Preferences of older Australians for fall prevention exercise program features: a discrete choice experiment

Area of Science:

• Gerontology
• Public Health
• Exercise Science

Background:

• Falls are a significant cause of injury and disability in older Australians.
• Exercise interventions effectively reduce falls, but participation rates are low.
• Understanding participant preferences is crucial for designing effective fall prevention programs.

Purpose of the Study:

• To investigate the preferences of community-dwelling older Australians for fall prevention exercise program features.
• To identify key attributes influencing program uptake and adherence.
• To inform the design and implementation of scalable fall prevention initiatives.

Main Methods:

• An online discrete choice experiment was conducted with 383 older Australians (≥60 years).
• Participants evaluated program attributes: cost, delivery mode, class size, personalization, duration, and support.
• Data were analyzed using mixed multinomial logit and latent class models, with policy simulations for uptake prediction.

Main Results:

• Most participants preferred lower-cost, shorter-duration (1-3 months) programs delivered in-person at home with on-demand professional support.
• No significant preference for personalization was observed.
• Latent class analysis revealed three subclasses: 'opt-out' (19%), 'cost-sensitive' (37%), and 'support-oriented' (44%).
• Policy simulations indicated high uptake in the 'support-oriented' class and low uptake in the 'opt-out' class, with 'cost-sensitive' participants responsive to cost reductions.

Conclusions:

• Preferences for fall prevention program features are heterogeneous among older Australians, with distinct subclasses identified.
• Flexible program configurations, including low-cost options and enhanced features, are recommended to improve uptake and sustainability.
• Actionable evidence is provided for designing and implementing scalable, effective fall prevention programs.