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Supporting implementation of occupational therapy led Falls Hazard Reduction at Home: A scoping review.

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Title: Supporting implementation of occupational therapy led Falls Hazard Reduction at Home: A scoping review.
Authors: Melchert, Susan (AUTHOR), Lowrie, Daniel (AUTHOR), Pighills, Alison (AUTHOR)
Source: Australian Occupational Therapy Journal. Feb2026, Vol. 73 Issue 1, p1-22. 22p.
Subjects: Home accident prevention, Patient education, Independent living, Human services programs, Research funding, Interprofessional relations, CINAHL database, Home environment, Occupational therapy, Systematic reviews, MEDLINE, Stakeholder analysis, Accidental falls
Abstract: Introduction: Accidental falls among older people pose a significant threat to both morbidity and mortality. Falls Hazard Reduction at Home (FHR@Home) when delivered by occupational therapists has been demonstrated as an effective fall prevention intervention. Despite the evidence, FHR@Home is not routinely implemented in practice. This scoping review seeks to explore existing literature to support implementation of FHR@Home by answering the question: 'What is known about implementation strategies used to support home and community environmental falls prevention intervention in health care?' Methods: This review used the Joanna Briggs Institute (JBI) methodological guidance for the conduct of scoping reviews. A comprehensive search was conducted across electronic databases, government websites, and web‐based search engines. Studies were included if they incorporated FHR@Home as part of their intervention and explicitly referenced implementation science or knowledge translation concepts. Data were extracted from the included studies and reported implementation strategies were mapped using the Expert Recommendations for Implementing Change (ERIC) taxonomy and their associated clusters. A separate thematic analysis process was also conducted. Consumer and Community Involvement: There was no consumer and community involvement. Results: Nineteen studies met the inclusion criteria. All ERIC implementation strategy clusters are reported on in the studies. Strategies relating to engagement and education of stakeholders appear more often in the literature. Three themes were identified as having influence on implementation outcomes: (1) Home as a practice context; (2) Collaboration is key to success; and (3) Balance of assumed knowledge, experience and fidelity. Conclusion: The findings underscore the need for further research to explore how implementation strategies can better support occupational therapists in delivering FHR@Home, particularly in ways that respect the consumer's sense of home while maintaining fidelity to evidence‐based protocols. Expanding the literature in this area will be beneficial to improve uptake and sustainability of FHR@Home practices. PLAIN LANGUAGE SUMMARY: For older people, falls can lead to serious injury and possible long‐term disability. Occupational therapists can help to prevent falls by working with older people in their homes to find and reduce falls hazards in a structured way. We call this Falls Hazard Reduction at Home or FHR@Home. Even though research shows FHR@Home works well, it is not always used in health care. We wanted to understand what helps support health services to use FHR@Home more regularly. To do this, we looked at research that included FHR@Home as part of falls prevention programs and that mentioned ideas from implementation science (a field that studies the ways we can support the use of good ideas in practice). We found 19 studies. Many of them focused on educating health workers and older people, as well as working closely with other people involved in falls prevention. We also found three important themes that affect the way we put FHR@Home into practice: (1) being in people's homes matters because it is not clinical, it is personal; (2) working closely with older people and other services is key to success; and (3) occupational therapists need to balance FHR@Home theory and their own knowledge and assumptions to get good outcomes. We suggest more research is needed to help health services use FHR@Home more often. Future work should focus on how to support older people's sense of home while making sure therapists follow best practices. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Introduction: Accidental falls among older people pose a significant threat to both morbidity and mortality. Falls Hazard Reduction at Home (FHR@Home) when delivered by occupational therapists has been demonstrated as an effective fall prevention intervention. Despite the evidence, FHR@Home is not routinely implemented in practice. This scoping review seeks to explore existing literature to support implementation of FHR@Home by answering the question: 'What is known about implementation strategies used to support home and community environmental falls prevention intervention in health care?' Methods: This review used the Joanna Briggs Institute (JBI) methodological guidance for the conduct of scoping reviews. A comprehensive search was conducted across electronic databases, government websites, and web‐based search engines. Studies were included if they incorporated FHR@Home as part of their intervention and explicitly referenced implementation science or knowledge translation concepts. Data were extracted from the included studies and reported implementation strategies were mapped using the Expert Recommendations for Implementing Change (ERIC) taxonomy and their associated clusters. A separate thematic analysis process was also conducted. Consumer and Community Involvement: There was no consumer and community involvement. Results: Nineteen studies met the inclusion criteria. All ERIC implementation strategy clusters are reported on in the studies. Strategies relating to engagement and education of stakeholders appear more often in the literature. Three themes were identified as having influence on implementation outcomes: (1) Home as a practice context; (2) Collaboration is key to success; and (3) Balance of assumed knowledge, experience and fidelity. Conclusion: The findings underscore the need for further research to explore how implementation strategies can better support occupational therapists in delivering FHR@Home, particularly in ways that respect the consumer's sense of home while maintaining fidelity to evidence‐based protocols. Expanding the literature in this area will be beneficial to improve uptake and sustainability of FHR@Home practices. PLAIN LANGUAGE SUMMARY: For older people, falls can lead to serious injury and possible long‐term disability. Occupational therapists can help to prevent falls by working with older people in their homes to find and reduce falls hazards in a structured way. We call this Falls Hazard Reduction at Home or FHR@Home. Even though research shows FHR@Home works well, it is not always used in health care. We wanted to understand what helps support health services to use FHR@Home more regularly. To do this, we looked at research that included FHR@Home as part of falls prevention programs and that mentioned ideas from implementation science (a field that studies the ways we can support the use of good ideas in practice). We found 19 studies. Many of them focused on educating health workers and older people, as well as working closely with other people involved in falls prevention. We also found three important themes that affect the way we put FHR@Home into practice: (1) being in people's homes matters because it is not clinical, it is personal; (2) working closely with older people and other services is key to success; and (3) occupational therapists need to balance FHR@Home theory and their own knowledge and assumptions to get good outcomes. We suggest more research is needed to help health services use FHR@Home more often. Future work should focus on how to support older people's sense of home while making sure therapists follow best practices. [ABSTRACT FROM AUTHOR]
ISSN:00450766
DOI:10.1111/1440-1630.70061