{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T13:18:50Z","timestamp":1793884730011,"version":"4.7.0"},"reference-count":51,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2025,9,23]]},"abstract":"<jats:sec><jats:title>Importance<\/jats:title><jats:p>With rapidly aging populations globally, there is a lack of evidence on effective fall prevention strategies among community-dwelling older people in resource-constrained areas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the effectiveness of a fall prevention program integrated in primary health care systems on the risk of falls among Chinese rural older adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>A 12-month, open-label, cluster randomized clinical trial, conducted in 128 rural villages from 4 Chinese provinces, involving adults 60 years or older at risk of falls (recruitment from September 19, 2023, to November 15, 2023; last follow-up, January 15, 2025).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>The fall prevention intervention, consisting of balance and functional exercises and community-engaged health education, was integrated with the rural primary health care system. The control group received usual care, health education alone, without active involvement with the communities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was the proportion of participants who reported at least 1 fall in 12 months following the intervention. Six secondary outcomes included the rate of falls, 3 measures of functional mobility, the proportion of participants who reported fall-related injury, and health-related quality of life. Fall-related data were collected via quarterly participant self-reports supported by a calendar; functional mobility was measured at baseline and 12-month follow-up using validated measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 2616 participants recruited, 6 died before randomization and 2610 (median age, 70.0 years [IQR, 66.4-74.2]; 1553 female [59.5%]) were randomized either to the intervention group (1311 from 64 villages) or to the control group (1299 from 64 villages). During a mean follow-up of 358.0 (SD, 31.3) days, 388 participants (29.7%) in the intervention group reported falling at least once during the 12-month follow-up compared with 497 (38.3%) in the control group (odds ratio, 0.67; 95% CI, 0.48-0.91; <jats:italic>P<\/jats:italic>\u2009=\u2009.01). All secondary outcomes favored the intervention except the Timed Up and Go Test (for functional mobility), which showed no significant difference.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Relevance<\/jats:title><jats:p>This cluster randomized trial found that integrating a fall prevention program in a primary health care system was associated with a significant reduction in the risk of self-reported falls among Chinese rural older people. This intervention, comprising balance and functional exercises and community-engaged health education, has the potential to be scaled-up in China and other low- and middle-income countries with rapidly growing aging populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>Chinese Clinical Trial Registry Identifier: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.chictr.org.cn\/indexEN.html\">ChiCTR2300075879<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jama.2025.12724","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T15:31:01Z","timestamp":1756135861000},"page":"1068","source":"Crossref","is-referenced-by-count":21,"title":["A Fall Prevention Program Integrated in Primary Health Care for Older People in Rural China"],"prefix":"10.1001","volume":"334","author":[{"given":"Junyi","family":"Peng","sequence":"first","affiliation":[{"name":"School of Public Health, Harbin Medical University, Harbin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengpeng","family":"Ye","sequence":"additional","affiliation":[{"name":"National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boya","family":"Nan","sequence":"additional","affiliation":[{"name":"School of Public Health, Harbin Medical University, Harbin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shichun","family":"Yan","sequence":"additional","affiliation":[{"name":"Heilongjiang Provincial Center for Disease Control and Prevention, Harbin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhifang","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Li","sequence":"additional","affiliation":[{"name":"Hubei Provincial Center for Disease Control and Prevention, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruilin","family":"Meng","sequence":"additional","affiliation":[{"name":"School of Public Health, Harbin Medical