Evaluation of MOVE Together: Reduce Falls in older people from culturally and linguistically diverse communities

The co-designed MOVETogether: Reduce Falls program. The aim of the program is to support participants to engage in individualised and tailored exercises, designed to reduce their risk of falls. The codesign process utilised an Integrated Knowledge Translation approach, which included a research team of 24 people (including people aged over 65 from ethnic communities, representatives from ethnically diverse community groups and service providers) who developed our intervention over 5 stages. Two stages engaged 75 research participants including 63 (84%) people aged over 65 years from 3 ethnically diverse communities (Chinese, Italian and Arabic-speaking) and 12 service providers. The research participants participated in one of 11 workshops (which ran for up to 2,5 hours) to identify barriers and enablers to exercise for falls prevention, and then one of three workshops (which ran for up to 2.5 hours) to review the intervention prototype. Six research participants trialed the intervention prototype . More details on the co-design process can be obtained from Ramage ER,, et al. Moving together to facilitate equity and inclusion in research. The co-production of interventions for clinical trials to facilitate participation of people from ethnically diverse communities. Health Research Policy and Systems. 2026;24(1):9. The MOVETogether: Reduce Falls program includes 10-12 individually tailored sessions delivered by a physiotherapist over 12-months. The sessions will include prescription of an individually tailored exercise program, to be done by the participant in their home, with a focus on balance and functional exercises (e.g. exercises which incorporate functional movements such as standing up from a chair). Further detail on the program is below. The exercise program will be tailored to meet the individual’s level of function and will be progressed to ensure the exercises are appropriate and sufficiently challenge the individual’s physical capability (e.g., balance) to induce a training effect. The exercise dosage will be gradually increased: while the aim is to achieve a target dose of three hours a week, this may not be possible for all participants. Individualised behaviour change strategies will be incorporated to support long-term engagement. The initial session will be delivered in person, in the participant’s own home, or at the hospital (depending on participant’s preference). Remaining sessions will occur in the participant’s own home (or preferred accommodation) or at the hospital (depending on participant’s preference) and will be delivered via a combination of in-person and telehealth (teleconference via Zoom or telephone). A checklist will be completed by the physiotherapist to determine participants who are not suitable for telehealth. Funding is available to provide tablet devices and mobile data to participant’s who do not have access to appropriate technology. Participants will be provided with simple exercise equipment if required (e.g. step, resistance bands), up to a value of $50 per participant. MOVETogether: Reduce Falls Program Components: There is flexibility around timing to meet participant needs and preferences (e.g. to accommodate participant holidays, participant preferences, other commitments, illness etc). The first 5 sessions should occur in the first 3 months. The second 5 sessions occur over the next 6 months, reducing in frequency from monthly to bimonthly). There are two additional optional session which can be used as ‘boosters’ to assist people reengage with the program if required (e.g. after an illness or absence) or address any other issues that arise. The reasons for delivery of any ‘booster’ sessions will be recorded. The initial session will be 45 – 60 mins, subsequent sessions will be 30 -45 mins. Mode of delivery: Mixture of in-person and telehealth. (either phone or videoconferencing). Participants will be provided with support to utilise telehealth (including demonstration and practice sessions if required) and funding is available to provide tablet devices and mobile data to participant’s who do not have access to appropriate technology. The method used to deliver the resources and participant information will be tailored to the participants’ needs and preferences (e.g. via email or an application such as WhatsApp or WeChat). The physiotherapist will utilise a checklist (adapted with permission from a tool developed by Dr Camile Short and colleagues, based on the Dutch Blended Checklist) to determine the suitability of telehealth for each participant on an individual basis. If telehealth is determined not suitable for a participant, their session can be delivered in person. Behaviour change support: The physiotherapist will use a ‘coaching’ approach to provide tailored behaviour change support to respond to individualised barriers and enabler identified within physiotherapy sessions. Participants will work with the Physiotherapist to develop their own plan to support behaviour change. Where appropriate, and where participants would like to document their plan, this will be documented on an Action plan. Peer support: Participants will have the option to enroll in the trial with a family member or a friend who also meets the eligibility criteria. This will provide participants with peer support which is likely to enhance engagement and positive behaviour change. If participants do enroll as part of a dyad, they will be given the option to schedule their sessions at the same time, one after the other, or at different times, depending on their preferences. Participants who enrol without a family member/ friend will be encouraged to consider whether there is a friend or family member who can provide them with support, even if they do not meet the eligibility criteria and are not enrolled in the trial. Program Folder: Participants will receive a program folder which will include their individualised program information, such as: • Program staff contact information. • Appointment schedule • Co-designed exercise resources, as described below, prescribed by the physiotherapist to support independent exercise practice. • “Conversation topic’ Resources, as described below. • Falls calendar. Codesigned exercise resources: A range of hard copy, digital (e.g. pdf) and video exercise resources have been codesigned and translated /narrated into Italian, Arabic, Mandarin and Cantonese, and are being translated/ narrated into Vietnamese and Greek. Physiotherapists will select appropriate resources for each participant on an individual basis. Where appropriate, physiotherapists may prescribe exercises not on the list (e.g. instructions for a balance exercise not included below). The physiotherapist will develop resources to support the exercise as appropriate for the participant (e.g. video the participant doing the exercise). Participants will also be provided with a diary to track their exercise as one of the tools to support behaviour change. Codesigned ‘Conversation Topics’: Resources have been co-designed for this study for nine core and one optional ‘Conversation Topics’, which address many of the common barriers and facilitators to exercise. ‘Conversation topics’ will be discussed over the ten to 12 physiotherapy sessions. Participants will be provided with infographics in their preferred language. Physiotherapists will be provided with a ‘Conversation Guide’ which highlights key points to be discussed. The nine core ‘Conversation Topics’ include: 1. Exercise for mobility, independence and fall prevention (infographic and animated video) 2. Reducing falls risk (infographic and animated video) 3. How hard should I work 4. Exercising with health conditions 5. Staying motivated 6. Getting back in to exercise after a break 7. Exercise and weather 8. How to modify my own exercises 9. Staying safe while exercising There is one optional conversation topic; 10. Exercising in a group. Some people prefer to exercise in a group. While this program will not specifically provide group exercise classes, this topic will provide participants who are interested in group exercise with the opportunity to identify appropriate options. These resources are not publicly available.