Keep Exercising & Stay Steady: Co-design of an Exercise Maintenance Intervention for People Exiting Falls Prevention Programmes
Abstract
Introduction
Falls management exercise (FaME) programmes, led by postural stability instructors, improve physical function and reduce falls risk. However, older adults rarely continue exercising after programmes end, resulting in lost improvements and increased falls risk. This study aimed to co-design an exercise maintenance intervention acceptable for older adults to receive and service providers to deliver.
Methods
In consultation with older adults exiting FaME programmes and professional stakeholders, the intervention was developed using an iterative three-stage co-design approach. In stages 1 and 2, researchers facilitated six round-table discussions on evidence-based intervention components. Stakeholders voted on component inclusion. Discussions were audio-recorded, transcribed and analysed thematically. In stage 1, voting results were organised hierarchically and themes were used to develop an intervention framework. Stage 2 consultations scrutinised and voted on the framework components using the APEASE criteria (acceptability, practicality, effectiveness, affordability, side effects, equality). Stage 3 developed the intervention schedule and delivery plan in collaboration with a local FaME service provider.
Results
Stage 1: 9 older adults, 6 falls rehabilitation professionals and a patient and public involvement member attended a consultation. Popular intervention components were: local exercise service information (88%), motivational strategies (81%), follow-up group meetings (69%), education (63%), digital strength and balance app (Keep-On-Keep-Up) (44%) and exercise booklets (44%). Stage 2: 9 professional stakeholders and 2 older adult representatives attended consultations. Stage 2 consultations determined the intervention should include follow-up group sessions containing motivational strategies, education, local exercise service information, exercise practice and home exercise plans delivered by postural stability instructors. Supporting tools included functional Fitness MOT, physical activity monitoring tools, exercise booklets and the Keep-On-Keep-Up app. Stage 3: developed 8 group behaviour change sessions delivered over 8 months.
Conclusion
Through rigorous co-design, stakeholder recommendations informed an exercise maintenance intervention ready for testing in a feasibility study.
Comments
Cheering on the project aims for sustaining exercise
It was with great interest that I read the poster on the KESS intervention as we all have a challenge but responsibility to ensure that our participants stay active for the long term. For Community Dwelling older persons we have found that continuing exercising in a group setting with "Swedish Fika" can be a great motivator as well as adding something new each term to aim for.
Cheering on the project aims for sustaining exercise: Reply
Hello, Thank you for your kind comment. That sounds really interesting, hopefully our paths will cross at the conferance and you can tell me more about how you tackle this important issue in Sweden :)
Best wishes
Sarah
Cheering on the project aims for sustaining exercise Fika
Dear Sarah! Yes that would be lovely to meet up for maybe a "fika" at the conference! (e-mail ksb [at] du.se or text me at +46 730-89 61 62) I'll be there for all three days. I will be chairing a symposium on Falling Competence - Rediscovering the missing piece in fall prevention on Wednesday at 2 pm (I believe it was) as well as having a poster lightning presentation on Friday at 1 pm. Hope that you might be able to make it to any of those occasions also.