Church-based social marketing to motivate older adults to take balance classes for fall prevention: Cluster randomized controlled trial

Objective. Determine whether a church-based social marketing program increases older adults' participation in balance classes for fall prevention. Methods. In 2009-10, 51 churches (7101 total members aged >= 60) in Colorado, U.S.A. were randomized to receive no intervention or a social marketing program. The program highlighted benefits of class participation (staying independent, building relationships), reduced potential barriers (providing convenient, subsidized classes), and communicated marketing messages through church leaders, trained "messengers," printed materials and church-based communication channels. Between-group differences in balance class enrollment and marketing message recall among congregants were compared using Wilcoxon Two-Sample Test and regression models. Results. Compared to 25 control churches, 26 churches receiving the social marketing program had a higher median proportion (9.8% vs. 0.3%; p < 0.001) and mean number (7.0 vs. 0.5; IRR = 11.2 [95%CI: 7.5, 16.8]) of older adult congregants who joined balance classes. Intervention church members were also more likely to recall information about preventing falls with balance classes (AOR = 6.2; 95% CI: 2.6, 14.8) and availability of classes locally (AOR = 7.7; 95% CI: 2.6, 22.9). Conclusions. Church-based social marketing effectively disseminated messages about preventing falls through balance classes and, by emphasizing benefits and reducing barriers and costs of participation, successfully motivated older adults to enroll in the classes. (C) 2014 Elsevier Inc All rights reserved.