BACKGROUND AND OBJECTIVES: Fear of falling (FoF) is associated with decreased physical functioning and an increased fall risk. Interventions generally demonstrate moderate effects and optimized interventions are needed. Intervention characteristics, such as setting or delivery method may vary. We investigated which overarching intervention characteristics are associated with a reduction in FoF in community-dwelling older people. RESEARCH DESIGN AND METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) in community-dwelling older people without specific diseases was performed. Associations between intervention characteristics and standardized mean differences (SMD) were determined by univariate meta-regression. Sensitivity analyses were performed. RESULTS: Data on 62 RCTs were extracted, 50 intervention groups were included in the meta-analysis. Most intervention characteristics and intervention types were not associated with the intervention effect. Supervision by a tai chi instructor (SMD -1.047, 95% confidence interval (CI) -1.598 to -0.496) and delivery in a community setting (SMD -0.528, 95% CI -0.894 to -0.161) were-compared to interventions without these characteristics-associated with a greater reduction in FoF. Holistic exercise, such as Pilates or yoga (SMD -0.823, 95% CI -1.255 to -0.392), was also associated with a greater reduction in FoF. Delivery at home (SMD 0.384, 95% CI 0.002 to 0.766) or with written materials (SMD 0.452, 95% CI 0.088 to 0.815) and tailoring were less effective in reducing FoF (SMD 0.687, 95% CI 0.364 to 1.011). DISCUSSION AND IMPLICATIONS: Holistic exercise, delivery with written materials, the setting and tailoring potentially represent characteristics to take into account when designing and improving interventions for FoF in community-dwelling older people. PROSPERO international prospective register of systematic reviews, registration ID CRD42018080483.
Copyright the Gerontological Society of America. Reproduced by permission of the publisher.

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