Abstract

BackgroundThe Lifestyle-integrated Functional Exercise (LiFE) program is an effective but resource-intensive fall prevention program delivered one-to-one in participants’ homes. A recently developed group-based LiFE (gLiFE) could enhance large-scale implementability and decrease resource intensity. The aim of this qualitative focus group study is to compare participants’ experiences regarding acceptability of gLiFE vs LiFE.MethodsPrograms were delivered in seven group sessions (gLiFE) or seven individual home visits (LiFE) within a multi-center, randomized non-inferiority trial. Four structured focus group discussions (90–100 min duration; one per format and study site) on content, structure, and subjective effects of gLiFE and LiFE were conducted. Qualitative content analysis using the method of inductive category formation by Mayring was applied for data analysis. Coding was managed using NVivo.ResultsIn both formats, participants (N = 30, 22 women, ngLiFE = 15, nLiFE = 15, mean age 78.8 ± 6.6 years) were positive about content, structure, and support received by trainers. Participants reflected on advantages of both formats: the social aspects of learning the program in a peer group (gLiFE), and benefits of learning the program at home (LiFE). In gLiFE, some difficulties with the implementation of activities were reported. In both formats, the majority of participants reported positive outcomes and successful implementation of new movement habits.ConclusionThis is the first study to examine participants’ views on and experiences with gLiFE and LiFE, revealing strengths and limitations of both formats that can be used for program refinement. Both formats were highly acceptable to participants, suggesting that gLiFE may have similar potential to be adopted by adults aged 70 years and older compared to LiFE.Trial registrationClinicalTrials.gov, NCT03462654. Registered on March 12, 2018.

Highlights

  • The Lifestyle-integrated Functional Exercise (LiFE) program is an effective but resource-intensive fall prevention program delivered one-to-one in participants’ homes

  • Most participants understood and liked the concept of lifestyle-integrated exercise: “And what I found appealing is that these are exercises that can be integrated into daily life”

  • Future studies should focus on possible solutions to the identified limitations, for example the revision of the strategies used in group-based LiFE (gLiFE) to help participants find situations for the implementation of LiFE activities

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Summary

Introduction

The Lifestyle-integrated Functional Exercise (LiFE) program is an effective but resource-intensive fall prevention program delivered one-to-one in participants’ homes. A recently developed group-based LiFE (gLiFE) could enhance large-scale implementability and decrease resource intensity. The aim of this qualitative focus group study is to compare participants’ experiences regarding acceptability of gLiFE vs LiFE. Most evidence-based fall prevention programs are based on ‘structured’ group exercises conducted at least once a week [2, 3] These programs often fail to sustain long-term effectiveness due to regressive adherence rates [4]. The alternative approach of lifestyle-integrated training [5] aims for higher adherence rates through long-term behavior change. Poor adherence (

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