Assessing early-stage acceptability of the adapted version of the lifestyle-integrated functional exercise (aLiFE) programme among community-dwelling Chinese older adults in the UK

Abstract Background Falls are a leading cause of injury and loss of independence among older adults. Although exercise-based interventions can reduce fall risk, sustaining adherence is challenging. The adapted Lifestyle-integrated Functional Exercise (aLiFE) programme addresses this by embedding balance, strength and physical activity tasks into daily routines. However, acceptability depends on whether older adults perceive aLiFE as understandable, manageable, safe and relevant. This may be particularly important for older Chinese adults living in UK, whose language preferences, cultural beliefs, social contexts and health-related experiences may shape perceptions of falls prevention. This study explored initial acceptability and perceived feasibility of aLiFE among older Chinese adults and healthcare professionals in UK. Methods Community-dwelling older Chinese adults and healthcare partners were purposively recruited in Manchester, UK. Three focus groups with 18 older Chinese adults and three individual interviews with healthcare partners were conducted. Participants completed aLiFE Activity Acceptability Rating Scale and Short Falls Efficacy Scale-International. Quantitative data were analysed descriptively, and qualitative data were analysed inductively using Reflexive Thematic Analysis to identify patterns in participants’ views, concerns and recommendations. Results Four main themes were identified: (1) Perceived feasibility and practicality of the lifestyle-integrated concept; (2) Usability and accessibility of programme delivery and materials; (3) Perceived burden and accessibility of programme documentation and (4) Acceptability and perceived capability of programme activities. The lifestyle-integrated approach was generally viewed positively as being flexible and compatible with daily routines. Some participants considered documentation burdensome and queried accessibility and credibility of written records. Visual materials and group-based, face-to-face teaching were preferred to written instructions alone. Some activities were viewed as less acceptable because of concerns about safety, confidence and physical discomfort, particularly where tasks involved more challenging balance or strength components. Differences were also observed between older participants and healthcare partners, the latter tending to take a more cautious view of challenging activities and potential risks. Conclusions The aLiFE programme was generally perceived as feasible and acceptable among older Chinese adults and healthcare partners. Acceptability depended on how the concept, activities, materials and delivery format were understood and received. These findings provide insights to inform cultural adaptation of aLiFE for this population and support further refinement before wider implementation or evaluation.