Limitations
Despite its innovativeness, this study had a number of limitations.
First, because of the small sample size and most
participants being relatively healthy with no history of
falls, results may not be generalizable to a broader population,
although this study adds to current knowledge about
minority elderly adults, because most of the participants
were low-income African-American and Asian older adults
(70.3%). Second, some participants reported not enjoying
listening to the GRI audio CD simply because it was not
personable. The GRI audio CD was created through a
review of general concepts and ideas in the research on
healthy aging, FOF, and imagery. A suggestion for future
researchers interested in using guided imagery might be to
create customized imagery scripts that focus on target
behaviors, such as decreasing FOF or increasing exercise
levels. Third, it was a challenge to monitor and identify
whether participants listened to their audio CDs during
the intervention phase. The authors asked participants to
sign a trust agreement letter stating that they would follow
listening directions, but a future recommendation might be
to create a more reliable and modernized method for monitoring
(e.g., on-line accounts). Fourth, the first author was
aware of the randomization for each participant, which
might have created a potential source of bias, especially
with the facilitated outcome measure (TUG). In efforts to
reduce investigator bias and for consistency, the first
author was the only person who conducted the baseline
and follow up measures, and there were no indications
of group assignment in the data collection tools. For
future studies, a recommendation might be to have a
blinded team member conduct data collection to reduce
investigator bias. Last, self-reported data for the questionnaires
may have been misinterpreted, and responses
may have reflected inaccurate recall or limited detail.
Future studies might consider using more-objective measures
such as heart monitors or accelerometers in addition
to self-reported questionnaires to examine the effects of
GRI further.