title: [A Matter of Balance: strategy for implementation in Dutch homecare organizations].
abstract: BACKGROUND
  The Dutch version of A Matter of Balance (AMB-NL) is a cognitive behavioral group program to reduce fear of falling and related activity avoidance in community-living older persons. This paper presents the strategy for implementation of AMB-NL in Dutch homecare organizations and the outcomes of this implementation. The aim was to implement AMB-NL in at least 50 % of 64 homecare organizations in The Netherlands in 2009 and 2010.
  
  
  METHODS
  The implementation strategy was based on the four phases of the Replicating Effective Interventions: pre-conditions, pre-implementation, implementation, and maintenance and evolution.
  
  
  RESULTS
  After preparing the implementation activities, such as identifying implementation barriers, consulting stakeholders, preparing the materials involved in the implementation, and training the facilitators of the program (n = 53), AMB-NL was implemented in 16 of the 64 homecare organizations (25 %). Another five homecare organizations indicated that they would shortly include AMB-NL in their care program. These organizations conducted the intervention 19 times to a total of 178 participants. After the implementation phase another 16 facilitators were trained, and program materials were successfully disseminated.
  
  
  CONCLUSIONS
  The implementation of AMB-NL was well performed. The targeted aim is not fully reached within the two-year timeframe, but the program is well received by participants, trainers and homecare organizations. Further implementation and maintenance of AMB-NL in primary health care is recommended.
authors: Trimbos-instituut, Utrecht, The Netherlands. mjonge@trimbos.nl
authors: M C
authors: MC
authors: de Jonge
authors: A
authors: A
authors: van der Poel
authors: J C M
authors: JC
authors: van Haastregt
authors: M F T M
authors: MF
authors: Du Moulin
authors: G A R
authors: GA
authors: Zijlstra
authors: I
authors: I
authors: Voordouw
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods* / Q000458:organization & administration; D005239:Fear / Q000523:psychology*; D005260:Female; D016330:Frail Elderly / Q000523:psychology; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D016896:Treatment Outcome