The search strategy resulted in a total of 17,407 records, totaling 9280 unique records, after the duplicates were removed. The screening of title and abstract excluded another 9110 records. The full texts of 170 reports were read, of which 83 were found eligible. Eleven additional reports were identified by hand searching fifteen relevant literature reviews and by citation tracking of the eligible reports. In total, 94 reports described the implementation of single, multicomponent, or multifactorial falls prevention interventions. Due to the complexity and the different risk factors that contribute to the risk of falling, the research group and stakeholder group decided to make an amendment to the protocol and to only include reports implementing multifactorial falls prevention interventions. This resulted in the exclusion of 45 reports. After screening the included reports, the researchers and stakeholders noted that some reports (n = 11) did not describe or evaluate the implementation strategies. Therefore, it was decided to add the following new inclusion criteria to the protocol: the implementation strategies needed to be described, reports exploring the experiences, and perceptions and needs of the target group were only included if it was primary research. In addition, literature showed that education alone is not sufficient for behaviour change [55]. As a result, an additional exclusion criteria was formulated. Due to the specificity and the complexity of certain diseases like multiple sclerosis, cancer, and cardiovascular diseases, the research group decided not to focus on a specific patient population. Based on all these adaptations, 71 reports were excluded. In total, 23 reports (18 studies) were included in this systematic review [17, 27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48]. A full description of the identification, screening, eligibility, and inclusion process is outlined in the PRISMA 2020 flow diagram (Fig. 1).

The majority of the reports scored high (n = 18), and five scored moderate on the relevance to the research question. The methodological quality of the reports was in general moderate (n = 16); four reports scored low and three high. No reports were excluded based on the methodological quality. Based on these ratings, the relative contribution (sensitivity analysis) of the reports could be appraised (Table 2). In total, fourteen reports scored high and nine moderate on the sensitivity analysis. Due to the heterogeneity in terms of study design, setting, multifactorial falls prevention interventions, and implementation strategies and outcomes, the extent to which data could be synthesized was limited. Therefore, the results of the sensitivity analysis could not be taken into account in the data synthesis (i.e., giving more weight to reports with a higher score on relevance to the research question and methodological quality).

Table 3 gives a description of the included studies and reports. Seven studies (twelve reports) were conducted in Australia [27,28,29,30, 32,33,34,35,36,37, 39, 48] and seven studies (seven reports) in the USA [17, 31, 41, 43,44,45,46]. The other studies were performed in Belgium [38], New Zealand [42], Iran [40], and Thailand [47]. The majority of the reports (n = 15) were older than 5 years [17, 27, 28, 30, 33,34,35,36,37,38, 41,42,43, 46, 47]. Seven studies took place in different settings; in a combination of community organization, home of the older persons, senior apartment buildings, and senior centers [27, 28, 31, 40, 41, 45, 47, 48], five studies were performed at the home of the older person [30, 32, 38, 39, 42], two studies took place in a community or senior center [43, 46], one in medical practices [29], and three studies were performed in the community in general [33,34,35,36,37], in home health agencies [17], and in an assisted living community [44]. In total, eight reports used a mixed method design [31, 32, 37,38,39, 44, 45, 47], six had a qualitative design [28,29,30, 41, 43, 46], three were quantitative descriptive [17, 33, 36], three were non-randomized controlled trials [34, 35, 48], and three reports were randomized controlled trials [27, 40, 42].

All included studies implemented multifactorial falls prevention interventions. There is abundant variation in the content and manner in which the multifactorial falls prevention interventions were delivered (e.g., different healthcare professionals involved, supervised versus unsupervised exercise). Table 3 gives an overview of the fall risk factors on which the study interventions focused on. All included reports described the evaluation of risk factors (assessment), but only seven reports (seven studies) clearly described screening for fall risk [29, 30,