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). Design: The EASY LiFE study was a mixed-methods, 4-month feasibility intervention that included seven group-based sessions and two telephone calls. 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 (M-age = 66.23, SD = 3.98) and showed changes in their level of action control [mean difference(T1-T2) = 1.7, 95% CI (-2.2 to 0.8)1, action planning [mean difference(T1-T2) = 0.8, 95% Cl (-1.1 to -0.2)], automaticity [mean difference(T1-T2) = 2.5, 95% Cl (-3.7 to -1.2)], and exercise identity [mean difference(T1-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. (C) 2015 Elsevier Ltd. All rights reserved.