[Evidence and Dissemination of Lively 100-Year-Old Exercise: Promoting Community-based Initiatives for Fall Prevention Among Community-dwelling Older Adults].
Chisato Hayashi, J. Saito, Ayako Okuyama • Nihon eiseigaku zasshi. Japanese journal of hygiene • 2026
Sustained dissemination of the Lively 100-Year-Old Exercise requires evidence-based implementation strategies, systematic evaluation of implementation outcomes, and close collaboration among researchers, local governments, and community stakeholders.
Key Findings
Background
Falls among older adults are a growing public health concern and an increasingly important cause of long-term care needs in Japan.
The paper identifies falls as a major driver of long-term care needs among community-dwelling older adults in Japan.
Participation in regular exercise remains limited among community-dwelling older adults in Japan despite available evidence-based programs.
Regional disparities in implementation of fall-prevention programs persist across municipalities.
Background
Exercise programs combining balance and resistance training have evidence supporting their effectiveness in reducing fall risk.
The paper cites existing evidence that combined balance and resistance training programs can effectively reduce fall risk.
Despite this evidence, uptake of regular exercise among community-dwelling older adults in Japan remains limited.
The gap between evidence and practice motivated the application of implementation science frameworks.
Background
The Lively 100-Year-Old Exercise is a resident-led, community-based fall-prevention program developed in Kochi City in 2002 that has spread to many municipalities nationwide.
The program was originally developed in Kochi City in 2002.
It has since spread to many municipalities across Japan.
Despite nationwide spread, regional disparities in implementation remain.
Older men are identified as a population particularly less likely to participate.
Methods
The Consolidated Framework for Implementation Research (CFIR) identified barriers and facilitators to program implementation across five domains.
The five CFIR domains applied were: innovation, outer setting, inner setting, individual, and implementation process.
Key facilitating strategies identified include strengthening social appeal, administrative support, interdepartmental collaboration, and resident leadership.
The framework was used to address challenges including regional disparities and low participation among certain populations.
Methods
The COM-B model identified individual-level barriers and facilitators to participation in the Lively 100-Year-Old Exercise across three categories.
Capability barriers and facilitators related to understanding health benefits of the program.
Motivation barriers and facilitators related to enjoyment and sense of purpose.
Opportunity barriers and facilitators related to social support and accessible environments.
The COM-B model was used specifically to address why certain populations, particularly older men, are less likely to participate.
Conclusions
Sustained dissemination of the Lively 100-Year-Old Exercise requires evidence-based implementation strategies, systematic evaluation of implementation outcomes, and close collaboration among multiple stakeholders.
Stakeholders identified as essential include researchers, local governments, and community stakeholders.
Systematic evaluation of implementation outcomes is identified as a necessary component for sustained dissemination.
The paper concludes that both program-level and individual-level frameworks must be applied together to address dissemination challenges.
What This Means
This research paper examines how a Japanese community exercise program called the 'Lively 100-Year-Old Exercise' — originally created in Kochi City in 2002 to prevent falls among older adults — can be more effectively spread and sustained across Japan. Falls are a major health problem for older adults and one of the leading reasons people end up needing long-term care. Although exercise programs that combine balance and strength training are known to reduce fall risk, many older adults in Japan do not regularly participate in them, and there are large differences between regions in how well these programs are being implemented.
The researchers applied two established frameworks from implementation science to analyze why the program succeeds or struggles. The first framework (CFIR) looked at organizational and community-level factors, finding that social appeal, government support, collaboration across departments, and community leadership are important for getting programs running and keeping them going. The second framework (COM-B) focused on why individual older adults do or do not join, identifying that people need to understand the health benefits (capability), find the activity enjoyable and meaningful (motivation), and have social support and easy access to participate (opportunity). Older men were highlighted as a group that is particularly hard to reach.
This research suggests that closing the gap between what works in research and what happens in real communities requires a coordinated effort involving scientists, local governments, and community members working together. It also highlights the need for ongoing, systematic measurement of how well programs are being implemented — not just whether they reduce falls in theory. The findings offer practical guidance for communities in Japan and potentially elsewhere looking to design or expand fall-prevention programs for older adults.
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Chisato Hayashi, J. Saito, Ayako Okuyama. (2026). [Evidence and Dissemination of Lively 100-Year-Old Exercise: Promoting Community-based Initiatives for Fall Prevention Among Community-dwelling Older Adults].. Nihon eiseigaku zasshi. Japanese journal of hygiene. https://doi.org/10.1265/jjh.26002