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PHysical activity Implementation Study In Community-dwelling AduLts (PHISICAL): study protocol
  1. Hannah Carpenter1,
  2. Sarah Audsley1,
  3. Carol Coupland1,
  4. John Gladman2,
  5. Denise Kendrick1,
  6. Natasher Lafond1,
  7. Philippa Logan2,
  8. Dawn A Skelton3,
  9. Clare Timblin1,
  10. Stephen Timmons4,
  11. Derek Ward5,
  12. Elizabeth Orton1
  1. 1 Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
  2. 2 Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
  3. 3 School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Glasgow, UK
  4. 4 Centre for Health Innovation, Leadership and Learning, Business School, University of Nottingham, Nottingham, UK
  5. 5 College of Health and Social Care, University of Derby, Derby, UK
  1. Correspondence to Dr Elizabeth Orton, Division of Primary Care, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK; elizabeth.orton{at}


Background Falls in older people are a leading causes of unintentional injury. Due to an ageing population, injuries are likely to increase unless more is done to reduce older people’s falls risk. In clinical trials, the Falls Management Exercise (FaME) programme has reduced the rate of falls and falls-related injuries in community-dwelling older adults. However, the commissioning of FaME is inconsistent across England, potentially due to a lack of evidence that FaME can be delivered effectively in a ‘real world’ setting. The PHysical activity Implementation Study In Community-dwelling AduLts (PHISICAL) study is designed to study the implementation of FaME in a range of different settings in England.

Methods The PHISICAL study will use a mixed-methods, triangulation, multilevel design to explore the implementation of FaME. Framework analysis of semistructured interviews with up to 90 stakeholders (exercise programme users, service providers, referrers and commissioners) and observational data from locally led communities of practice will identify the factors that influence FaME’s implementation. Quantitative, anonymised, routine service data from up to 650 exercise programme users, including measures of falls and physical activity, will allow assessment of whether the benefits of FaME reported in clinical trials translate to the ‘real world’ setting.

Conclusion The findings from this study will be used to develop a toolkit of resources and guidance to inform the commissioning and delivery of future FaME programmes. This study has the potential to inform public health prevention strategies, and in doing so may reduce the number of falls in the older population while delivering cost savings to health and social care services.

  • fall
  • community
  • outcome of injury

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  • Contributors The study was conceived by EO, DK, JG, PL and DAS. HC and EO drafted this manuscript in consultation with all coauthors. All coauthors critically reviewed and approved the final version of this manuscript and response to reviewers' comments.

  • Funding The research was funded by the NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands (CLAHRC EM) and Leicestershire County Council.

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests DAS is a director of Later Life Training, a not for profit training provider, delivering training to PSIs in delivery of the FaME programme. DAS will not have access to any raw quantitative data to look at efficacy and will not attend any CoP events or be able to influence the results or analysis of the study. DAS will, however, have access to raw data on quality assurance of the PSIs in order to provide feedback on fidelity and quality of teaching. All other authors have no competing interest to declare.

  • Patient consent Obtained.

  • Ethics approval This study was approved by the London-Chelsea Research Ethics Committee, reference number 16/LO/0396.

  • Provenance and peer review Not commissioned; externally peer reviewed.