Examining Factors Influencing Older Adult Engagement in Fall Prevention: A Comparative Analysis Among Stakeholders.

Background: Falls are a leading cause of fatal and non-fatal injuries for older adults in the United States with significant consequences for health, mobility, and independence. Understanding what barriers influence older adult engagement is essential to facilitating uptake of evidence-based interventions to prevent falls and fall-related injuries.

Methods: Semi-structured focus groups were held with 59 participants in three stakeholder groups: (1) community-dwelling older adults, (2) caregivers of older adults, and (3) healthcare providers who engage with older adults. Themes that emerged were categorized by the stakeholder group that identified them and evaluated using the social-ecological model and assigned to a level within that framework (individual, interpersonal, community, or societal).

Results: Barriers identified to older adult participation in fall prevention activities had the most themes emerge at the individual-level, which included denial; discomfort avoidance; fear of being a burden; pride; and self-perception. Interpersonal-level themes were the normalization of falls; healthcare provider attitude, behavior, and practices; social support; and well-intentioned family. Finally, the themes observed at the community level included cost; lack of education and awareness; limited healthcare resources; lack of transportation; and healthcare system timing and weaknesses. Some themes were identified across all stakeholder types, while others were recognized by only one or two. The only theme at the societal level was age-related stigma.

Conclusions: These findings demonstrate a variety of barriers across stakeholder types and provide valuable insights for developing strategies to effectively promote older adult participation in fall prevention activities to reduce falls and enhance healthy aging.