Dear Dr. Linnerud,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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The authors of this systematic review aimed to assess the effectiveness of implementation strategies for uptake of fall prevention interventions in community settings. The review is relevant however, my major concern is that the search is over a year old. The search date is a concern for two reasons: 

firstly, as the authors have themsleves highlighted that the review by Vandervelde et al is of a similar scope and is very recent;

secondly, there are only a few studies included in the review and any recent study might have major implications on the results of the review.

I would suggest that if the authors could update the search, the results would be more recent and relevant.

==============================

Please submit your revised manuscript by Jan 03 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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Rehana Abdus Salam

Academic Editor

PLOS ONE

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Additional Editor Comments:

The authors of this systematic review aimed to assess the effectiveness of implementation strategies for uptake of fall prevention interventions in community settings. The review is relevant however, my major concern is that the search is over a year old. The serach date is a concern for two reasons:

firstly, as the authors have themsleves highlighted that the review by Vandervelde et al is of a similar scope and is very recent;

secondly, there are only a few studies included in the review and any recent study might have major implications on the results of the review.

I would suggest that if the authors could update the search, the results would be more recent and relevant.

1. Line 130: "In case of disagreement...."

2. The authors have used the terms 'recommendations' and 'interventions interchangeably and I would suggest consistency for readers.

3. This statement in the Disucssion section is not clear: "the use of an implementation strategy did not provide unambiguous effects for falls leading to referral to acute care."

4. I think that it is important to specify how the authors eligibiltiy criteria differed from the review by Vandervelde et al in the disucsison sestion where they state: "Vandervelde et al. (14) aimed at summarize implementation strategies in multifactorial fall prevention interventions and had other eligibility criteria than used in this current systematic review." especially when they have inlcuded three RCTs and three non_RCTs that do not overlap with the included studies in this review.

4. Line 319: Change Prospero to PROSPERO

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: Yes

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2. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: N/A

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3. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #1: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

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Reviewer #1: Thank you for giving me the opportunity to review this manuscript. This is a very important area, which requires commitment from stakeholders to deliver effectively, and can be challenging in local contexts. Evidence of effective implementation strategies are needed.

Introduction

The literature to date is clearly presented, with good level of detail on other reviews in the area.

Methods

Supported with appropriate guidelines and pre-registered.

Line 143: was the implementation strategy extracted verbatim? see comment on Table 1 below.

Lines 202 – 214: I find this section difficult to follow. Suggest “the strategy used by…” rather than “ the first strategy”, or add some more context. Were the studies comparing the effects between the standard and enhanced support? In line with Table 1, suggest describing Ford et al’s study before the others.

Table 1: A number of changes may help readability here. Can I suggest to add reference numbers to the studies listed; I initially read Guse 2015 and Paterson 2015 as one report – two citation numbers would help here. Add “1st” to Author. Explain BHAS and ALCOVE abbreviations. Is “cluster of single strategies” described in the text? What guided your categorization of these into A-F? I would be inclined to add more detail to the interventions in the table.

Results

Results are clearly presented and demonstrate the challenge to coming to a conclusive answer.

Strength, Limitations and Conclusions are clear and well presented.

Presentation:

There is a different font used in Table 1 for “comparison”. Line 130 [I]n cases of disagreement….

Figure 1 was not clear in the PDF document.

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Reviewer #1: No

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Dear Dr. Linnerud,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

==============================

I would like to thank the authors for revising the draft. However, the manuscript still lacks clarity with regards to the eligibility criteria. This could be due to the fact that the authors had to ammend their protcol due to a recent publication in the same domain. However, the methodology appears to lack the rigor and I have highlighted quite a few major revisions required in order to consider the draft again for publication.

==============================

Please submit your revised manuscript by Mar 15 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols . Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols .

We look forward to receiving your revised manuscript.