University, Harbin, China"},{"name":"Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangchun","family":"Li","sequence":"additional","affiliation":[{"name":"Heilongjiang Provincial Center for Disease Control and Prevention, Harbin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyou","family":"Hao","sequence":"additional","affiliation":[{"name":"Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Hubei Provincial Center for Disease Control and Prevention, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dandan","family":"Peng","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zijian","family":"Xu","sequence":"additional","affiliation":[{"name":"School of Public Health, Harbin Medical University, Harbin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanni","family":"Wang","sequence":"additional","affiliation":[{"name":"Wuxi Medical Health Group, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Si","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Western Sydney University, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Yao","sequence":"additional","affiliation":[{"name":"Center for Healthy Aging Transdisciplinary Sciences, China Center for Health Development Studies, Peking University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health, Harbin Medical University, Harbin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Tian","sequence":"additional","affiliation":[{"name":"School of Basic Medicine, Harbin Medical University, Harbin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongchen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of General Practice, Second Affiliated Hospital of Harbin Medical University, Harbin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Ivers","sequence":"additional","affiliation":[{"name":"School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia"},{"name":"The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maoyi","family":"Tian","sequence":"additional","affiliation":[{"name":"School of Public Health, Harbin Medical University, Harbin, China"},{"name":"Department of General Practice, Second Affiliated Hospital of Harbin Medical University, Harbin, China"},{"name":"The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"3","key":"joi250053r1","doi-asserted-by":"publisher","first-page":"422","DOI":"10.2105\/AJPH.2004.047779","article-title":"Fall-induced deaths among elderly people.","volume":"95","author":"Kannus","year":"2005","journal-title":"Am J Public Health"},{"issue":"1","key":"joi250053r2","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1097\/00005373-200101000-00021","article-title":"Geriatric falls: injury severity is high and disproportionate to mechanism.","volume":"50","author":"Sterling","year":"2001","journal-title":"J Trauma"},{"issue":"12","key":"joi250053r4","doi-asserted-by":"publisher","first-page":"e907","DOI":"10.1016\/S2468-2667(21)00231-0","article-title":"Burden of falls among people aged 60 years and older in mainland China, 1990-2019: findings from the Global Burden of Disease Study 2019.","volume":"6","author":"Ye","year":"2021","journal-title":"Lancet Public Health"},{"issue":"1","key":"joi250053r5","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1186\/s12913-020-05645-0","article-title":"Falls prevention interventions for community-dwelling older people living in mainland China: a narrative systematic review.","volume":"20","author":"Ye","year":"2020","journal-title":"BMC Health Serv Res"},{"issue":"8","key":"joi250053r6","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.28960","article-title":"Perceptions of facilitators and barriers to implementation of falls prevention programs in primary health care settings in China.","volume":"5","author":"Ye","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"1","key":"joi250053r7","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012424.pub2","article-title":"Exercise for preventing falls in older people living in the community.","volume":"1","author":"Sherrington","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"issue":"15","key":"joi250053r8","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1136\/bjsports-2019-101512","article-title":"Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review.","volume":"54","author":"Sherrington","year":"2020","journal-title":"Br J Sports Med"},{"key":"joi250053r9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5661","article-title":"Consort 2010 statement: extension to cluster randomised trials.","volume":"345","author":"Campbell","year":"2012","journal-title":"BMJ"},{"issue":"10054","key":"joi250053r10","doi-asserted-by":"publisher","first-page":"1922","DOI":"10.1016\/S0140-6736(16)00582-1","article-title":"Doctors in China: improving quality through modernisation of residency