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BACKGROUND: As the older population grows rapidly, the incidence of falls and fall-related injuries is rising, underscoring the urgent need for systematic, evidence-based fall prevention.

OBJECTIVE: This study aimed to examine the implementation of the World Falls Guidelines for falls prevention in a region of Sweden, with particular attention to the implications of anchoring and developing a knowledge support tool within policy and practice.

METHODS: A participatory research design was employed, involving five diverse settings: primary care, hospital care, homecare, municipal social services and pensioners' organizations. Data collection included workshops, field notes and written material. Early implementation processes focused on anchoring and developing, aligning with the i-PARIHS framework. The data were analysed using a framework analysis.

RESULTS: The anchoring process revealed a lack of managerial support at the appropriate organizational level, which hindered cross-sectoral collaboration. Further, the developing process refined the content structure to better address the needs of both professionals and older adults. Seven themes were mapped by using i-PARIHS framework: (i) Innovation-adoption and adaptation, risk assessment; (ii) Recipients-intermediate managerial decision-making; (iii) Context-collaboration and resources, documentation and information sharing and accessibility and outreach and (iv) Facilitation-project or process.

CONCLUSION: Successful implementation requires anchoring and organizational alignment across all levels, with particular emphasis on the engagement of intermediate management. While the primary challenges emerge at the organizational (meso) level, they are closely interconnected with both micro-level and macro-level influences. Coordinated efforts across all levels are therefore essential for effective implementation strategies.

Background

Physical inactivity is a major public health concern worldwide. Psychological distress is linked to physical inactivity, which increases the risk of several diseases. Women tend to be more physically inactive than men. Moreover, physical inactivity increases with age in both sexes. Therefore, this study aimed to investigate the association between psychological distress and physical inactivity in adults aged ≥ 65 years, the role of psychosocial factors and explore sex-based differences.

Methods

This study included 14,213 older adults, comprising 7,069 women (52%) (median age = 75 years), who responded to a survey questionnaire sent to a random population sample in Mid-Sweden in 2022. The response rate in the population aged ≥ 65 years was 61%. The association between psychological distress as defined by the Kessler-6 and physical inactivity (< 150 min/week of physical activity) was analyzed using binary logistic regression, adjusting for sex, age, country of birth, educational level, and psychosocial factors.

Results

Overall, 30% of the participants reported psychological distress, and 45% were physically inactive. Psychological distress and physical inactivity were significantly associated (p < 0.001), being more common among women (p < 0.001). In the fully adjusted model, the Odds Ratio (OR) for physical inactivity was 1.46 (95% confidence interval (CI) 1.43–1.50) for women and 1.70 (95% CI: 1.65–1.74) for men regarding moderate psychological distress and 2.87 (95% CI: 2.72–3.04) for women and 2.43 (95% CI: 2.28–2.58) for men regarding serious psychological distress. Not participating in social activities in the last 12 months was associated with physical inactivity in both women and men.

Conclusions

Psychological distress is significantly associated with physical inactivity among older adults. Participation in social activities was identified as an essential factor in addressing physical inactivity. Social connections and physical inactivity are important factors to consider when supporting older adults’ mental health. Public health interventions should promote and raise awareness of physical and mental health as well as the social dimensions of aging, while also considering age and sex-based differences.