Purpose Participation in evidence-based falls prevention programs and implementation of specific falls prevention behaviours can reduce falls among older adults. However, uptake of these falls prevention activities is low. This study sought to identify factors that influence whether older adults would participate in a falls prevention program, and factors that influence the extent to which older adults adopt recommended falls prevention behaviours.

Methods Data were collected March 2000–September 2013 through a cross-sectional survey of 164 community-dwelling older adults living in North Carolina. Information collected included: perceived need for a falls prevention program, ability to participate in the program, perceived efficacy of the program in reducing falls, enabling factors (e.g., health, family support), program characteristics, falls history, and falls prevention behaviours. Chi-square and Wilcoxon Rank Sum tests were used to describe the association between each factor and the likelihood of participating and implementing falls prevention behaviours.

Results Most participants indicated they would be likely to participate in a falls prevention program if given the opportunity (65%). Participants who were afraid of falling, had a high perceived risk of falling, had confidence in their ability to participate, and felt the program would reduce fall risks were more likely to participate in a falls prevention program (p-values: <0.05). Program cost was also found to influence the likelihood of participation (p-value: 0.043). Fear of falling, perceived likelihood of falling, and history of falls were not associated with implementing falls prevention behaviours.

Conclusions Individual factors associated with perceived need, efficacy and outcome expectations, and enabling factors influence an older adults’ willingness to participate in a falls prevention program.

Significance Given the low uptake of falls prevention programs in the community, results begin to identify ways in which existing falls prevention programs can be modified for better uptake in the community.