Evidence and Dissemination of Lively 100-Year-Old Exercise: Promoting Community-based Initiatives for Fall Prevention Among Community-dwelling Older Adults

Falls among older adults are a growing public health concern and an increasingly important cause of long-term care needs. Evidence shows that exercise programs combining balance and resistance training can effectively reduce fall risk, yet participation in regular exercise remains limited among community-dwelling older adults in Japan. The Lively 100-Year-Old Exercise was developed in Kochi City in 2002 as a resident-led, community-based fall-prevention program. Despite its spread to many municipalities nationwide, regional disparities in implementation remain, and certain populations-particularly older men-are less likely to participate. To address these challenges, in this paper, implementation science frameworks are applied. The Consolidated Framework for Implementation Research was used to identify barriers and facilitators across five domains, namely, innovation, outer setting, inner setting, individual, and implementation process. Key strategies include strengthening social appeal, administrative support, interdepartmental collaboration, and resident leadership. Furthermore, the COM-B model was used to identify barriers and facilitators to individual participation in the Lively 100-Year-Old Exercise, classifying them into capability (understanding health benefits), motivation (enjoyment and sense of purpose), and opportunity (social support and accessible environments). In this paper, it is concluded that 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.