Beyond barriers: a qualitative TDF and COM-B analysis of participation in active ageing programmes

Global populations are ageing rapidly, underscoring the need for strategic policy responses such as active ageing programmes (AAPs). This study examined the barriers and facilitators influencing participation in the Live Well, Age Well AAPs among both participants and non-participants, to inform future programme refinements.

Purposive sampling was employed to recruit older adults aged 50 years and above from diverse participation levels, non-participants, and dropouts from the programme. A total of 28 adults (23 females and 5 males; mean age: 72.8 ± 7.1 years) were recruited, and semi-structured interviews were conducted to gain insights from participants. The analysis was guided by the Theoretical Domains Framework (TDF) and Capability, Opportunity, Motivation - Behavior (COM-B).

Analysis of interviews with 28 participants revealed motivation as a central aspect of programme participation, with capability and opportunity identified and discussed in relation to motivational factors. Willingness to participate was driven by intentions to enhance knowledge, manage well-being, and develop digital skills. Health concerns about age-related ailments motivated engagement, though some reported physical discomfort deterred participation. Self-confidence was undermined by health conditions and negative perceptions about ageing. Technology-related fears, particularly regarding scams, combined with low digital proficiency heightened anxiety. Memory difficulties and limited English literacy further impeded engagement. Environmental factors including time availability and geographical accessibility were key determinants. Social influences operated alongside environmental factors, with family encouragement promoting engagement whilst discouragement created participation barriers.

This study demonstrates how TDF and COM-B models can guide theory-informed interventions for AAPs, revealing that participation involves multiple interrelated determinants requiring targeted approaches across capability, opportunity, and motivation domains.