Table 1 Components and details of the BF2P2

Exercise classes

Progressive strength training: with dumbbell at 5 different muscles of the upper part of the body and with weight-cuffs at 5 different muscles of the lower part of the body;

Progressive balance training: exercises in standing position, gait variations, exercises with aids like balloons, towel or strings;

1 h twice a week; groups of 8–10 participants; to qualify for exercise groups, residents had to be able to stand with support; exercises were adapted to each resident’s capabilities; exercise instructors for the first 6 months were physiotherapists or sport therapists, supported by a member of the nursing home staff; after 6 months the training was taken over by members of the nursing home staff.

Documentation of falls

Compulsory; documentation sheets were sent to the health care insurance (AOK)^a; regular feedback on fall statistics.

Environmental adaptations

Nurses were encouraged to look for person-environment mismatches using an environmental check list which included more than 100 items [41]

Medication review, vitamin D

Nurses were encouraged to discuss a regular medication review with the physicians focusing on reduction of inappropriate psychotropic drugs and on the prescription of vitamin D.

Hip protectors

Each home received a test kit of 5 hip protectors for demonstration purposes; recommendation of hip protectors was part of the program but they were not reimbursed by most German health care insurance companies.

Education and education materials

Change agents received a one-day training course; exercise instructors received a different one-day training course; manual with all contents of the program [13]; material for in-house education; web page with additional information [42].