JMIR Publications

ABSTRACT

Background:

Lack of healthcare coverage, low education, low motivation, and inconvenience remain barriers to participating in fall prevention programs, especially in low-income older adults. Low-income status also contributes to negative aging self-perceptions and is associated with a high perceived barrier to care. Existing fall prevention intervention technologies do not enable participants and practitioners to interact and collaborate even with technologies that bring viable strategies to maintain independence, prevent disability, and increase access to quality care. Research is also limited on the use of technology to enhance motivation and help individuals align their perception with physiological fall risk. We developed a novel, 8-week, Physio-fEedback Exercise pRogram (PEER) which includes: a) technology-based physio-feedback using a real-time portable innovative technology—the BTrackS Balance Tracking System (BBS), which is reliable, affordable, allows for home testing, provides feedback and tracks balance progression; b) cognitive reframing using the FRA matrix, and c) peer-led exercises focusing on balance, strength training, and incorporating exercises into daily activities.

Objective:

This study consists of three aims. Aim 1: Examine the effects of the technology-based PEER intervention on fall risk, dynamic balance, and accelerometer-based physical activity. Aim 2: Examine the effects of the PEER intervention on FRA shifting and negative self-perceptions of aging. Aim 3: Explore participants’ experiences with the PEER intervention and potential barriers to accessing and adopting the technology-based PEER intervention to inform future research.

Methods:

This is an intention-to-treat, single-blinded, parallel, two-arm clustered randomized controlled trial study. We collect data from 340 low-income older adults at baseline (T1) and measure outcomes after program completion (T2), follow-up at 3 months (T3), and 6 months (T4). Participants will be enrolled if they meet all of the following inclusion criteria: 1) ≥ 60 years of age; 2) cognitively intact; and 3) able to stand without assistance. Exclusion criteria:1) a medical condition precluding exercise or physical activity; 2) currently receiving treatment from a rehabilitation facility; 3) plan to move within 1 year; (4) hospitalized more than 3 times in the past 12 months; and (5) does not speak English or Spanish. This study is registered in ClinicalTrials.gov identifier NCT05778604. The study was approved by the institutional review board, University of Central Florida (Protocol No. STUDY00003206; October 14, 2022).

Results:

As of August 2023, the enrollment of participants is ongoing.

Conclusions:

This study addresses the public health problem by optimizing a technology-driven, tailored approach that can operate in low-resource environments with unlimited users to prevent falls and reduce health disparities in low-income older adults. Clinical Trial: This study is registered in ClinicalTrials.gov identifier NCT05778604. https://www.clinicaltrials.gov/ct2/show/study/NCT05778604