Abstract

Orientation and Mobility Specialists (O&Ms) are experienced in working with people with vision impairment (VI), but have not previously delivered exercise-based falls prevention programs. Here, we aim to explore the implementation of the Lifestyle-Integrated Functional Exercise program in older adults with VI (v-LiFE), delivered by 38 trained O&Ms using a process evaluation nested within a randomised controlled trial. The process evaluation included four measures: (1) Program adherence was assessed through observation of O&Ms delivering v-LiFE using a standardised checklist, where higher scores indicated fidelity (range=0–64); (2) Complete delivery was gauged by number of sessions (range=0–11), where five or more sessions represents complete delivery; (3) Participant receipt was assessed through post-intervention semi-structured interviews and the Attitudes to Falls-Related Intervention Scale (AFRIS), where higher scores indicate positive attitudes (range=6–42); (4) Participant enactment was gauged using the Self-Report Habit Index (SRHI), where scores of 36 or above indicated the presence of a habit. Checklist scores (n=6) indicated the program was being delivered as intended (median=54.5, interquartile range=13.8). The majority (95.1%) received the full program (mean number of sessions=7.2, standard deviation=1.4). Qualitative data (n=47) revealed that participants were generally positive about v-LiFE. The average AFRIS score (mean=35.9, standard deviation=5.1) corresponded to an average score of 6.0 per item, indicating participants ‘agreed’ with the positive statements about v-LiFE. SRHI scores indicated habit formation (mean=47.7, standard deviation=9.9) for a nominated v-LiFE activity that the participant was able to implement. The findings of this process evaluation support the delivery of v-LiFE by O&Ms. Participant perspectives and enactment of program activities also indicate that v-LiFE may be an appropriate falls prevention program for older adults with VI. The v-LiFE program is feasible and delivery through existing O&M services may offer a scalable solution to preventing falls in this high risk population.