7 Optimizing and implementing a community-based group fall prevention program | 133 consisted of five focus groups. Three focus groups were held with FPP participants, one focus group with therapists, and one focus group with other stakeholders (280). Inclusion and exclusion criteria For the focus groups, older adults living in the environment of Amsterdam, Veghel and Best in the Netherlands and participating in the randomized controlled trial investigating the (cost-) effectiveness of the In Balance FPP were invited to participate in this study (280). Participants were 65 years or older with an increased risk of falls according to the fall risk screening questionnaire (145-147, 280). All participants were able to independently execute activities of daily living (e.g., going to the bathroom and dressing) and walk 100 meter. Older adults were included if they were classified as non-frail or pre-frail based on the phenotype concept introduced by Fried et al. (29). Potential participants were excluded if they participated in a fall prevention intervention in the past 6 months, if they were unable to read and understand Dutch, if they had cognitive impairment defined as a score lower than 19 on the Mini-Mental State Examination (104), or if they had any self-reported uncontrolled comorbid conditions or contraindications for conducting physical exercises during the In Balance intervention (e.g., cardiovascular, neurological and orthopaedic problems). See the description of the study protocol of the (cost-)effectiveness study of the In Balance program for a more elaborate description of the inclusion and exclusion criteria (280). All therapists who participated in the in the (cost-)effectiveness study were invited to also participate voluntary in this study (280). For the stakeholders, we searched for a varied group in our network based on suggestions from the advisory group. Ethics Ethical approval was obtained from the Medical Ethical Committee Brabant (project number P2055) on 10 February 2021. This study was conducted according to the principles of the Declaration of Helsinki (7th revision, October 2013) and other guidelines, regulations and acts such as Good Clinical Practice and the statement conducting research involving humans. All participants of the focus groups signed informed consent and were aware that participation is voluntary. All FPP participants also signed consent for presenting their demographic characteristics. Participants were able to withdraw from the study at any time. In reporting this study, the consolidated criteria for reporting qualitative research (COREQ) were followed (282). This trial was registered in the Netherlands Trial Register: NL9248 (registered February 13 2021, URL: https://www.trialregister.nl/trial/9248).
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