Table 2 Implementation barriers and recommendations

Costs

The costs for the SALSA service should be kept at a minimum for older adults with lower SES who cannot afford full healthcare or sports classes.

Access to low SES users

Stakeholders believed that people with low SES that would benefit a lot from a service like SALSA. But reaching these people is challenging. To improve access to this group, one should make use of social workers, friends, family, or a physical therapy practice.

Segmentation of the healthcare sector

The healthcare sector in the Netherlands is strongly segmented, with each segment having its own financing structure. This makes it difficult to find common ground among organisations within and outside the healthcare sector, as their interests lie (too) far apart for an integrated approach.

Health information

Many older adults mistake ‘exercising’ for sports-related activities only, while health professionals also mean daily chores, like gardening, cooking, cleaning. Thus, even if older adults attend a weekly sports class, their daily physical activity levels are often low. More information about what it means to be active and about activity guidelines is necessary for this group.

Overprotection of health care providers and informal caregivers

Health professionals are trained to care for their clients when they are hospitalized. This often results in patients being inactive for most part of the day. However, the patients’ recovery process would benefit by staying physically active and do simple tasks like getting coffee. Informal caregivers are subject to the same paradox. More information for health professionals and informal caregivers is necessary about supporting patients with their recovery by helping them to perform daily tasks independently.