Application of the World Falls Guidelines to Online Self-Assessment

Introduction

The World Falls Guidelines introduced an algorithm for clinical practitioners to assess risk of falls in older adults. Digital tools can provide a way for people to self-assess, but for such tools to be successful they need to be co-designed with the people who are likely to use them. This project involved the co-design of a digital prototype to self-assess falls risk and be directed towards appropriate local support within one NHS board in Scotland, UK.

Method

Our overall approach was qualitative, participatory research. Participants were recruited through local third sector support organisations. In Stage 1, we interviewed older adults on their experiences of falls and receiving support. In Stage 2, we ran workshops with older adults and carers to validate our proposed approach. For Stage 3, we worked with carers (average of 6 per session who also self-identified as older adults) in a series of 5 participatory workshops interspersed with digital prototyping. We are currently running a final round of workshops to evaluate usability and acceptability of the prototype self-assessment tools.

Results

Our results so far show that the way professionals talk about falls risk is different from the way an older person talks about their own risk of falling. Modification to language and presentation is needed to make the algorithm suitable for self-assessment without the presence of a clinical practitioner. Participants showed considerable nuance in how they approached questions and tasks based on their personal context (e.g. mental and physical state, living situation, previous experiences with professional services, etc.). Participants also preferred more positive language (e.g. independence), particularly when viewing results.

Conclusions

Our initial results show that the standard guidelines such as the World Falls Guidelines may need adaptation for use in community self-assessment settings with older people and carers, which we will explore in future work.