implementation plan with implementation guidance for primary care areas (PCAs) in Flanders. This study implemented BE-EMPOWERed in four PCAs and evaluated its implementation processes and implementation outcomes.
This embedded mixed-methods process evaluation was conducted over a 2-year period in four PCAs. Implementation processes and outcomes were assessed using participant lists, fidelity checklists, observations, focus group interviews and self-reported intervention costs. The process evaluation was guided by the Medical Research Council framework. Quantitative data were analysed descriptively and qualitative data were analysed using the Qualitative Analysis Guide of Leuven.
A total of 196 people participated in the group program with high attendance across sessions. Fidelity assessments across 20 group programs demonstrated high adherence to many structural and delivery-related program components. However, lower fidelity was observed for some behaviour change components. Qualitative findings suggested increased knowledge and awareness among older people, with reported application of falls prevention interventions in daily life. Overall, the findings indicate that strong engagement stemmed from group dynamics and the way group leaders delivered the program, while sustainability was hindered by limited resources and reliance on local champions.
The BE-EMPOWERed program was feasible and acceptable across diverse PCAs, with high engagement and overall good fidelity. However, challenges in sustainability highlight the need for structural support to enable long-term implementation.
ClinicalTrials.gov (NCT06105437).

PMID:
43031542
Bibliographic data and abstract were imported from PubMed on 14 Nov 2026.

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