The paper introduces a new approach to reflecting and acting called participatory and appreciative action and reflection (PAAR). It explores its potential to enable individuals and groups to move forward, to improve their working practices and lives in particular communities and contexts. The paper situates PAAR in the historical context of participatory and action research and reflective learning. It suggests that using PAAR requires four strategic ‘turns’. By turn we mean a change in direction from one way of thinking and practising to another. The four turns are: (i) away from a preoccupation with changing behaviours in order to solve problems, with ‘fixing’ things and an engagement in deficit‐based discourses, towards the development of appreciative insight, understanding the root causes of success and sustaining strengths‐based discourses in order to amplify those things that will help build a better future from the positive present; (ii) away from self‐learning (individualism and isolation) and towards collective learning through interconnectedness, appreciative knowledge sharing and the use of new forms of communications technology which enable simultaneous action in dispersed geopolitical spaces; (iii) away from one way of knowing and one perspective on truth to an acceptance of more pluralistic view of ways of knowing, of understanding human experience and putting this knowing to good use; (iv) away from reflective cycles and spirals and towards the use of a reflective learning (r‐learning) framework comprising four mutually supportive processes. They are those of developing an appreciative ‘gaze’, of reframing lived experience, of building practical wisdom and of achieving and moving forward.

To offer fall prevention exercise programs that attract older people of both sexes there is a need to understand both women’s and men’s views and preferences regarding these programs. This paper aims to systematically review the literature to explore any underlying gender perspectives or gender interpretations on older people’s views or preferences regarding uptake and adherence to exercise to prevent falls. A review of the literature was carried out using a convergent qualitative design based on systematic searches of seven electronic databases (PubMed, CINAHL, Amed, PsycINFO, Scopus, PEDro, and OTseeker). Two investigators identified eligible studies. Each included article was read by at least two authors independently to extract data into tables. Views and preferences reported were coded and summarized in themes of facilitators and barriers using a thematic analysis approach. Nine hundred and nine unique studies were identified. Twenty five studies met the criteria for inclusion. Only five of these contained a gender analysis of men’s and women’s views on fall prevention exercises. The results suggests that both women and men see women as more receptive to and in more need of fall prevention messages. The synthesis from all 25 studies identified six themes illustrating facilitators and six themes describing barriers for older people either starting or adhering to fall prevention exercise. The facilitators were: support from professionals or family; social interaction; perceived benefits; a supportive exercise context; feelings of commitment; and having fun. Barriers were: practical issues; concerns about exercise; unawareness; reduced health status; lack of support; and lack of interest. Considerably more women than men were included in the studies. Although there is plenty of information on the facilitators and barriers to falls prevention exercise in older people, there is a distinct lack of studies investigating differences or similarities in older women’s and men’s views regarding fall prevention exercise. In order to ensure that fall prevention exercise is appealing to both sexes and that the inclusion of both men and women are encouraged, more research is needed to find out whether gender differences exists and whether practitioners need to offer a range of opportunities and support strategies to attract both women and men to falls prevention exercise.

Daily life requires frequent estimations of the risk of falling and the ability to avoid a fall. The objective of this study was to explore older women’s and men’s understanding of fall risk and their experiences with safety precautions taken to prevent falls. A qualitative study with focus group discussions was conducted. Eighteen community-dwelling people [10 women and 8 men] with and without a history of falls were purposively recruited. Participants were divided into two groups, and each group met four times. A participatory and appreciative action and reflection approach was used to guide the discussions. All discussions were audio recorded and transcribed verbatim. Data were analysed by qualitative content analysis, and categories were determined inductively. Three categories describing the process of becoming aware of fall risks in everyday life were identified: 1] Facing various feelings, 2] Recognizing one’s fall risk, and 3] Taking precautions. Each category comprised several subcategories. The comprehensive theme derived from the categories was “Safety precautions through fall risk awareness”. Three strategies of ignoring [continuing a risky activity], gaining insight [realizing the danger in a certain situation], and anticipating [thinking ahead and acting in advance] were related to all choices of actions and could fluctuate in the same person in different contexts. The fall risk awareness process might be initiated for various reasons and can involve different feelings and precautions as well as different strategies. This finding highlights that there are many possible channels to reach older people with information about fall risk and fall prevention, including the media and their peers. The findings offer a deeper understanding of older peoples’ conceptualizations about fall risk awareness and make an important contribution to the development and implementation of fall prevention programmes.

The demographic development indicates an increased elderly population in Sweden in the future. One of the greatest challenges for a society with an ageing population is to provide high-quality health and social care. New information and communication technology and services can be used to further improve health care. To enable elderly persons to stay at home as long as possible, various kinds of technology, such as safety alarms, are used at home. The aim of this study was to describe the experiences of elderly persons through testing a mobile safety alarm and their reasoning about safety, privacy and mobility. The mobile safety alarm tested was a prototype in development. Five elderly persons with functional limitations and four healthy elderly persons from a pensioner's organisation tested the alarm. The mobile alarm with a drop sensor and a positioning device was tested for 6 weeks. This intervention was evaluated with qualitative interviews, and analysed with latent content analysis. The result showed four main categories: feeling safe, being positioned and supervised, being mobile, and reflecting on new technology. From these categories, the overarching category ‘Safety and mobility are more important than privacy’ emerged. The mobile safety alarm was perceived to offer an increased opportunity for mobility in terms of being more active and as an aid for self-determination. The fact that the informants were located by means of the positioning device was not experienced as violating privacy as long as they could decide how to use the alarm. It was concluded that this mobile safety alarm was experienced as a tool to be active and mobile. As a way to keep self-determination and empowerment, the individual has to make a ‘cost–benefit’ analysis where privacy is sacrificed to the benefit of mobility and safety. The participants were actively contributing to the development process.

This is a reflective account of aspects of our collective concern about developing and sustaining ways that might enable elderly people to feel more empowered to exercise their right of self‐determination. This work has been undertaken in the context of home healthcare in northern Sweden. In this paper we put three espoused values ‘under pressure’ from client, professional (homecare staff) and research perspectives. We also explore three aspects of the pictorial landscape of homecare (see Figure 1). They are the notions of client participation, empowerment and ICT. The living data for this paper is drawn from two days of workshop activities with 35 homecare staff working in the municipality of Luleå, Sweden. The workshop was one outcome of the e‐Home Health Care @ North Calotte (eHHC) Project of 2003–2005. We conclude with some collective reflections about: (a) the practice of participation (dialogue) and an intention of it (empowerment) in the context of clients accelerating service change; (b) how to reframe traditional views of the relationships between research and practice and, as a consequence, open up new possibilities for understanding how elderly people’s lived experiences can be a positive force for service improvement; and (c) the use of storyboards as an appreciative approach to enable frontline staff to reflect on their work, share and learn together.