Stakeholder perspectives on selecting falls prevention programmes in Brunei Darussalam

Background: Falls are a major contributor to morbidity, disability, and loss of independence among older adults. Although several evidence-based falls prevention programmes have demonstrated effectiveness, decisions about which programmes to implement in practice should take into account feasibility, accessibility, and local context. Understanding the perspectives of key stakeholders is necessary to inform programme selection and implementation. Methods: This qualitative descriptive study explored the perspectives of two key stakeholders, community-dwelling older adults and allied health professionals, regarding falls prevention programmes in Brunei Darussalam. Focus group discussions were conducted with older adults (n = 15), and semi-structured individual interviews with allied health professionals (n = 6). Participants discussed three established falls prevention programmes: the Otago Exercise Programme, Stepping On, and Lifestyle-integrated Functional Exercise. Data were analysed using reflexive thematic analysis. Results: Four interrelated themes were identified. Older adults expressed agreement regarding the importance of reducing falls risk and supported initiatives to introduce falls prevention programmes, focusing primarily on accessibility rather than differentiating between specific interventions. In contrast, allied health professionals engaged more critically regarding programme delivery and sustainability. They expressed a conceptual preference for Stepping On, while considering how delivery could be adapted to local settings. Across both groups, the need for contextual and cultural adaptation emerged as a shared priority. Conclusions: Stakeholder perspectives highlighted that programme preference was shaped less by intervention content or evidence base and more by feasibility, accessibility, and system fit. Integrating older adults’ and allied health professionals’ perspectives may enhance uptake, acceptability, and sustainability of fall prevention initiatives