Image: Mostphotos: https://www.mostphotos.com/10435624/elderly-woman-with-tablet-computer
Image: Mostphotos: https://www.mostphotos.com/10435624/elderly-woman-with-tablet-computer
Research project The overarching objective of this research initiative is to enable independent engagement in strength and balance exercises among older individuals prone to falls. Safe Step is a research project focused on evaluation of a digital fall prevention exercise program specifically designed for older adults through co-creation.
Engaging in regular strength and balance exercises has proven effective in reducing falls in the older population, but accessible evidence-based self-managed exercise programs are urgently needed. 'Safe Step,' a digital exercise program empowering seniors to start and maintain fall-preventive exercises. The programme is developed in co-creation with seniors and has indicated promise in trials as a primary preventive measure. The current phase involves implementing Safe Step in municipal fall prevention efforts and nationwide distribution for older adults in Sweden.
Falls represent the most prevalent cause of injury in the older population, resulting in escalating societal costs and challenges. Regular engagement in strength and balance exercise has proven to substantially reduce the incidence of falls and associated injuries. However, it's crucial to improve access to exercises based on evidence and encourage older adults to manage their own exercise routines.
The Safe Step app is a digital exercise programme designed in co-creation with older individuals. The app offers a collection of exercise videos, guiding users in the autonomous creation of a personalized exercise programme. To enhance program adherence, the app incorporates a set of behaviour change techniques. Additionally, it provides video lectures on subjects related to falls prevention and healthy ageing. See for more information.
The Safe Step research project aligns with the guidelines outlined by the Medical Research Council of the United Kingdom for the development and evaluation of complex interventions. The app has undergone comprehensive evaluation, encompassing a feasibility trial and a nationwide randomized controlled trial (RCT). Participant interviews showed strong self-efficacy in managing exercise and the app was preferred over traditional methods for better adherence. The RCT was design to mimic the conditions of a real-world setting and the 1628 participants included were monitored over a year, with monthly fall reports and quarterly digital surveys.
The results of the study show a reduction in the proportion of individuals in the training group who experienced falls. The conclusion is that access to a digital self-training program, such as Säkra steg, can be an effective and scalable component of a primary fall-prevention strategy for older adults living in the community. The study suggests that the program is most suitable for individuals with a low to moderate risk of falling. Further research is needed to identify strategies that improve adherence.
In the next phase, we will proceed with implementation studies to support decision-making in municipalities that wish to include Säkra steg in their fall-prevention initiatives. In addition, this phase includes a national rollout of the app for free download.
The aim of the current phase is to describe and evaluate the implementation of Safe Step into the fall prevention initiatives in three medium-sized municipalities situated in the northern region of Sweden. Additionally, it seeks to examine the usage patterns of the app among older individuals in Sweden, once it becomes freely available for download.
Our approach includes comprehensive documentation of the strategies employed in each municipality, followed by a one-year study and evaluation of their implementation efforts. The implementation studies are structured in accordance with the PRISM/RE-AIM framework.
The results will describe factors that facilitate or hinder the use of Säkra steg as a fall-prevention intervention in each municipality. Säkra steg is available as an app for free download and can also be used on a computer; see
