Designing an Effective Fall Preparedness and Recovery Program for Older Adults: An e-Delphi Study

Background and Purpose: While numerous programs aim to address fall prevention in older adults, there is a notable gap in programs specifically targeting fall preparedness and recovery and their impact on fear of falling. This study seeks to establish expert consensus on effective fall recovery and landing strategies for older adults by surveying geriatric physical therapy professionals. Methods: A three-round e-Delphi survey was conducted to identify essential components of a fall preparedness and recovery program for older adults. Recruitment was carried out via emails to the geriatric physical therapy listserv and at professional conferences. In Round 1, demographic data were collected, and 172 participants proposed items for inclusion in the program. Researchers analyzed the data to identify three key themes and ten sub-themes. In Round 2, participants rated the importance of these themes and sub-themes and provided additional suggestions for inclusion. In Round 3, participants re-rated themes and sub-themes based on feedback from Round 2 to refine consensus. Quantitative data were analyzed using descriptive statistics in SPSS, while qualitative data were independently analyzed by two researchers. Consensus was defined as a median of ratings ≥3, interquartile range (IQR) ≤1, and ≥75% agreement in Round 2, increasing to ≥80% agreement in Round 3, with stability of each item confirmed through the Wilcoxon rank-sum test (p < 0.05). Results and Discussion: 65 participants completed all three rounds of the e-Delphi survey. The survey identified three key themes: Education, Floor Transfers, and Fall Landing Strategies. Of the 46 proposed items, 43 met the agreement criteria for inclusion in the fall preparedness program. Conclusions: This study provides a foundational framework for a comprehensive fall preparedness program by achieving expert consensus on 43 strategies centered on education, safe landing techniques, and floor transfers. expanding the paradigm from a sole focus on prevention to also encompass proactive fall preparedness.