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Understanding Factors to Implement a Peer-Led Exercise Program Aiming to Reduce Risk of Falls in a Community Setting: A Qualitative Study
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DOI：10.1155/hsc/5554842.png)
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Abstract
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BackgroundZoomers in Balance is an evidence-based fall prevention group exercise program offered for free to participants and led by peer-volunteer leaders. Since 2009, it has been expanded to more sites, delivering to 800% more participants by adding capacity and online options. This program aims to reduce the risk of falls among adults aged 50+. To sustain and continue spreading the program as requests grow, it is crucial to understand the factors that drive success and pose challenges.MethodsThirteen key informants (eight leaders and five key community partners involved in program delivery) participated in individual interviews examining barriers and facilitators to delivering Zoomers in Balance (the innovation). Content analysis was used to categorize participants' barriers and facilitators into the five domains of the Consolidated Framework for Implementation Research (CFIR 2.0): intervention characteristics, outer setting, inner setting, characteristics of individuals, and process.ResultsThe analysis of the interviews revealed 249 factors that influenced the implementation of the Zoomers in Balance program: 150 facilitators and 99 barriers. All five domains were represented among the reported barriers and facilitators. Most perceived facilitators (55%) were from the innovation and individuals domains, while most perceived barriers (56%) were from the inner setting and implementation process domains. Interestingly, a large proportion of factors were related to the volunteer peer model for both facilitators and barriers.ConclusionThe results suggest that, while the program is highly valued by both leaders and participants, organizational capacity and implementation procedures pose significant challenges. Overall, the prominence of the volunteer peer leader model across both facilitators and barriers underscores its central role in the program. Strategies are therefore needed to support peer leaders while acknowledging the model's limitations.
Keywords:
aging
balance
barriers
facilitators
fall prevention
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