Falls are a leading risk factor for older adults, often leading to fractures, hospitalization, and the need for long-stay medical care. While balance and strength training-based falls reduction programs have been demonstrated to be effective for reducing falls risk, it is difficult to engage community-dwelling older adults in such programs. Many individuals avoid these classes due to time, health concerns, or defeatist views of their ability to manage age-related changes in physical function. An article in the Journal of Applied Gerontology reports on community-dwelling older adults’ attitudes about a proposed church-delivered, balance-based falls reduction program.
Researchers conducted group and individual discussions with older adults living in Mesa County, Colorado, an area with a relatively high proportion of older adults and high rates of attendance at religious services. The researchers used the principles of social marketing, an approach to influence target audiences through education and persuasion.
A first stage of discussions focused on participants’ involvement in churches and exercise classes, as well as their perceptions of falls and aging. Researchers discovered that a hospital-based balance program had previously been offered in the area, but that interest in it was low among potential participants.
The next stage focused on key informants in the community who were influential in older adult community participation in the area, such as recreation center and church staff. This stage also included six focus groups with a total of 50 potential participants in the proposed falls reduction class, which were conducted with members of a variety of churches, in both Spanish and English.
In this stage, researchers found that participants were somewhat averse to falls prevention marketing, because falls can be a disconcerting topic. Participants were more amenable to a focus on strength and independence, both significant potential benefits of participation in falls reduction programs. However, formal exercise classes seemed unfamiliar and threatening to most participants, who typically had little experience with exercise as a recreational activity, associating it more with physical labor. Despite this concern, it emerged that relationships among potential participants may be a useful way to encourage and maintain participation in exercise-based falls reduction programs.
Ultimately, based on the focus group discussions and interviews, it was determined that an appealing product to the targeted community would be a social and interactive program that didn’t require special exercise clothing or experience with exercise training. Participants felt that the program should be in or near familiar locations such as churches or workplaces, and not a hospital or clinical setting. Participants noted that cost, time of day, and transportation would be limiting factors for many potential users of such a program. Although some of the findings may be specific to the community in which the study was located, this study shows how attention to the social context and the beliefs of potential participants in falls reduction programs are an important part of designing and marketing such interventions.
Clark L, Thoreson S, Goss CW, et al. Understanding fall meaning and context in marketing balance classes to older adults. Journal of Applied Gerontology (2013); 32(1):96–119.