8 General discussion and summary | 169 supervised for two hours per week, and one hour can be done unsupervised as homework. Sustained engagement over time is essential, ensuring that older adults continue exercising even after the intervention ends (332). To evaluate the Strengths, Weaknesses, Opportunities and Threats of In Balance as a fall prevention program, we included a SWOT analysis in Table 8.3. This analysis provides a structured overview of the positive aspects of the program, for example the combination of education and exercise, alongside areas where there may be room for improvement, like the lack of follow-up exercise programs. Additionally, the SWOT presents future opportunities, such as integration of technology, and potential threats, such as maintaining long-term adherence among participants. Table 8.3. SWOT analysis of In Balance Strengths Weaknesses Group fall prevention program including education, exercise and a social component (Ch 7) Positive trend in outcome measures (e.g., falls, injuries, mobility, costs) (Ch 5 and 6) Tailored approach for older adults (Ch 7) Scientific basis about (cost-)effectiveness (Ch 5 and 6) Widely implemented and in healthcare agreement Certified therapists Locally in the neighborhood of the participants (Ch 7) Use of MBvO instructors to upscale In Balance and increase the cost-effectiveness Less effective than expected (Ch 5 and 6) Lack of follow-up exercise programs (Ch 7) Requires commitment and participation from participants (Ch 5) Requires enough participants Limited reach in rural areas Uncertainty about the best target population Hardly used for people with a migration background (Ch 7) Limited focus on training at home Not suitable for frail older adults Opportunities Threats Adaptations within the In Balance program (Ch 5, 6 and 7) Increasing ageing population and growing demand for fall prevention Embedding in chain approach: Integration with community and healthcare services and health insurances Use of technology for more flexibility and accessibility Enhancing participant engagement through personalized support and regular check-ins Implementation could easily be scaled up Funding issues with small group sizes (Ch 7) Maintaining long-term adherence among participants (Ch 7) Limited availability of follow-up exercise programs nationwide Adherence of participants to the program is a challenge (Ch 5 and 6) Dependence on enough trained instructors
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