Abstract
This study explored clinicians’ perspectives on the Individualized Reduction of Falls (iROLL) program for wheelchair and scooter users. Findings emphasize clinician feedback for intervention optimization, effective use of technology, and accessibility issues.
Primary Author and Speaker: Ziwei Li
Additional Authors and Speakers: Laura Rice
Falls are prevalent among wheelchair/scooter (WC/S) users with spinal cord injury (SCI) and multiple sclerosis (MS) and negatively impact quality of life (QOL) and community engagement. The Individualized Reduction of Falls (iROLL) program, a six-week online hybrid intervention, was developed to support fall prevention and management in this population. However, the key elements influencing its effectiveness are unclear. This qualitative phenomenological study aimed to investigate clinicians’ perspectives on iROLL’s effectiveness, content, features, strengths, and weaknesses to guide future optimization for individuals using WC/S full-time with SCI and MS. Clinicians with over 4 years of experience were recruited to evaluate the iROLL program. After providing informed consent, clinicians reviewed iROLL asynchronous materials and watched synchronous session recordings. Data was collected through weekly surveys and semi-structured interviews. Phenomenological analysis was conducted to explore clinicians’ subjective experiences and perspectives. Four themes emerged: 1) the Practical Nature of iROLL, 2) Opportunities for Improvement, 3) Mechanisms of Change, and 4) the Role of the Online Delivery Method. Clinicians reported positive impressions, observing significant improvements in participants’ self-management. They noted increased confidence in coping with fall risk, crucial for long-term behavioral adaptation. Technology enhanced program reach but posed barriers for some. Clinician impressions suggest iROLL promotes self-efficacy and facilitates behavioral change in fall prevention among WC/S users. Their feedback highlights program strengths and areas for improvement, contributing to optimizing iROLL for this population. This study provides insights into an evidence-based fall prevention program tailored to a specific population’s needs, advancing occupational therapy practice through clinician-informed intervention refinement and technology integration guidance.
Abou, L., & Rice, L. A. (2023). Frequency and characteristics of falls, fall-related injuries, and fear of falling among wheelchair users with spinal cord injury. The journal of spinal cord medicine, 46(4), 560–568. https://doi.org/10.1080/10790268.2022.2097995
Rice, L., Kalron, A., Berkowitz, S. H., Backus, D., & Sosnoff, J. J. (2017). Fall prevalence in people with multiple sclerosis who use wheelchairs and scooters. Medicine, 96(35), e7860. https://doi.org/10.1097/MD.0000000000007860
Rice, L. A., Peterson, E. W., Backus, D., Sung, J., Yarnot, R., Abou, L., Van Denend, T., Shen, S., & Sosnoff, J. J. (2019). Validation of an individualized reduction of falls intervention program among wheelchair and scooter users with multiple sclerosis. Medicine, 98(19), e15418. https://doi.org/10.1097/MD.0000000000015418