Elucidating Canadian Older Adult Experiences Navigating a Virtual Fall Prevention Program During a Pandemic

Background/Purpose: In response to COVID-19, the Fall Prevention Program (FPP) at Sunnybrook Health Sciences Centre was modified to include virtual components. We set out to uncover the experiences of this unique older-adult patient population to inform FPP quality improvement and appropriate incorporation of technology post-pandemic.

Method: FPP patients during the COVID-19 pandemic (February 2020 - February 2022) and their primary caregivers met inclusion criteria. Out of 18 eligible patients, 10 consented to participate in 20-minute semi-structured telephone interviews conducted and transcribed by a single interviewer who was not involved with patient care. Inductive coding was completed by two independent coders. Themes were generated through collaborative analysis.

Results: Demographic questions characterized the participants (n=10) as 60% female, mean age 84 years, 60% living alone, and 70% university educated. Theme 1, First steps first, revealed the importance and essentials of a successful FPP highlighting health benefits, desired socialization, preferred program length, and individualized attention. Theme 2, Strength and support influences adaptation, highlighted participants' experiences overcoming barriers of virtual care and COVID-19 elaborating on protective factors that eased transition. Theme 3, Finding balance between safety, effectiveness, and efficiency, elaborated on participants' ideal combination of virtual and in-person components. Theme 4, Standing together, delved into attitudes of hope and necessary supports for success.

Discussion: Technology can both create and alleviate barriers necessitating individualized incorporation of virtual components informed by the patients themselves. These interviewed older adults revealed agreement on FPP necessity, increasing program length, one-on-one interaction, family involvement, and program flexibility for unique patient needs.

Conclusion: Incorporating virtual assessment prior to in-person exercises was largely favoured and should be considered as an appropriate use of technology post-pandemic.