The Role of Social Prescribers in Engaging Older Adults in Strength and Balance Training After Being Discharged From Physiotherapy Rehabilitation: A Qualitative Investigation

Background: Older adults are advised to undertake strength and balance training (SBT) to prevent falls. This can be provided by physiotherapy services for a limited time, but long-term engagement is required to maintain the benefits. Finding ways to support long-term engagement is needed.

Aim: To understand if it is feasible to develop a referral pathway from physiotherapy services to social prescribers for engaging older adults in long-term SBT within their daily lives.

Methods: We purposefully recruited and interviewed social prescribers via Microsoft Teams. We undertook a framework analysis based on the Capability-Opportunity-Motivation behaviour change framework.

Results: We interviewed eight social prescribers including one manager and two whose role was related specifically to physical activity and exercise. All participants demonstrated motivation to engage older adults in SBT. However, there was variation in their perceived capability and opportunity to do this. Some felt their roles were well suited to encourage SBT as their role was linked to exercise provision, but others felt less confident and identified barriers. All participants identified that the social prescribers were becoming overwhelmed by their workload. They identified motivation as the most potent barrier to older adults engaging in SBT along with opportunity and capability barriers. Participants felt that improving motivation would be the biggest driver of behaviour change but not all felt equipped to do this.

Conclusion: It may be feasible to trial setting up a referral pathway from physiotherapy services to social prescribing to support older adults to engage in SBT. However, services may lack capacity, and there was variability in how services work and social prescribers identified barriers to engaging older adults in SBT. A better option may be to explore the development of a pathway from outpatient physiotherapy services directly to community physical activity services.