Evidence map›Paper›PMID 40998446›Full record

ArticleBMJ open2025

Scalability evaluation of a complex community-based falls prevention intervention in Australian stroke rehabilitation.

Ingrid Lin, Sally Day, Catherine M Dean, Lindy Maxted Clemson, Joanne Valentina Glinsky, Anne Cusick, Natasha A Lannin, Katharine Scrivener

Abstract read
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In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ingrid LinDepartment of Health Sciences, Macquarie University, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0002-3613-6992
Sally DaySydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
Catherine M DeanDepartment of Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
Lindy Maxted ClemsonSydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0003-2687-1114
Joanne Valentina GlinskySydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
Anne CusickSydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
Natasha A Lannin *Department of Neuroscience, Monash University, Melbourne, Victoria, Australia Natasha.Lannin@monash.edu.ORCID http://orcid.org/0000-0002-2066-8345
Katharine Scrivener *Department of Health Sciences, Macquarie University, Sydney, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate the scalability of the multi-component Falls After Stroke Trial (FAST) intervention tailored to community-dwelling adults with stroke to enable post-trial implementation.

designA mixed-methods formative evaluation of FAST data guided by the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework.

settingCommunity settings across three states in Australia.

participantsStroke participants were a subset of FAST trial participants (n=50) who were community-dwelling adults who had experienced a stroke up to 5 years prior and were at risk of falling. Therapists who delivered the intervention in the trial (interventionists) were physiotherapists and occupational therapists, trained in the FAST intervention.

interventionsThe FAST intervention is an individually tailored home safety and functional exercise programme designed to reduce falls and improve community mobility. It is offered over a 6-month period using 10 home visits, two telephone calls and programme resources, for example, manual and worksheets. PRIMARY AND SECONDARY OUTCOME MEASURES: Trial data, including interventionist training records and delivery data, resources and stroke participants' adherence data were used to assess the Adoption, Implementation and Maintenance dimensions of the RE-AIM framework.

resultsThe FAST intervention was delivered by 22 interventionists. High implementation fidelity was shown with 90% of the stroke participants receiving FAST dose and content. Effective strategies supporting implementation included standardised programme resources, comprehensive pre-programme training, regular interventionist feedback and interventionist mentoring from experts. Online training and peer support networks will be required for scale up.

conclusionsThis study identifies how a complex intervention to prevent falls after stroke was successfully delivered. The AIM dimensions provided insights to FAST features essential for scale-up. Interventionist training, resources and mentoring/feedback were essential for adoption within the trial. Training and resources should be accessible in an online format for scale up (maintenance). TRIAL REGISTRATION NUMBER: ACTRN12619001114134.

Indexed as

Accidental FallsExercise TherapyStrokeStroke RehabilitationAgedAged, 80 and overAustraliaFemaleHumansIndependent LivingMaleMiddle AgedProgram EvaluationBehaviorClinical trialsImplementation ScienceRandomized Controlled TrialREHABILITATION MEDICINEStroke

Identifiers

PMID40998446
PMCPMC12481250

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.