education.","volume":"388","author":"Zhu","year":"2016","journal-title":"Lancet"},{"issue":"10112","key":"joi250053r11","doi-asserted-by":"publisher","first-page":"2584","DOI":"10.1016\/S0140-6736(17)33109-4","article-title":"The primary health-care system in China.","volume":"390","author":"Li","year":"2017","journal-title":"Lancet"},{"issue":"6","key":"joi250053r12","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1093\/ageing\/afq102","article-title":"Does the \u201cOtago exercise programme\u201d reduce mortality and falls in older adults? a systematic review and meta-analysis.","volume":"39","author":"Thomas","year":"2010","journal-title":"Age Ageing"},{"issue":"1","key":"joi250053r13","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1186\/s12912-024-02310-3","article-title":"Efficacy of the Otago-Exercise-Programme to reduce falls in community-dwelling adults aged 65-80 when delivered as group or individual training: Non-inferiority-clinical-trial.","volume":"23","author":"Albornos-Mu\u00f1oz","year":"2024","journal-title":"BMC Nurs"},{"issue":"2","key":"joi250053r14","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","article-title":"The timed \u201cUp & Go\u201d: a test of basic functional mobility for frail elderly persons.","volume":"39","author":"Podsiadlo","year":"1991","journal-title":"J Am Geriatr Soc"},{"issue":"9","key":"joi250053r15","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1093\/ptj\/80.9.896","article-title":"Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test.","volume":"80","author":"Shumway-Cook","year":"2000","journal-title":"Phys Ther"},{"issue":"9","key":"joi250053r16","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afac205","article-title":"World guidelines for falls prevention and management for older adults: a global initiative.","volume":"51","author":"Montero-Odasso","year":"2022","journal-title":"Age Ageing"},{"issue":"1","key":"joi250053r17","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1186\/s12916-022-02280-w","article-title":"Predictive validity of the Stopping Elderly Accidents, Deaths & Injuries (STEADI) program fall risk screening algorithms among community-dwelling Thai elderly.","volume":"20","author":"Loonlawong","year":"2022","journal-title":"BMC Med"},{"issue":"1","key":"joi250053r18","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1186\/s13690-023-01219-8","article-title":"An observational pilot evaluation of the Walk with Ease program for reducing fall risk among older adults.","volume":"81","author":"Lamoureux","year":"2023","journal-title":"Arch Public Health"},{"issue":"3","key":"joi250053r19","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/0168-8510(90)90421-9","article-title":"EuroQol\u2014a new facility for the measurement of health-related quality of life.","volume":"16","author":"EuroQol Group","year":"1990","journal-title":"Health Policy"},{"issue":"4","key":"joi250053r20","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1016\/j.jval.2016.11.016","article-title":"Estimating an EQ-5D-5L value set for China.","volume":"20","author":"Luo","year":"2017","journal-title":"Value Health"},{"issue":"4","key":"joi250053r21","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1016\/j.rehab.2019.08.003","article-title":"Accuracy of modified 30-s chair-stand test for predicting falls in older adults.","volume":"63","author":"Roongbenjawan","year":"2020","journal-title":"Ann Phys Rehabil Med"},{"issue":"5","key":"joi250053r22","doi-asserted-by":"publisher","first-page":"319","DOI":"10.2519\/jospt.2011.3515","article-title":"A comparison of 3 methodological approaches to defining major clinically important improvement of 4 performance measures in patients with hip osteoarthritis.","volume":"41","author":"Wright","year":"2011","journal-title":"J Orthop Sports Phys Ther"},{"issue":"3","key":"joi250053r23","doi-asserted-by":"publisher","first-page":"386","DOI":"10.5535\/arm.2012.36.3.386","article-title":"Effect of lower limb strength on falls and balance of the elderly.","volume":"36","author":"Cho","year":"2012","journal-title":"Ann Rehabil Med"},{"issue":"3","key":"joi250053r24","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1227\/NEU.0000000000001320","article-title":"Assessment of the minimum clinically important difference in the Timed Up and Go Test after surgery for lumbar degenerative disc disease.","volume":"80","author":"Gautschi","year":"2017","journal-title":"Neurosurgery"},{"issue":"10","key":"joi250053r25","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1007\/s12603-011-0062-0","article-title":"Timed Up and Go test and risk of falls in older adults: a systematic review.","volume":"15","author":"Beauchet","year":"2011","journal-title":"J Nutr Health