Abstract
(type = abstract)
Falls are a serious public health issue among adults age 65 and older. More than a third of older adults fall each year (Hausdorff, Rios, & Edelber, 2001). Strength and balance exercise interventions have been found to reduce the risk of falls (Rand Report, 2003). Yet, more than 50% of older adults reject fall-related interventions (Campbell et al., 1997; Robertson, Devlin, Gardner, & Campbell, 2001; Stevens, Holman, Bennett, & de Klerk, 2001). One possible but untested intervention strategy is to have older adults plan pro-strength and balance exercise messages for his/her peers. An active involvement intervention is promising because older adults learn better when activities are perceived as exciting and lively (Best, 2001; Pearson & Wessman, 1996). Guided by the theory of active involvement (TAI, Greene, 2013), this study examined components of active involvement interventions. To identify the key mechanism of change, intervention components were tested individually, combined, and compared to a standard care group yielding a total of four versions of an intervention: (1) idea generation, (2) message planning, (3) idea generation and message planning combined, and (4) standard care. Seventy-two adults age 65 and older were randomly assigned to one of four versions. This project measured motivation to process information (perceived novelty, perceived involvement, perceived gain, and reflectiveness), cognitions (perceived benefits, perceptions of norms, and readiness for change), behavior (strength and balance exercise-related stage progression and fall status), and interpersonal communication (talk about strength and balance exercise and intervention condition) to assess the effects of version over time (pretest, immediate posttest, and 10 week delayed posttest). The results showed that the idea generation and message planning combined was more successful than the idea generation, message planning, and standard care in changing participants’ perceived benefits, perceptions of norms, and strength and balance exercise-related stage progression over time. Participants’ frequency of discussion about intervention topic and activity was greater for idea generation and message planning combined than the idea generation, message planning, and standard care. Implications from these findings can guide the development of future fall-prevention messages.