Learning from the early adoption of an evidence-based Falls Management Exercise Programme (FaME) in Ireland

Abstract

Background The Falls Management Exercise (FaME) programme is a group-based strength and balance intervention shown to reduce falls and support physical activity and independence in older adults, with lasting effects. A key component is teaching participants how to get up from the floor, reducing fear and ambulance calls. Although UK studies highlight implementation challenges, FaME remains effective across populations. With Ireland’s over-65 population projected to exceed one million within a decade and injury costs set to surpass €2 billion, community-based falls prevention is urgently needed. In 2022, the AFFINITY project funded the training of 120 instructors to deliver FaME nationally. FaME Ireland now aims to assess early adoption, focusing on service integration, programme acceptability, and sustainability. Methods To evaluate early adoption, all FaME-trained instructors were surveyed on their delivery experiences. The HSE Change Guide, an experience-based co-design and action research approach, is being applied at three early-adopter sites reflecting varied contexts. Interviews, observations, and co-design workshops explored delivery, access, sustainability, and post-programme physical activity. Results Survey response rate was 67% (n=103), with good geographic coverage. Just over half reported delivering FaME, though some faced long waiting lists. Strong demand and positive participant feedback enabled uptake, but barriers included funding, venue shortages, and limited referral systems. Participants valued improved confidence and social connection, but access, awareness, and follow-on options were limited. Instructor job insecurity and short-term funding threatened sustainability. Local workshops proposed solutions including increased awareness, better referral pathways, and stronger networks. Conclusion FaME is valued and impactful, but early implementation reveals service gaps. To scale effectively, improved referral systems, long-term funding, and workforce support are needed. Upcoming HSE restructuring presents an opportunity to embed FaME nationally and enhance older adults’ independence and wellbeing.