iROLL-O+

BackgroundFalls are prevalent among people living with Multiple Sclerosis (PwMS) and Spinal Cord Injury (PwSCI) who use wheelchairs or scooters (WC/S) full time, however, there is a scarcity of evidence-based fall prevention and management programs.ObjectiveTo describe the systematic translation of an in-person fall prevention and management program (Individualized Reduction Of FaLLs – iROLL) for PwMS to an online platform, extending its scope to include PwSCI, and to evaluate the preliminary useability, usefulness, and safety of the intervention.MethodsiROLL was systematically translated to an online platform (iROLL-O). PwMS and PwSCI who use a WC/S full time, experienced at least one fall within the past 36 months, and could transfer independently or with minimal to moderate assistance, enrolled in iROLL-O. Usability, usefulness, and safety were evaluated through 1:1 semi-structured interviews, gathering feedback on: perceived impact of the intervention on falls and functional mobility, program experiences, adverse events, and recommendations for improvement.ResultsFive participants successfully completed the iROLL-O program. No safety concerns were raised by participants. Themes emerging from the semi-structured interviews included: (1) barriers and facilitators to program access, (2) motivation for participation, (3) program outcomes, and (4) program content and structure. Participants reported reduced concerns about falling, enhanced functional mobility skills, and highlighted the supportive nature of synchronous group meetings for learning.ConclusionNo adverse events occurred during the implementation of iROLL-O and participants found the program to be useable and useful. Further testing is needed to examine efficacy among a large and diverse population.

This study aimed to explore the potential of a mobile health (mHealth) application (app) to support the delivery of a fall prevention and management program, Individualized Reduction of FaLLs (iROLL), for people with spinal cord injury (SCI) and multiple sclerosis (MS) who use wheelchairs and scooters (WC/S) full-time by seeking end-users' input into the functioning and ongoing design of the iROLL-O?+?mobile app. Two focus group discussions included nine adults with SCI or MS who used a WC/S for at least 75% of mobility, who experienced at least one fall in the past three years and have internet and access to an internet-capable device. One group had prior iROLL experience (n?=?4); while the other had none (n?=?5). The focus groups examined the app's usefulness, accessibility, appearance, and ease of use. The participants with prior iROLL experience also discussed how the app would enhance their experience with the program. Thematic analysis revealed five app-related themes: perceived usefulness, perceived usability, accessibility, appearance, and enhancement of the iROLL experience, with participants providing actionable suggestions for improvement. Participants with previous exposure to the iROLL program emphasized the app's potential to facilitate flexible access to the program and expand its reach to a wider audience. The iROLL-O?+?app was perceived positively, especially with respect to the enhancement of users' access and experience with the program. Focus group findings will inform ongoing app development for optimized usability and reduced likelihood of technology abandonment.