1,254 community-dwelling adults aged 65 or older and from 43 different practices were cluster-randomized to either the Falls Management Exercise Program (FaME), the Otago Exercise Program (OEP), or to usual care. The purpose of the study was to determine if the two programs increased physical activity in older adults to the recommended levels. The FaME program significantly improved the proportion of participants achieving the recommended level of physical activity and significantly reduced fall risk compared to usual care at 1 year follow-up, while the OEP displayed similar results to usual care. Both programs significantly benefited balance confidence and increased positive expectations of exercise. Neither program significantly affected quality of life, and costs were found to be higher in the FaME program.