An Occupational Therapy–Led Multifactorial Fall Prevention Program for Community-Dwelling Older Adults: A Pilot Feasibility Study

Abstract

Background: Falls threaten older adults’ independence and participation in meaningful occupations. From an occupational therapy perspective, fall prevention extends beyond reducing injury risk; it sustains connection, autonomy, and belonging within one’s community. This pilot study examined the feasibility, acceptability, and community impact of an occupational therapy–led, occupation-focused fall prevention program designed to enhance safety, participation, and collective well-being among community-dwelling older adults. Methodology: A quasi-experimental pretest-posttest pilot study was conducted at a community site (seven enrolled; six completed). Six weekly sessions integrated exercise, education, and environmental strategies mapped to the Occupational Therapy Practice Framework, Fourth Edition. Feasibility indicators included recruitment, retention, fidelity, acceptability, and contextual barriers. Secondary outcomes included the Timed Up and Go (TUG), 30-Second Chair Stand, Activities-specific Balance Confidence (ABC) Scale, and Falls Efficacy Scale (FES). Quantitative data were summarized using medians and interquartile ranges and analyzed with Wilcoxon signed-rank tests (α = 0.10); effect sizes (r) estimated the magnitude of change. Results: All feasibility benchmarks were met (86% retention, high attendance, positive feedback). Median TUG improved from 14 to 11 seconds (r = 0.74), indicating a potential signal of improved mobility; other measures showed small, nonsignificant directional changes. Participants described increased confidence, mutual encouragement, and social connection, reflecting a shared commitment to safety and interdependence. Conclusion: An occupation-based, therapist-led fall prevention program was feasible and well received, fostering safe engagement in daily activities and social connectedness. Preliminary directional changes in mobility and confidence suggest potential benefits for future study of effects on participation and wellbeing. Interpreting outcomes through the doing, being, becoming, and belonging lens highlights how mobility practice, confidence, emerging routines, and mutual support can be advanced together in community programs.