Abstract
BackgroundFalls are the leading cause of injury-related death in older adults. Due to various constraints, objective fall risk screening is seldom performed in clinical settings. Smartphones offer a high potential to provide fall risk screening for older adults in home settings. However, there is limited understanding of whether smartphone technology for falls screening is usable by older adults who present age-related changes in perceptual, cognitive, and motor capabilities.ObjectiveThe aims of this study were to develop a fall risk mobile health (mHealth) app and to determine the usability of the fall risk app in healthy, older adults.MethodsA fall risk app was developed that consists of a health history questionnaire and 5 progressively challenging mobility tasks to measure individual fall risk. An iterative design-evaluation process of semistructured interviews was performed to determine the usability of the app on a smartphone and tablet. Participants also completed a Systematic Usability Scale (SUS). In the first round of interviews, 6 older adults participated, and in the second round, 5 older adults participated. Interviews were videotaped and transcribed, and the data were coded to create themes. Average SUS scores were calculated for the smartphone and tablet.ResultsThere were 2 themes identified from the first round of interviews, related to perceived ease of use and perceived usefulness. While instructions for the balance tasks were difficult to understand, participants found it beneficial to learn about their risk for falls, found the app easy to follow, and reported confidence in using the app on their own. Modifications were made to the app, and following the second round of interviews, participants reported high ease of use and usefulness in learning about their risk of falling. Few differences were reported between using a smartphone or tablet. Average SUS scores ranged from 79 to 84.ConclusionsOur fall risk app was found to be highly usable by older adults as reported from interviews and high scores on the SUS. When designing a mHealth app for older adults, developers should include clear and simple instructions and preventative strategies to improve health. Furthermore, if the design accommodates for age-related sensory changes, smartphones can be as effective as tablets. A mobile app to assess fall risk has the potential to be used in home settings by older adults.
Highlights
In adults 65 years or older, 1 in 4 will fall per year [1]
The slide bar was replaced with a key-in entry (Figure 6), and forward and back arrows were added to each screen
This study suggests the potential for mobile technology to offer fall risk screening to older adults
Summary
In adults 65 years or older, 1 in 4 will fall per year [1]. Falls are the leading cause of injury-related death in older adults [2]. Objective fall screening is rarely assessed in clinical settings, in part because it requires expensive equipment, clinicians have time constraints, or they may not have the training or relevant expertise [3] Mobile technology such as smartphones offer a potential solution for measuring fall risk objectively, inexpensively, and with minimal training required. Smartphones offer a high potential to provide fall risk screening for older adults in home settings. Modifications were made to the app, and following the second round of interviews, participants reported high ease of use and usefulness in learning about their risk of falling. Conclusions: Our fall risk app was found to be highly usable by older adults as reported from interviews and high scores on the SUS. A mobile app to assess fall risk has the potential to be used in home settings by older adults
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