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Educating older adults about extrinsic falls risk factors at home

Supporting Patient-Practitioner Collaboration and Adherence via Mobile 3D Interior Design Technology

Falls are the main cause of death and injury for older adults in the UK. Many of these falls occur within the home as a result of extrinsic falls risk factors such as poor lighting, loose/uneven flooring, and clutter. Falls education plays an important role in self-management education about extrinsic hazards and is typically delivered via information leaflets, falls apps, and educational booklets. Serious games have the potential of delivering an engaging and informative alternative to traditional methods but almost exclusively, these are currently delivered as exergaming applications that focus solely on intrinsic falls risk factors. This study presents ‘Falls Sensei’ a first-person 3D exploration game that aims to educate older adults about extrinsic falls risk factors within the home environment. After presenting Falls Sensei, game usability and older adults’ perceptions and attitudes towards using the game in practice are explored.

This study involved a sample of community dwelling older adults. After playing the Falls Sensei game, participants completed a Systems Usability Scale (SUS) questionnaire and post task interview, and follow-up interviews three weeks later. Inductive and deductive thematic template analysis, informed by the Unified Theory of Acceptance and Use of Technology model, was used to analyse the think-aloud, post-task and follow-up interview transcripts. Descriptive statistical analysis and one-sampled t-tests were used to analyse log-file data and SUS responses.

Three high-level themes emerged from the analysis of transcriptions: Performance Expectancy; Effort Expectancy; Social Influence. The SUS score was 77.5/100 which indicates ‘Good’ levels of usability. Interestingly, reported usability of the game increased with participant age. Participants were positive about the usability of the game (p < = 0.05 for 9/10 items). The most memorable fall hazards were those most commonly encountered in the game or those most challenging to participants.

The results support the use of serious games as an engaging tool for educating older adults about extrinsic falls risk factors. Awareness of home hazard detection was raised by the game, and some older adults became more aware for the need to adapt their own homes after gameplay. Further research would be needed to draw comparisons with established interventions.

Meet the Principal Investigator(s) for the project

Dr Arthur Money
Dr Arthur Money - Dr Arthur G. Money is a Reader in the Department of Computer Science at Brunel University London, where he also received his MSc in Distributed Information Systems with distinction in 2001 and PhD in Multimedia Computing in 2007. Prior to embarking on a fully funded EPSRC PhD scholarship in 2004, he worked for Oracle UK Ltd as an e-Business Technology Consultant. Dr Money’s research focuses on the user-centred design, development and evaluation of multimedia computing systems and the effective deployment of these systems with users who have complex needs spanning a range of domains including older adults, healthcare, education, and defence.

Related Research Group(s)

robotic hand

Inclusive Design - Inclusive Design Research Group at Brunel University London brings together multidisciplinary expertise to understand different factors causing exclusion, to develop methods and interventions for improvement, and to advance the knowledge of design for inclusion.


Interactive Multimedia Systems - Building sensor and media-rich, cross-layer, inclusive e-systems, with an interest in human-machine interaction, sensorial-based interfaces, data visualisation and multimedia.


Smart Technology Advancements in Health and Rehabilitation - Data science/wearable technology and Rehabilitation; Haptic feedback, multi-sensory interfacing and Robotics in Health; Immersion and Engagement in Virtual Rehabilitation; TeleHealth/TeleRehab; Data: using AI and Machine learning to improve health.

Partnering with confidence

Organisations interested in our research can partner with us with confidence backed by an external and independent benchmark: The Knowledge Exchange Framework. Read more.

Project last modified 13/10/2023