Co-Producing a Theory-Informed Psychological Intervention to Increase Acceptance of Home Modifications for Fall Prevention.

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T Hall1; L Newson1; E Davies1; L Alcock2; C Maganaris1; M Hollands1; A Akpan3; R Foster1
1. Liverpool John Moores University 2. National Institute for Health and Care Research (NIHR), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust 3. Bunbury Regional Hospital
Scientific Research
SP - Education / Training
Patient/ Family Involvement
View DOI

Abstract

Introduction

Home modifications are recommended as part of multifactorial fall prevention interventions for adults aged 50+, yet uptake remains inconsistent. Our previous work, including a mixed-methods systematic review and World Café consultations, identified key psychological and social services barriers which are rarely addressed in routine services. This study aimed to review and prioritise these barriers with members of the public and a falls prevention service, to inform the co-production of a psychologically informed intervention to increase acceptance of home modifications.

Methods

Findings from the systematic review and World Café consultations were consolidated into 12 behavioural barriers relevant to home modification decision-making. Barriers were mapped to the Capability, Opportunity, Motivation-Behaviour (COM-B) model to identify modifiable behavioural sources. Two co-production workshops were conducted: one with adults aged 50+ (n=7) and one with the falls prevention healthcare professionals (n=5). Participants prioritised barriers and generated intervention ideas using structured worksheets. Data were analysed descriptively.

Results

Prioritised Barriers: Adults aged 50+ prioritised (1) not knowing what help exists, (2) a combined psychological barrier encompassing denial of ageing and fear of losing independence, and (3) limited social support. Healthcare professionals prioritised two clusters of barriers: (1) denial of ageing, fear of losing independence, and overwhelming emotional responses, and (2) stigma and appearance concerns alongside fear of scams or mistrust of strangers.  
Intervention ideas: Members of the public prioritised trusted, community-based and peer-supported approaches that normalise ageing and address informational and social barriers.  Professionals highlighted early, proactive, and normalising conversations, supported by trusted information pathways and visible real- world examples of home modifications to build confidence and engagement.

Conclusion

This study demonstrates a theory-informed co-production approach to translating psychological and social services barriers into intervention development for falls prevention services. Addressing psychological and social services barriers alongside practical concerns may support earlier engagement with home modifications. 

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