Aging"},{"issue":"1","key":"joi250053r26","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1186\/s12889-022-13832-3","article-title":"The effectiveness of the Healthworks Staying Steady community-based falls prevention exercise programme to improve physical function in older adults: a 6-year service evaluation.","volume":"22","author":"James","year":"2022","journal-title":"BMC Public Health"},{"issue":"11","key":"joi250053r27","doi-asserted-by":"publisher","first-page":"3293","DOI":"10.1007\/s11136-022-03231-x","article-title":"Establishing the minimal clinically important difference of the EQ-5D-3L in older adults with a history of falls.","volume":"31","author":"Jehu","year":"2022","journal-title":"Qual Life Res"},{"key":"joi250053r28","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1416214","article-title":"Regional differences in the Association of Healthy Aging with the incidence of falls: an analysis based on the China Health and Retirement Longitudinal Study from 2011 to 2020.","volume":"12","author":"Li","year":"2024","journal-title":"Front Public Health"},{"issue":"1","key":"joi250053r29","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1136\/injuryprev-2017-042597","article-title":"Risk factors for falls among older community dwellers in Shenzhen, China.","volume":"25","author":"Zhou","year":"2019","journal-title":"Inj Prev"},{"issue":"1","key":"joi250053r30","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1186\/s12877-019-1391-9","article-title":"Falls and risk factors of falls for urban and rural community-dwelling older adults in China.","volume":"19","author":"Zhang","year":"2019","journal-title":"BMC Geriatr"},{"issue":"9","key":"joi250053r31","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1161\/CIRCULATIONAHA.115.015373","article-title":"A cluster-randomized, controlled trial of a Simplified Multifaceted Management Program for Individuals at High Cardiovascular Risk (SimCard Trial) in rural Tibet, China, and Haryana, India.","volume":"132","author":"Tian","year":"2015","journal-title":"Circulation"},{"issue":"17","key":"joi250053r32","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1001\/jama.2017.15006","article-title":"Comparisons of interventions for preventing falls in older adults: a systematic review and meta-analysis.","volume":"318","author":"Tricco","year":"2017","journal-title":"JAMA"},{"issue":"1","key":"joi250053r33","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1001\/jama.2024.8481","article-title":"Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force Recommendation Statement.","volume":"332","author":"Nicholson","year":"2024","journal-title":"JAMA"},{"issue":"1","key":"joi250053r34","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1001\/jama.2024.4166","article-title":"Interventions to prevent falls in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.","volume":"332","author":"Guirguis-Blake","year":"2024","journal-title":"JAMA"},{"key":"joi250053r35","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/j.gerinurse.2023.01.004","article-title":"Frailty knowledge level and its influencing factors among older adults in China.","volume":"50","author":"Zhou","year":"2023","journal-title":"Geriatr Nurs"},{"key":"joi250053r36","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1259204","article-title":"Differences in the influence of daily behavior on health among older adults in urban and rural areas: evidence from China.","volume":"11","author":"Liu","year":"2023","journal-title":"Front Public Health"},{"issue":"1","key":"joi250053r37","doi-asserted-by":"publisher","first-page":"2564","DOI":"10.1186\/s12889-024-19910-y","article-title":"Barriers and facilitators for accepting health education of Chinese rural older adults in Henan Province: a qualitative study.","volume":"24","author":"Zhang","year":"2024","journal-title":"BMC Public Health"},{"key":"joi250053r38","doi-asserted-by":"publisher","DOI":"10.1007\/s41999-025-01206-y","article-title":"Falls prevention in community-dwelling older adults and implementation of world falls guidelines: a call for action across Europe by the European Geriatric Medicine Society Special Interest Group on Falls and Fractures.","author":"van der Velde","year":"2025","journal-title":"Eur Geriatr Med"},{"issue":"10339","key":"joi250053r39","doi-asserted-by":"publisher","first-page":"1964","DOI":"10.1016\/S0140-6736(22)00325-7","article-title":"A village doctor-led multifaceted intervention for blood pressure control in rural China: an open, cluster randomised trial.","volume":"399","author":"Sun","year":"2022","journal-title":"Lancet"},{"key":"joi250053r40","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1186\/1471-2458-14-345","article-title":"Population impact of a high cardiovascular