Human-Centered Design and Development of a Fall Prevention Exercise App For Older Adults in Primary Care Settings

Background: Falls in older adults are a serious public health problem that can lead to reduced quality of life or death. Patients often do not receive fall prevention guidance from primary care providers, despite evidence that falls can be prevented. Mobile health technologies may help to address this disparity and promote evidence-based fall prevention. Objective: Our main objective was to use Human-Centered Design (HCD) to develop a user-friendly, fall prevention exercise app using validated user requirements. The app features evidence-based behavior change strategies and exercise content to support older people initiating and adhering to a progressive fall prevention exercise program. Methods: We organized our multi-stage, iterative design process into three phases: Gathering User Requirements, Usability Evaluation, and Refining App Features. Our methods include focus groups, usability testing, and subject matter expert meetings. Results: Focus groups (Total n=6), usability testing (n=30) including a post-test questionnaire [Health-ITUES score: mean (SD)= 4.2 (1.1)], and subject matter expert meetings demonstrate participant satisfaction with the app concept and design. Overall, participants saw value in receiving exercise prescriptions from the app that would be recommended by their PCP and reported satisfaction with the content of the app, but several participants felt that they were not the right user for the app. Conclusions: This study demonstrates the development, refinement and usability testing of a fall prevention exercise app and corresponding tools that primary care providers may use to prescribe tailored exercise recommendations to their older patients as an evidence-based fall prevention strategy accessible in the context of busy clinical workflows.

Publication History

Received: 02 October 2023

Accepted after revision: 22 January 2024

Accepted Manuscript online:
13 February 2024