Social factors play a key role in people’s de-
cisions whether to participate in falls pre-
vention interventions (15, 16). In European
countries a personal invitation from a
trusted health professional is an important
motivation for taking up an intervention,
and approval and encouragement from
family, friends and health professionals
influence initial and continued participa-
tion (5). Participation in group activities
is influenced by anticipated and actual
positive and negative social contacts with
members and leaders of the group. A major
barrier is the perception that falls preven-
tion is only for very old and frail people and
not relevant to oneself (3-5). Inversely, old
and frail people may see health promoting
activities as strenuous and only suitable for
people who are younger and fitter (6). Since
seeing prevention activities as appropriate
for someone like oneself is the foremost
predictor of intention to undertake these
activities (3, 17) it may be valuable to use
media pictures and peer role models to
promote a positive social image of strength
and balance training. The latter is as a suit-
able activity for those who are still fit and
active, in order to maintain their mobility
and independence, while emphasizing that
it can still be a safe and effective method of
falls prevention for those at higher risk of
falling.
d) Ensure that the intervention is designed to
meet the needs, preferences and capabilities
of the individual.
Review of evidence generally suggests that
a tailored personal approach – even for
group contexts – can greatly improve the
chance of older people engaging with and
maintaining an intervention programme
(1-2). There is a need to consider the
individual’s lifestyle, values, religious and
cultural beliefs, which may be associated
with ethnicity and gender-specific factors.
Environmental determinants such as the
wealth of the society in which the older
person lives; their place of residence and
availability and access to services should
also be contemplated. Interventions need
to be presented in ways that are tailored to
the cultural preferences of older people and
be realistic within the resources available.
Group sessions with trained-balance and
strength-exercise instructors for example,
are relatively low-tech affordable interven-
tions that should be within the means of
many societies. Although more research is
necessary, there is growing evidence that
many older people may prefer exercises
delivered at home with some professional
guidance (4, 12).