AUTHOR=van der Laag Patricia J. , Dorhout Berber G. , Heeren Aaron A. , Veenhof Cindy , Barten Di-Janne J. A. , Schoonhoven Lisette 

TITLE=Barriers and facilitators for implementation of a combined lifestyle intervention in community-dwelling older adults: a scoping review

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1253267

DOI=10.3389/fpubh.2023.1253267

ISSN=2296-2565

ABSTRACT=Background: Lifestyle interventions, combining nutrition and exercise, are effective in improving physical functioning of community-dwelling older adults and preventing healthcare risks due to loss in muscle mass. However, the potential of these type of interventions is not being fully exploited due to insufficient implementation. Having insight into the determinants that could hinder or facilitate the implementation of a combined lifestyle intervention could improve the development of matching implementation strategies and enhance the implementation of such lifestyle interventions. The aim of this study is to identify barriers and facilitators for a successful implementation of a combined lifestyle intervention for community-dwelling older adults. Method: A scoping review was conducted. A literature search was conducted in four electronic databases, references were checked for additional inclusion. Studies were screened if they met the inclusion criteria. Barriers and facilitators were extracted from the included studies. To validate the results of the literature search, healthcare professionals and community-dwelling older adults were interviewed. Barriers and facilitators were categorized by two researchers according to the constructs of the Consolidated Framework for Implementation Research (CFIR).The search identified 12364 studies, 23 were found eligible for inclusion in the review. Barriers and facilitators for 26 of the 39 constructs of the CFIR were extracted. The interviews with healthcare professionals and older adults yielded six extra barriers and facilitators for implementation, resulting in determinants for 32 of the 39 CFIR constructs. According to literature and healthcare professionals cosmopolitanism (network with external organizations), patient needs and resources, readiness for implementation, costs, knowledge and beliefs about the intervention, network and communication, and engaging were found to be the most important determinants for implementation of a combined lifestyle intervention.A broad range of barriers and facilitators across all domains of the CFIR framework emerged in this study. The results of this review reflects on determinants that should be taken into account when planning for implementation of a combined lifestyle intervention. A further step in the implementation process is development of implementation strategies aiming at the identified determinants, to enhance the implementation of a combined lifestyle intervention in community care.