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Cambridge University Press (CUP), Ageing and Society, 04(28)

DOI: 10.1017/s0144686x07006861

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

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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 bysearching electronic databases, checking reference lists, andcontacting 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 specifi- cally examined interventions that promote participation in falls-prevention programmes; the others explored older people’s attitudes and views. The factors thatfacilitatedparticipation includedsocialsupport, lowintensityexercise,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 ex- pectations and the stigma associated with programmes that targeted older people. KEY WORDS – health attitudes, health-related behaviour, adherence, older people, falls prevention, systematic review.