Provider Perspectives on Fall Prevention Exercise Services in Ontario: A Qualitative Analysis

BACKGROUND: Approximately 30% of older adults (≥65) fall annually, yet community delivery of evidence-based fall prevention exercise remains poorly understood. This qualitative study explores fall prevention exercise service delivery from the perspective of exercise providers in Ontario. METHODS: We conducted semi-structured interviews with 20 exercise providers, guided by the Consolidated Framework for Implementation Research, and analyzed data thematically. FINDINGS: While providers valued evidence-based balance and functional training, those in large-group settings struggled with exercise tailoring and progression. Instead, many prioritized building trust, creating safe environments, and facilitating socialization. BARRIERS WERE HIGHLY CONTEXTUAL: kinesiologists lacked resources, independent providers lacked networking, and municipal/non-profit staff faced low pay and organizational competition. DISCUSSION: To enhance implementation of fall prevention exercise services, support must address unique contextual barriers while balancing clinical tailoring with participant adherence. Our insights suggest that leveraging existing community services and focusing on provider-specific supports are essential for effective implementation of fall prevention exercise services in Ontario.