Dini Smilde

We aimed to describe and evaluate the implementation of a home-based exercise program among community-dwelling adults aged ≥65 years. In an observational study, the twelve-week program was implemented in a community setting. The implementation plan consisted of dialogues with healthcare professionals and older adults, development of an implementation protocol, recruitment of participants, program implementation, and implementation evaluation. The dialogues consisted of a Delphi survey among healthcare professionals, and of individual and group meetings among older adults. The implementation of the program was evaluated using the framework model RE-AIM. In the dialogues with healthcare professionals and older adults, it was found that negative consequences of a fall and positive effects of preventing a fall should be emphasized to older adults, in order to get them engaged in fall prevention activities. A total of 450 older adults enrolled in the study, of which 238 started the program. The process evaluation showed that the majority of older adults were recruited by a community nurse. Also, a good collaboration between the research team and the local primary healthcare providers was accomplished, which was important in the recruitment. Future fall prevention studies may use this information in order to translate an intervention in a research project into a community-based program.

This observational study was conducted to determine which factors are associated with frequent participation in a home-based exercise program. The effects of frequent participation on health-related outcomes over time are investigated, as well. Community-dwelling adults aged ≥65 years participated in a twelve-week home-based exercise program. The program consisted of an instruction book with exercises that were performed individually at home. Frequent participation was classified as performing exercises of the instruction book daily or a few days a week during the study period. A logistic regression analysis was performed to determine the association between factors (i.e., demographic and health-related characteristics) and frequent participation. Furthermore, to investigate the effects of frequent participation on health-related outcomes, generalized linear and logistic regression models were built. A total of 238 participants (mean age 81.1 years (SD ± 6.7), 71% female) were included in the study. Frequent participation during the study period was indicated by fifty-two percent of participants. Analyses showed that a higher degree of pain (OR: 1.02, 95% CI: 1.–1.04) was associated with frequent participation. In addition, the effect of frequent participation over time was a significant improvement in current health perceptions (B: 4.46, SE: 1.99).