Appl Clin Inform 2024; 15(03): 544-555
DOI: 10.1055/a-2267-1727
Research Article

Human-Centered Design and Development of a Fall Prevention Exercise App for Older Adults in Primary Care Settings

Nichole K. Czuber
1   Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States
Pamela M. Garabedian
2   Clinical and Quality Analysis, Mass General Brigham, Inc., Boston, Massachusetts, United States
Hannah Rice
1   Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States
Christian J. Tejeda
1   Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States
Patricia C. Dykes
1   Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States
3   Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States
Nancy K. Latham
1   Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States
3   Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations


Background Falls in older adults are a serious public health problem that can lead to reduced quality of life or death. Patients often do not receive fall prevention guidance from primary care providers (PCPs), despite evidence that falls can be prevented. Mobile health technologies may help to address this disparity and promote evidence-based fall prevention.

Objective Our main objective was to use human-centered design to develop a user-friendly, fall prevention exercise app using validated user requirements. The app features evidence-based behavior change strategies and exercise content to support older people initiating and adhering to a progressive fall prevention exercise program.

Methods We organized our multistage, iterative design process into three phases: gathering user requirements, usability evaluation, and refining app features. Our methods include focus groups, usability testing, and subject-matter expert meetings.

Results Focus groups (total n = 6), usability testing (n = 30) including a posttest questionnaire [Health-ITUES score: mean (standard deviation [SD]) = 4.2 (0.9)], and subject-matter expert meetings demonstrate participant satisfaction with the app concept and design. Overall, participants saw value in receiving exercise prescriptions from the app that would be recommended by their PCP and reported satisfaction with the content of the app.

Conclusion This study demonstrates the development, refinement, and usability testing of a fall prevention exercise app and corresponding tools that PCPs may use to prescribe tailored exercise recommendations to their older patients as an evidence-based fall prevention strategy accessible in the context of busy clinical workflows.

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed by the Mass General Brigham Institutional Review Board.

Publication History

Received: 02 October 2023

Accepted: 22 January 2024

Accepted Manuscript online:
13 February 2024

Article published online:
10 July 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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