Background Hip protectors (HP) represent an attractive strategy for reducing hip fractures in high-risk elderly individuals. However, clinical studies have yielded conflicting results regarding their clinical effectiveness. This is mainly due to poor compliance (acceptance and adherence) among users. As a result, there is an urgent need to identify potential barriers and facilitators to initial acceptance and continued adherence with HP use.

Aims/Objectives/Purpose The objective of this Systematic Review is to (1) synthesize available research evidence to identify factors that influence HP compliance among older adults in long-term care facilities; (2) interpret the findings to identify the best strategies to overcome perceived barriers and improve acceptance and adherence with HP use; and (3) package and disseminate the findings in a form that is relevant, practical and easily interpreted by the knowledge users and decision makers.

Methods A key word search was conducted for studies published in English between 2000 and 2011 that employed quantitative, qualitative, or mixed-methods research designs. Each study was independently reviewed by two reviewers against the inclusion criteria with discrepancies determined by a third.

Results/Outcomes 24 articles met the criteria and 63 barrier and facilitator factors were separated into 4 levels: organizational, staff, resident, and product.

Significance/Contribution to the field The outcomes provide decision makers, health professionals, and caregivers with a greater awareness of strategies to improve compliance with the use of hip protectors. Furthermore, researchers will be able to use the information to design better clinical trials that will yield high acceptance and adherence.