JMIR Publications

ABSTRACT

Background:

Falls have implications for older adults’ health and well-being. Evidence shows that strength and balance interventions significantly reduce risk/rate of falls, but patients seldom meet the evidence based dose of exercise required. Health professionals have an important role in supporting older adults to carry out and progress their exercises, but have limited contact with them. Smartphone based teleconferencing could enable health professionals to support patients more frequently and provide other forms of social support important to exercise behaviour.

Objective:

1. Explore the overall concept and acceptability of teleconferencing for the delivery of falls rehabilitation with health professionals and older adults. 2. Explore the usability/acceptability of teleconferencing with healthcare professionals/patients.

Methods:

There were two stages to the research. Patient and participant workshops (PPI). Two Patient and Public Involvement (PPI) workshops, one with five healthcare professionals, the second with eight older adults from a community strength and balance exercise group. Usability testing. We tested smartphone based teleconferencing both one to one with the health professional and in small groups with one falls service and their patients for three weeks. We used semi-structured interviews and focus groups to explore acceptability and usability. Focus groups were carried-out with the service who tested the apps and two other services. Qualitative data were analysed using the framework approach.

Results:

Patient and participant workshops (PPI). Health professionals thought it provided an opportunity to save travel time and they and older people thought it could enable increased support. Safety was of key importance and delivery needed to be carefully considered. Both older adults and health professionals felt that it was important technology did not completely replace face to face contact. There were concerns from older adults about the intrusiveness of any technology. Usability testing. Seven patients and three health professionals took part in the usability testing, with interviews carried out with six patients and focus groups with three teams (11 healthcare professionals). Barriers and facilitators and were identified, with seven subthemes; poor connectivity, safety, intrusiveness, increased support and monitoring, different approaches.

Conclusions:

Teleconferencing as a way of delivering falls rehabilitation can be acceptable to older adults, patients and health professionals if it is working effectively and can be integrated into their home. Connectivity where there is no wifi provision is one of the largest issues and local infrastructure needs to be improved. A larger usability testing study is required to establish whether better equipment for delivery improves usability.