Adoption of a Tai Chi Intervention, Tai Ji Quan: Moving for Better Balance, for Fall Prevention by Rural Faith-Based Organizations, 2013–2014
COMMUNITY CASE STUDY — Volume 13 — July 14, 2016
For stage 1 (Planning), the barriers were that faith-based organizations (FBOs) and congregations were small, that the entry age of 65 years or older was too high, and congregants were hesitant to go to another FBO. Recommended facilitators were partnering with larger FBOs or congregations, lowering the entry age to 55 years or older, and holding classes at a neutral site. For stage 2 (Promotion), barriers were a fear that tai chi is a vigorous martial art and that the word “religion” might “turn people away.” Recommended facilitators were to educate and demonstrate that tai chi is not vigorous exercise and to avoid using the word “religion” in promotional messages. For stage 3 (Recruitment), barriers were that “outsiders” might not be trusted, congregants were hesitant to go outside their comfort zone to other FBOs, and that it is hard to motivate people to participate. Recommended facilitators were for the researchers to attend FBO activities to become “insiders,” to have pastors create a comfort zone, and to offer perks (healthy snacks, door prizes, t-shirts) to participate. For stage 4 (Implementation), barriers were inconvenient class scheduling, lack of transportation, and that participants would expect the program to have a religious component. Recommended facilitators were to use sensitivity when scheduling classes, use local buses or vans or establish a carpool, and to incorporate prayer into the exercise program. For stage 5 (Retention), barriers were competing activities or issues, and recommended facilitators were to offer incentives, education, and social activities. For stage 6 (Evaluation), the barrier was that too much effort may be required for the FBO to offer the class. Recommended facilitator for instructors would be seeing participants’ health improve and the program continue; for participants, a recommended facilitator would be the gain in personal benefits. A recommended facilitator for the FBOs would be witnessing a growth in membership and improvement in participants’ health. For Stage 7 (Outcomes), barriers were loss of interest by participants, participants’ skills plateauing, or the need for compensation for instructors to continue. Recommended facilitators were to give the participants progress reports, encouragement, and praise; for the instructors to progress the exercises and keep them challenging; and to compensate the exercise instructor (put out a tip jar). For Stage 8 (Dissemination), no barriers were noted. Recommended facilitators were to perform a community exercise demonstration, have physicians prescribe the class, and publicize the exercise program in church, district, and state newsletters; senior centers; and health centers.
Figure. Key barriers and facilitators by intervention stage from stakeholders who attended project forums before adoption of the Ti Ji Quan: Moving for Better Balance program in rural faith-based organizations, West Virginia, 2013–2014.
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