risk management program delivered by village doctors in rural China: design and rationale of a large, cluster-randomized controlled trial.","volume":"14","author":"Yan","year":"2014","journal-title":"BMC Public Health"},{"issue":"6","key":"joi250053r41","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1161\/CIRCOUTCOMES.111.961573","article-title":"Community Outreach and Cardiovascular Health (COACH) trial: a randomized, controlled trial of nurse practitioner\/community health worker cardiovascular disease risk reduction in urban community health centers.","volume":"4","author":"Allen","year":"2011","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"9926","key":"joi250053r42","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.1016\/S0140-6736(13)62629-X","article-title":"Effectiveness of a community-based intervention for people with schizophrenia and their caregivers in India (COPSI): a randomised controlled trial.","volume":"383","author":"Chatterjee","year":"2014","journal-title":"Lancet"},{"issue":"2","key":"joi250053r43","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1177\/1524839914533797","article-title":"Improving hypertension self-management with community health coaches.","volume":"16","author":"Dye","year":"2015","journal-title":"Health Promot Pract"},{"issue":"9","key":"joi250053r44","doi-asserted-by":"publisher","first-page":"593","DOI":"10.7326\/0003-4819-151-9-200911030-00004","article-title":"Community-based interventions to promote blood pressure control in a developing country: a cluster randomized trial.","volume":"151","author":"Jafar","year":"2009","journal-title":"Ann Intern Med"},{"issue":"4","key":"joi250053r45","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1017\/mdh.2018.40","article-title":"Visualising primary health care: World Health Organization representations of community health workers, 1970-89.","volume":"62","author":"Medcalf","year":"2018","journal-title":"Med Hist"},{"issue":"24","key":"joi250053r47","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.1056\/NEJM197206152862404","article-title":"The barefoot doctors of the People\u2019s Republic of China.","volume":"286","author":"Sidel","year":"1972","journal-title":"N Engl J Med"},{"issue":"1","key":"joi250053r48","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1186\/s12889-017-4241-8","article-title":"Strategies to improve engagement of \u201chard to reach\u201d older people in research on health promotion: a systematic review.","volume":"17","author":"Liljas","year":"2017","journal-title":"BMC Public Health"},{"key":"joi250053r49","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1016\/j.jenvman.2014.06.030","article-title":"Building a community of practice for sustainability: strengthening learning and collective action of Canadian biosphere reserves through a national partnership.","volume":"145","author":"Reed","year":"2014","journal-title":"J Environ Manage"},{"issue":"1","key":"joi250053r51","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1186\/s12877-024-04754-3","article-title":"Using a participatory design to develop an implementation framework for integrating falls prevention for older people within the Chinese primary health care system.","volume":"24","author":"Ye","year":"2024","journal-title":"BMC Geriatr"},{"key":"joi250053r3","unstructured":"World Health Organization. Step Safely: Strategies for Preventing and Managing Falls Across the Life-Course. World Health Organization; 2021. Accessed February 26, 2025. https:\/\/www.who.int\/publications\/i\/item\/9789240021914"},{"key":"joi250053r46","unstructured":"World Health Organization. Progress Report on the United Nations Decade of Healthy Ageing, 2021-2023. Geneva, Switzerland: World Health Organization; 2023. Accessed February 26, 2025. https:\/\/www.who.int\/publications\/i\/item\/9789240079694"},{"key":"joi250053r50","unstructured":"World Health Organization. Compassion and Primary Health Care. World Health Organization; 2025. Accessed March 26, 2025. https:\/\/www.who.int\/publications\/i\/item\/9789240105249"}],"container-title":["JAMA"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/articlepdf\/2838003\/jama_peng_2025_oi_250053_1758289709.27088.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T15:00:33Z","timestamp":1758639633000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2838003"}},"subtitle":["The FAMILY Cluster Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2025,9,23]]},"references-count":51,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,9,23]]}},"URL":"https:\/\/doi.org\/10.1001\/jama.2025.12724","relation":{},"ISSN":["0098-7484"],"issn-type":[{"value":"0098-7484","type":"print"}],"subject":[],"published":{"date-parts":[[2025,9,23]]}}}