Acceptability of a Technology-Based Dual-Task Programme for Falls Prevention – A Mixed-Methods Study

Introduction

Falls are a major health concern for older adults. Dual-task (DT) training, which integrates cognitive and physical exercises, has shown greater benefits for balance and mobility than physical training alone. This study evaluated the acceptability of a blended DT training programme, combining supervised and self-directed components, and delivered via a mobile application for older adults with a history of falls.  

Methods

Community-dwelling older adults aged 65+ with ≥2 falls in the past year were recruited. Participants completed the DT programme using the Peak Brain Training app: 12 weeks of blended supervised and self-directed training (Phase 1) and 12 weeks of self-directed training (Phase 2). Adherence was self-reported, and post-programme focus groups were conducted. Quantitative data were analysed using descriptive statistics, and qualitative data using Framework Analysis.

Results

Forty-three participants were recruited (39 via community events; 27 females, mean age: 79 years) and 4 via NHS falls prevention services referrals (3 females, mean age: 75 years). Adherence was 80.6% in Phase 1, dropping to 50% in Phase 2. Retention was 79.9%. Focus group feedback (n = 28; 20 females) indicated a preference for in-person recruitment over text/letter invitations, an explanation for low NHS referral uptake. Key facilitators of adherence included social interaction, structured routines, a sense of achievement, enjoyment of the app, and the blended delivery format. Barriers included competing priorities, low motivation, unsuitable home environments, and lack of personalised exercises. 

Conclusions

The DT programme was acceptable to older adults, particularly the supervised components. Social and structured routines supported adherence. Reduced adherence in phase 2 highlights the need for additional strategies to sustain motivation. This study demonstrates the feasibility of using technology to deliver cognitively engaging interventions. When paired with structured support, technology can be effectively integrated into fall prevention exercise programmes for older adults with a history of falls.