Health behaviour change theory meets falls prevention: Feasibility of a habit-based balance and strength exercise intervention for older adults

Objectives Habit formation is a proposed mechanism for behaviour maintenance. Very few falls prevention studies have adopted this as an intervention framework and outcome. Therefore, we tested feasibility of a theory-based behaviour change intervention that encouraged women to embed balance and strength exercises into daily life routines (e.g., eating, self-care routines). Main outcome measures We obtained performance-based (i.e., Short-Physical-Performance-Battery) and psychological self-report measures (i.e., intention, self-efficacy, planning, action control, habit strength, quality of life) from 13 women at baseline (T1) and 4-month follow-up (T2). We applied the Framework-Method to post-intervention, semi-structured interviews to evaluate program content and delivery. Results In total, 10 of 13 women completed the program (Mage = 66.23, SD = 3.98) and showed changes in their level of action control [mean differenceT1−T2 = 1.7, 95% CI (−2.2 to −0.8)], action planning [mean differenceT1−T2 = 0.8, 95% CI (−1.1 to −0.2)], automaticity [mean differenceT1−T2 = 2.5, 95% CI (−3.7 to −1.2)], and exercise identity [mean differenceT1−T2 = 2.0, 95% CI (−3.2 to −0.8)]. Based on the Theoretical Domains Framework we identified knowledge, behavioural regulation, and social factors as important themes. For program delivery, dominant themes were engagement, session facilitators and group format. Conclusion The theory-based framework showed feasibility for promoting lifestyle integrated balance and strength exercise habits. Using activity and object-based cues may be particularly effective in generating action and automaticity.