Empowering older people and families in fall management: a usability study of the Fallcheck app

Fall prevention strategies should emphasize education, training, creating safer environments, prioritizing fall-related research and establishing effective policies to reduce risk (WHO, 2012). In terms of creating safer environments, there is a gap in access to home-hazard assessment and intervention with only 65% of patients with hip fracture and only 19% of patients with non-hip fracture receiving home-hazard assessment by an occupational therapist (Royal College of Physicians, 2010).

This study sought to explore an innovative approach to home-hazard modification. Fallcheck is a web-app developed at Coventry University and enables a user to conduct a home-hazard assessment in their own, or a relative’s home. The idea for the app came from a previous study which identified a lack of resources for those at risk of falling, particularly resources regarding technological interventions (Ward, Holliday, Fielden et al, 2012; Ward, Holliday, Fielden et al, 2013). The app was developed with experts in falls prevention and assistive technology, and tested with a group of independent falls experts (Ward, Walker-Clarke & Holliday, 2017).

The aim of the latest study, led by Dr Gill Ward and Nikki Holliday was to assess the usability of the Fallcheck web-app with a group of older people and carers worried about the risk of falling at home. For this user trial, a mixed method approach was used to collect qualitative and quantitative data on the user experience and behavioural and environmental changes made to the home environment as a result of using the Fallcheck web-app. 30 people took part in a two-week trial, and 7 people took part in a “Think-aloud” study.

Project Findings

We found that the majority of participants found the app easy to use, ease to learn to use, and overall were satisfied with the Fallcheck app:

• 91% of carers and 82% of people at risk of falling agreed that the Fallcheck app is user friendly
• 100% of carers and 82% of people at risk of falling agreed that they were able to use the app successfully each time they used it
• 100% of carers and 91% of people at risk of falling agreed that the instructions were easy to follow
• 100% of carers and 86% of those at risk of falling agreed that the Fallcheck app would help people identify falls risks in the home
• 91% of carers and 82% of people at risk of falling would recommend the Fallcheck app to someone else who was at risk of falling

Overall the app was considered very suitable for older people at risk of falling, although it was recognised some older people may need a relative to help them access or use the app. The app may also be suitable for younger users – as it is not just older people who have long-term health conditions that make them more prone to falling. Overall the app was easy to use, and participants liked the design, however it was felt that some areas of content were missed by the app – for example, information on how to prevent falls in the garden, or person-based fall risks, such as medication, lack of exercise and clothing. Many people made changes to either their home or a loved one’s home following use of the app, either by purchasing goods, contacting helpful services, or by making ‘quick fixes’ (e.g. fixing rugs) to reduce their fall risk at home. Many of the participants said that they felt safer at home after using the app, and that their fear of falling had reduced. However, some participants were still fearful of falling outside the home – something which the Fallcheck app does not address.

Funder: Coventry University Pump-Prime Grant

Nikki Holiday, Design Manager, Prototype Design, Testing & Regulation, Centre for Intelligent Healthcare

Publications

Ward, G., Holliday, N., Fielden, S., & Williams, S. (2012). Fall detectors: a review of the literature. Journal of Assistive Technologies, 6(3), 202-215.

Ward, G., Holliday, N., Fielden, S., & Williams, S. (2013) Good practice and innovation in falls prevention and response services: an evaluation. Coventry: Coventry University [Online],PDF

Ward, G., Walker-Clarke, A., Holliday, N. (2017) Evaluation of a web-based app to assist home-hazard modification in falls prevention. British Journal of Occupational Therapy, 80 (12), 735-744 DOI

Submitted paper: Holliday, N., Ward, G., Barker, R., Walker-Clarke, A. Usability of a web-app designed to identify and modify home hazards for older people at risk of falling. 

Further information

We have already made improvements and changes to the Fallcheck app based upon the feedback received in the Pump-Prime study, and we are now seeking funding to trial Fallcheck and its impact on falls. You can access the Fallcheck web-app for free.

For more information, please contact Nikki Holliday – Design Manager, Centre for Intelligent Healthcare.