Co-designing an Exercise Maintenance Intervention for Older Adults Exiting Falls Prevention Programmes: A Multi-Stage Stakeholder Consultation Approach

Introduction: Falls Management Exercise (FaME) programmes improve physical function and reduce falls rate and risk in older adults, but after completion exercise engagement declines, leading to loss of the health benefits gained. This study aimed to co-design an exercise maintenance intervention for older adults exiting FaME programmes, addressing the critical need to sustain physical activity benefits after programme completion.<br/>Methods: A three-stage co-design process: Stage 1 involved community-based stakeholder consultations with older adults completing FaME and rehabilitation professionals (n=16) to identify acceptable intervention components. Stage 2 consisted of professional stakeholder consultations (n=11) to assess feasibility. In Stage 3, the Normalisation Process Theory guided development of implementation procedures with service-providers (n=2). Data were analysed using descriptive statistics and thematic analysis.<br/>Results: Community-based stakeholders identified core components: information on local physical activity opportunities (88%), motivational strategies (81%), follow-up group meetings (69%), and health education (63%). Professional stakeholders confirmed unanimous agreement for motivational strategies and health education. Concerns emerged regarding affordability of follow-up meetings for service-providers and equity of digital interventions. Follow-up phone calls, text message reminders, self-completed functional fitness assessments and exercise snacks in face-to-face sessions emerged as additional components.<br/>Conclusion: KESS is a rigorous, co-designed, stakeholder informed intervention targeting exercise maintenance in older adults after FaME ends. KESS aims to prevent a decline in exercise adherence and consequent increasing risk of falling, observed in FaME programme attendees &gt;6 months after programmes end if appropriate activity is not maintained. KESS is ready for feasibility and acceptability testing.