Falls are common and represent a major cause of severe injury and death among older people. Effective interventions to prevent falls have been developed, in particular ‘balance training’ - activities that enhance balance, coordination, and lower-leg muscle strength. However, older people’s uptake of falls prevention interventions can be low, and so older people require advice to help motivate them to undertake balance training. Tailoring, the method of making advice personally relevant to individuals, has been successfully used with other health behaviours to make advice more persuasive. The Internet lends itself to tailoring health advice, as it can reach a wide audience and present personally relevant advice to users through interactive websites.

This thesis evaluated the use of tailoring in falls prevention. A website was created that presented tailored advice intended to encourage older adults to undertake balance training. Theory and research guided the selection of factors chosen to tailor the advice and to evaluate its efficacy. From interviews with older people and health and social care providers, views towards the website suggested that the website was usable and acceptable. In a randomised controlled evaluation comparing the tailored advice with a generic equivalent, questionnaire scores indicated that after receiving the tailored advice, older people reported that the advice was more personally relevant, and reported greater confidence and intention to undertake balance training. Completing an action plan also increased older people’s confidence to undertake balance training.

Based on the feedback from participants derived from the two qualitative studies and the limitations identified from the quantitative study, a revised version of the website was created and re-tested. In a partial replication study, the tailored advice was reported by older people as more personally relevant and good for them to do, and creating an action plan increased their confidence to undertake balance training, although the effects of the intervention on intentions were weaker than in the first study, and did not quite reach significance. Nevertheless, the effect of tailoring on personal relevance and intention, and the effect of an action plan on confidence were significant in a meta-analysis of the two quantitative studies. Whilst not conclusive, this research suggests that a website providing tailored advice to encourage older people to undertake balance training may be usable and acceptable, and lead to greater intention and confidence to undertake balance training.