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A systematic review of older people's perceptions of facilitators and barriers to participation in falls-prevention interventions

Published online by Cambridge University Press:  03 November 2008

FRANCES BUNN*
Affiliation:
Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, Hertfordshire, UK.
ANGELA DICKINSON
Affiliation:
Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, Hertfordshire, UK.
ELAINE BARNETT-PAGE
Affiliation:
Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, Hertfordshire, UK.
ELIZABETH MCINNES
Affiliation:
Royal College of Nursing Institute, Oxford, UK.
KHIM HORTON
Affiliation:
Division of Health and Social Care, University of Surrey, Guildford, Surrey, UK.
*
Address for correspondence: Frances Bunn, Senior Research Fellow, Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane Campus, Hatfield AL10 9AB, UK. E-mail: f.bunn@herts.ac.uk

Abstract

The prevention of falls is currently high on the health policy agenda in the United Kingdom, which has led to the establishment of many falls-prevention services. If these are to be effective, however, the acceptability of services to older people needs to be considered. This paper reports a systematic review of studies of older people's perceptions of these interventions. The papers for review were identified by searching electronic databases, checking reference lists, and contacting experts. Two authors independently screened the studies and extracted data on the factors relating to participation in, or adherence to, falls-prevention strategies. Twenty-four studies were identified, of which 12 were qualitative. Only one study specifically examined interventions that promote participation in falls-prevention programmes; the others explored older people's attitudes and views. The factors that facilitated participation included social support, low intensity exercise, greater education, involvement in decision-making, and a perception of the programmes as relevant and life-enhancing. Barriers to participation included fatalism, denial and under-estimation of the risk of falling, poor self-efficacy, no previous history of exercise, fear of falling, poor health and functional ability, low health expectations and the stigma associated with programmes that targeted older people.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2008

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