Factors Influencing Participation in and Implementation of Tele-Exercise: A Qualitative Study within a Community-Based Fall Prevention Program

Background: Tele-exercise —online exercise programs that can be done from home— increases opportunities for year-round physical activity and may improve fall prevention outcomes. Moreover, tele-exercise supports can help overcome common barriers to in-person exercise. However, uptake is inconsistent due to factors such as technology acceptance, program characteristics, among others, that are still not well understood.

Objectives: To identify factors influencing participation in tele-exercise within a community-based fall prevention program (Zoomers in Balance), guided by the Senior Technology Acceptance Model  (STAM) and the Consolidated Framework for Implementation Research (CFIR).

Methods: Semi-structured interviews, based on the STAM and the CFIR, were conducted with key informants (participants, leaders, community partners, and staff) of Zoomers in Balance. Interviews were transcribed verbatim and analyzed by two independent coders; first coded inductively and then deductively with the frameworks. Conflicts were resolved by consensus or a third reviewer.

Results: Twenty individuals participated in this study (nine participants and five leaders aged between 50-83 years, 95% female; one community partner and five staff members). Pertinent to STAM, “gerontechnology self-efficacy” was the most common factor; previous experience supported confidence, but the lack of necessary skills to join classes was a common barrier. Other important constructs were “social relationships,” “physical functioning,” and “attitude to life and satisfaction." In relation to CFIR, “individuals” was the most common domain identified. Capable and supportive staff and leaders created a positive experience, but perceived gaps in leaders’ capability and confidence limited participation. Other important domains were “innovation,” “inner setting,” and “process”.

Discussion: Both technology acceptance and program implementation factors are important in the adoption and participation in tele-exercise programs for aging adults. Systematically developing individual and organizational strategies is the next step to increase the uptake of tele-exercise programs for aging adults.