Kind regards,

Rehana Abdus Salam

Academic Editor

PLOS ONE

Additional Editor Comments:

I would like to thank the authors for revising the draft. However, the manuscript still lacks clarity with regards to the eligibility criteria. This could be due to the fact that the authors had to ammend their protcol due to a recent publication in the same domain. However, the methodology appears to lack the rigor and I have highlighted quite a few major revisions required in order to consider the draft again for publication:

ABSTRACT:

1. Use of term 'clinical' in relation to the interventions is a bit confusing considering that the review includes studies conducted in community care rather than clinical or hospital settings. Use of the term 'clinical' in relation to the outcomes is fine since the those outcomes refer to ER admissions or hospitalisations. I would suggest if the authors could reconsider using the term 'clinical' in relation to the interventions in the abstract as well as elsewhere in the draft.

INTRODUCTION:

The introduction is lengthy and fails to make a good enough case for evaluating implementation strategies for interventions preventing falls in community settings. I have made a few suggestions below to improve that:

1. In line with the first comment under 'ABSTRACT', there is a lot of dicussion around uptake of implementation strategies in clinical practice. However, the authors do not make a good enough case for current practice and uptake in commuity settings.

2. The third paragraph in the 'Introduction' section appears to be more of a 'Discussion' around similarities and differences between this review and other existing reviews. I would suggest that the authors either move it to discussion or completely remove it if the same references are already being discussed in the 'Discussion' section.

3. Paragraph 4 seems repetitive of what has already been established in the end of paragraph 2. For e.g. "When implementing clinical guidelines in general, previous systematic reviews have identified clinical decision support, practice visits, audit and feedback, use of local opinion leaders, tailored interventions, and training as effective strategies. In addition, commonly used strategies for fall prevention include the involvement of stakeholders and tailoring. However, none of these reviews have evaluated the effectiveness of these implementation strategies specifically for fall prevention." can be deleted.

METHODS:

1. Please state all the outcomes considered under 'Implementation Outcomes' and 'Clinical Outcomes' separately. Later in the results section, authors mention the Proctors’ taxonomy of implementation outcomes. I would suggest clarifying in the methodology if these were considered or removing them from the Results section.

2. Considering that the authors have focused on the effectiveness of implementation strategies rather than interventions, I feel that it merits some elaboration in the methods section. For e.g. under the section on 'data extraction' when authors state 'details of implementation strategy' some details can be added on what implementation strategies were anticipated? which implementation strategies did author consider eligible for inclusion? Moreover, the statements like 'single strategies within each identified implementation strategy' could also be very confusing to readers who are not implementation scientists and hence some description of ERIC implementation strategies would be helpful to provide some insight on what are implementation strategies and what was eligible for inclusion in this review. The authors can also add a supplementary table for further reading here.

RESULTS:

1. Not sure why the authors have referred to the Proctors’ taxonomy of implementation outcomes under the section 'Implementation strategy' as it was not discussed in the methods section (as I have highlighted earlier). I would suggest that the authors either add the details in the methods section if any data was extracted based on Proctors' implementation outcomes or delete this statement from the Results section.

2. If the implementation strategies are highlighted earlier in the methods section as suggested, it would be easier for the readers to comprehend the results detailed under the section reporting on 'implementation strategies'.

3. Again, the statement "The second implementation strategy, known as the standard support, comprised funding and a training compendium, similar to the enhanced support (24, 28). For the purpose of this review, only the enhanced strategy has been included." does not make sense since the eligilibity of implementation strategies were not detailed in the methods section. I would suggest that the authors clearly define the implementation strategies considered for inclusion in the 'methods' section in order to guide the 'Results.

4. I would suggest that the authors separately report the implementation outcomes and the clinical outcomes in the text as well as they have reported in the table.

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[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

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Effectiveness of implementation strategies for uptake of fall prevention interventions in community care: A systematic review

PONE-D-24-39287R2

Dear Dr. Linnerud,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Rehana Abdus Salam

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: