The prevention of falls is currently high on the health policy agenda in the United Kingdom, which has led to the establishment of many falls-prevention services. If these are to be effective, however, the acceptability of services to older people needs to be considered. This paper reports a systematic review of studies of older people's perceptions of these interventions. The papers for review were identified by searching electronic databases, checking reference lists, and contacting experts. Two authors independently screened the studies and extracted data on the factors relating to participation in, or adherence to, falls-prevention strategies. Twenty-four studies were identified, of which 12 were qualitative. Only one study specifically examined interventions that promote participation in falls-prevention programmes; the others explored older people's attitudes and views. The factors that facilitated participation included social support, low intensity exercise, greater education, involvement in decision-making, and a perception of the programmes as relevant and life-enhancing. Barriers to participation included fatalism, denial and under-estimation of the risk of falling, poor self-efficacy, no previous history of exercise, fear of falling, poor health and functional ability, low health expectations and the stigma associated with programmes that targeted older people.

The substantial and increasing number of older Australian people from culturally diverse backgrounds justifies the investigation and inclusion of their experiences in ageing research. Few empirical studies have addressed culturally diverse issues in the older population, however, in part because of the particular challenges in recruiting and retaining people from different cultural backgrounds. This article reflects on a research team's experience of recruiting participants from seven cultural groups into a study that sought to explore the links between physical activity and the built environment. Three key issues for recruiting and retaining participants from culturally diverse backgrounds were identified: having access to key local informants; the central role of paid and trained bilingual interviewers; and supporting the research partners in recruitment activities. Furthermore, it appeared that a ‘one size fits all’ approach was not appropriate and that a flexible recruitment strategy may be required to ensure successful recruitment from all cultural groups. The differences observed in this study relating to recruitment and retention rates may be more dependent on the skills and characteristics of those responsible for the recruitment and interviewing, rather than the specific cultural group itself. Older people from some cultural backgrounds may be less likely to respond to traditional recruitment methods and researchers need to be more assiduous and strategic to improve participation rates in research.

Using social capital and social exchange theories, this investigation examined ethnic variation in patterns of social exchange in two heterogeneous racial groups, Blacks and Whites in the United States, and the effects of education and income on these patterns. The sample was 1,043 people aged 65–86 years from four ethnic groups (US-born European-Americans, immigrant Russians/Ukrainians, US-born African-Americans, and immigrant English-speaking Caribbeans) who had provided details of their instrumental and advice exchanges with kin and non-kin. Hierarchical multinomial logistic regressions were used to predict patterns of social exchange, variations by ethnicity, income and education, and the interactions. Ethnic differences in patterns of social exchange were found, but almost all were qualified by interactions. Those with income showed within-group heterogeneity: African-Americans and Russians/Ukrainians with higher income were more likely to engage in reciprocal instrumental kin exchange, whereas among English-speaking Caribbeans and European-Americans such exchanges were not associated with income. Unlike among European-Americans and English-speaking Caribbeans, Russians/Ukrainians with higher income and education were more likely to engage in reciprocal non-kin exchange. The findings suggest that ethnic variation in social exchange reflects both aspects of ethnic group membership and the relational context, as well as the enactment of reciprocity values in varying resource contexts.

This paper reports the evaluation of the effectiveness of incentives (viz. points and prizes) and of peer-group organisers (‘older people's champions') in the outcomes of a health-improvement programme for people aged 50+ years in a multi-ethnic district of the West Midlands, England. Health promotion activities were provided, and adherence, outcome variables and barriers to adherence were assessed over six months, using a ‘passport’ format. Those aged in the fifties and of Asian origin were under represented, but people of Afro-Caribbean origin were well represented and proportionately most likely to stay in the project. Those of greater age and with more illness were most likely to drop out. There were significant improvements in exercise, diet and the uptake of influenza vaccines and eyesight tests, but slighter improvements in wellbeing. Positive outcomes related to the incentives and to liking the format. The number of reported barriers was associated with lower involvement and lack of change, as was finding activities too difficult, the level of understanding, and transport and mobility problems, but when these were controlled, age did not predict involvement. Enjoying the scheme was related to positive changes, and this was associated with support from the older people's champions.

This paper analyses the impact of spousal care-giving on survivors' depressive symptoms six months into widowhood, and examines the applicability of a ‘relief model’ of spousal adjustment during bereavement. We examine several aspects of the care-giving situation, including care-giver stress, care-giving demands, and type and duration of care and how these affect survivors' depressive symptomatology. The sample is drawn from two waves of the Changing Lives of Older Couples (CLOC) survey, which was conducted in the United States in the Detroit Metropolitan Area, Michigan. The first wave of data was collected from couples and the second from the surviving spouse six months after the death of the partner. We use multiple regression analysis to examine the effects of key variables on depressive symptoms six months into widowhood, controlling for various demographic characteristics and personal circumstances. The results demonstrate that the duration of care-giving is the most influential predictor of survivors' depressive symptoms six months after the death. Indeed, long-term care-givers experience greater relief than both non-caregivers and short-term care-givers, as the predicted probabilities indicate. The results lead us to emphasise that care-giving and spousal bereavement should be studied as related processes rather than distinct phenomena. Indeed, relief from a chronically stressful care situation may actually ameliorate the negative effect of spousal loss for survivors.

Research on the division of family work has focused on household work and child-care to the exclusion of other domains, whereas studies on care-giving for older people typically ignore spouses' support to care-givers. In this paper we apply an approach that is typical of research on spouses' division of family work in caring for parents, in that the theoretical model focuses on the ‘cultural mandates’ that guide spouses' division of care, namely gender ideologies about appropriate roles, kinship obligations, and taboos against cross-gender personal care. Other predictors of the spousal division of care drawn from economic and health-care utilisation models are also examined. The analyses use pooled data on 1,449 care occasions from the first five waves of the US Health and Retirement Study. It was found that most couples to some extent share parent care, and that the involvement of husbands depended on a complex interplay of cultural mandates and contexts. Husbands participated most in personal care for parents if the care was mandated by kinship obligations (they cared more for their own than their wife's parents), and by cross-gender care taboos (they cared more for fathers than mothers). Other cultural contexts (such as race), a spouse's other commitments, health-related ability, resources (including support from the parents' other children), and care-burden also played a role. The findings demonstrate that decisions to care for parents emerge from complex negotiations among spouses and their children and siblings or, in other words, that parental care is a family endeavour.