Implementation of fall prevention for older clients in community rehabilitation: protocol for the pilot stepped wedge cluster randomised trial of SAIFR (Systematic Approach to the Implementation of Falls Recommendations).

INTRODUCTION

Evidence-based guidelines provide recommendations to prevent falls, but the best way to implement these recommendations in health services is not clear.

AIM: To evaluate the feasibility and potential impact of the Systematic Approach to the Implementation of Falls Recommendations (SAIFR), a structured approach to implementing fall prevention guidelines in a community rehabilitation setting.

METHODS

An open label, pilot stepped wedge cluster randomised hybrid type 2 trial across two Community Rehabilitation Program sites. Implementation will be staggered, with order randomised. The population will be clients of the Program aged 65 years and older who receive occupational therapy and/or physiotherapy. Implementation support will include training, workshops, and creation and enhancement of resources to align practice to the World Falls Guidelines and Australian Falls Guidelines recommendations. Interviews will be conducted with 24-40 clients and therapists, alongside medical record audits, falls surveys, and a researcher log. Primary outcomes will be recruitment (trial feasibility) and reach and implementation (potential impact). Secondary measures will be further measures of trial feasibility along with effectiveness, adoption, reach and implementation (potential impact). Outcomes of trial feasibility and potential impact will be assessed against progression rules.

ETHICS AND DISSEMINATION: The Eastern Health and La Trobe University Human Research Ethics Committees approved this study (LR25-093-124,139), which was registered prospectively with the Australian and New Zealand Clinical Trials Registry (ACTRN12626000096358, https://anzctr.org.au/TrialSearch.aspx). Data collection extends from March 2026 to June 2027. Results will inform the design of an adequately powered stepped-wedge cluster randomised controlled trial.