The Developments and Iterations of a Mobile Technology-Based Fall Risk Health Application

Abstract

Falls are a prevalent and serious health concern across clinical populations. A critical step in falls prevention is identifying modifiable risk factors, but due to time constraints and equipment costs, fall risk screening is rarely performed. Mobile technology offers an innovative approach to provide personalized fall risk screening for clinical populations. To inform future development, this manuscript discusses the development and testing of mobile health fall risk applications for three unique clinical populations [older adults, individuals with Multiple Sclerosis (MS), and wheeled-device users]. We focus on key lessons learned and future directions to improve the field of fall risk mHealth. During the development phase, we first identified fall risk factors specific to each population that are measurable with mobile technology. Second, we determined whether inertial measurement units within smartphones can measure postural control within the target population. Last, we developed the interface of each app with a user-centered design approach with usability testing through iterative semi-structured interviews. We then tested our apps in real-world settings. Our cumulative work demonstrates that mobile technology can be leveraged to provide personalized fall risk screening for different clinical populations. Fall risk apps should be designed and tailored for the targeted group to enhance usefulness and feasibility. In addition, fall risk factors measured with mobile technology should include those that are specific to the population, are measurable with mobile technology, and can accurately measure fall risk. Future work should improve fall risk algorithms and implement mobile technology into fall prevention programs.

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“…Previous research has emphasized the importance of user-centered design 1 processes in developing effective mHealth apps for various health domains, such as self-management of chronic conditions ( 21 , 22 ), mental health ( 23 ), persons living with HIV ( 24 , 25 ), women in substance use recovery ( 26 ), and participants with fall risk ( 27 ). Schnall et al ( 24 ) conducted formative research, which included focus groups, participatory design sessions, and usability evaluations, to guide the development of a health management app for individuals living with HIV.…”

“…Through an iterative design process, the authors showed that users’ feedback helped tailor an mHealth app to maximize usability, access, and safety for this at-risk population. Lastly, Hsieh et al ( 27 ) aimed to provide personalized fall risk screening for clinical populations, including older adults, individuals with Multiple Sclerosis, and wheeled-device users, by utilizing mHealth apps. The authors developed the interface of each app with a user-centered design approach through iterative usability testing and semi-structured interviews.…”