What do Caucasian and South Asian 60-70 year old adults think about exercise for fall prevention?

Introduction:Fall prevention remains a key public health priority. Strategies to help prevent falls often include taking regular exercise. However, 40% of over 50s in the UK report less physical activity than is considered necessary to maintain good health. Sedentary behaviour is even more common in South Asian older people in the UK. Aims:The primary aims were to: 1. investigate the cultural influences and2. identify salient beliefs that drive or hinder the uptake and adherence of exercise for fall prevention in 60-70 year old Caucasian and South Asian community dwellers. Methods:An ethnographic approach using participant observation, 15 focus group discussions (n = 87; mean age = 65.74 yrs) and 40 semi-structured interviews (mean age = 64.83 yrs) were used to elicit the salient attitudes and beliefs to the uptake and adherence of physical activity and in relation to falls and fall prevention. Framework analysis was used for data analysis and classification.Results:There main themes were identified:1. Beliefs - Both Caucasian and South Asian older adults, who had experienced a fall, held more positive beliefs about the potential for exercise in preventing falls; falls do not generally figure in both Caucasian and South Asian 60-70 years olds lives; Caucasian and South Asian older adults perceived falling as a general bodily weakness, so the idea of exercising purely for preventing a fall was considered superfluous to other pressing general health issues; South Asian older adults believed that the act of prayer (namaz) was a good form of exercise; Reactive beliefs were particularly strong in relation to falls prevention, in both groups, when people had had a previous fall 2. Motivation - previous fall.3. Barriers - Both groups were not generally motivated to perform exercise on a regular basis purely to help prevent falls. Discussion:Falls prevention, among both Caucasian and South Asian older adults takes a very low priority and there appears to be little association between exercise and fall prevention. Both Caucasian and South Asian 60-70year olds do not recognise their risk of falls. Therefore, fall prevention should not be the focus of marketing strategies but the peripheral benefits of both exercise and physical activity need to be promoted. Both Caucasian and South Asian older adults, who had experienced a fall were more likely to report being more motivated to perform exercise for this reason. This seemed to be related to their perceived fear of falling, which promoted the belief that they may fall again. Therefore, the focus of marketing strategies for falls prevention should be on promoting healthy lifestyles and target health promotion activities at older adults who have had a fall, as this is likely to be more successful than population based approaches. Caution should be used in terms of promoting prayer as exercise, as the effects of this from of exercise are not proven and under-researched.Few differences existed between Caucasian and South Asian 60-70 year olds, except in the area of fatalism about falls and the need for gendered exercise sessions.