142 | Chapter 7 Recruiting and motivating older adults to participate To optimally benefit from the FPP, it is important that the target group consists of community-dwelling older adults with a fall history or fear of falling. This is the group that is intrinsically motivated to participate in the program: “The people who most recognize themselves in things are the people who have had a fall once or twice and very often they say: they didn’t know how that happened, but are still a bit in that shock of: oh, I fell and I have to do something with it. And I think that group is the best to train with.” [therapist] Although most eligible participants already experienced a fall, therapists describe that participants of the In Balance FPP should not be too vulnerable. The appropriate target group can be identified using screening tools that focus on frailty status and fall risk. These screening tools are not generally available yet, while therapists noticed that there is a need for this. Trial participants in the current study, but also participants who follow the In Balance FPP outside this research, were mostly well-educated older adults with a higher socioeconomic status and without a migration background. Therefore, according to the therapists, most of the FPP participants are not a reflection of the society. To have a more representative group of participants, recruitment should be done using a personal approach in the local environment of the potential participants, for example via health professionals, at community centres or via local newspapers. When recruiting, the social element and the person-centred approach of the program are important to focus on. Also, positive labelling is helpful for the recruitment, for example not using the term ‘fall prevention’, but ‘remaining your balance’, and use language at the ECRL-B1 level to enhance clarity. Structure and content of the program Overall, FPP participants, therapists and stakeholders were positive about the structure and content of the FPP. Positive aspects were the combination of education and exercises, the interdisciplinarity, having the same therapist(s) during the program, and the tailor-made approach: “Everyone could do the exercises on their own occasion, at their own pace. I quite liked that.” [older male participant] However, several barriers were mentioned. With respect to content, the high number of training sessions was mentioned as a barrier for FPP participants to participate, according to therapists and stakeholders. Second, some FPP participants noticed that there should be more attention for the mental component after a fall, for example when fear of falling increases.
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