Differences of expected intervention effects between participant-led and facilitator-led preventive care services in Japan.

Participants were not randomly allocated; they came from classes with different management methods. The groups were not equivalent at baseline: total community competence and occupational deprivation differed, and all participants in the participant-led class were new while 44.8% of facilitator-led participants had prior class experience. Attrition was high: 91 were recruited, but 19 dropped out early and 29 did not complete post-evaluation, leaving 43 analysed, 47.3% of recruited. The programme content was not identical: participant-led participants set duration and added programmes, while facilitator-led content was predetermined. The sample was small and mostly women (92.9% of participant-led and 75.9% of facilitator-led participants were women). Participants were high-functioning community-dwelling older adults, so results may not apply to people with greater difficulty in daily activities. Snowfall and health problems likely affected attendance and post-intervention activity.

Do not read participant-led classes as better overall. Participant-led classes improved self-rated health and occupational deprivation, but facilitator-led classes improved sit-to-stand speed and had better Timed Up and Go scores. The classes included exercises, dual tasks, recreation, group work, and lectures, and allocation was not randomised, so the management style alone cannot be separated.