e-Counseling for Fall Prevention in Older Adults: Scoping Review

Clinical Snapshot

Key Findings

• P Value: Not applicable for scoping review

• Effect Size: Variable effect sizes due to diverse interventions and populations

• Primary Outcome: Fall incidence reduction ranging from 15% to 90.9% across studies

• Nnt Or Sensitivity: Cultural tailoring and digital literacy support associated with higher engagement rates

• Confidence Interval: Not reported (descriptive synthesis)

Clinical Application

Scalable approach but requires consideration of digital divide and technology support infrastructure Relevant to Australian aged care settings; aligns with TGA digital health framework and could complement existing fall prevention programs under Medicare chronic disease management Community-dwelling older adults aged 60+ with access to digital technology and basic digital literacy

Abstract

BACKGROUND: Falls are a major contributor to injury, disability, and mortality among older adults worldwide. Digital health-based e-counseling has emerged as a scalable strategy to support fall prevention by addressing physical, behavioral, and cognitive risk factors. OBJECTIVE: This scoping review aimed to map the scope, characteristics, and outcomes of e-counseling interventions for fall prevention among adults aged 60 years or older. METHODS: Guided by Arksey and O'Malley's framework and reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews), we searched PubMed, ScienceDirect, CINAHL, and ProQuest for studies published between January 2019 and May 2025. Eligible studies evaluated digital or telehealth-based counseling interventions for fall prevention. Data were synthesized descriptively, and methodological quality was appraised using the Mixed Methods Appraisal Tool. RESULTS: A total of 13 studies were included, comprising randomized controlled trials, feasibility studies, qualitative research, and retrospective cohorts conducted across Asia, Europe, and North America. e-Counseling modalities included virtual reality, mobile health application, teleconsultations, and wearable-triggered feedback systems. Reported outcomes included reductions in fall incidence ranging from 15% to 90.9%, improvements in balance and mobility, increased fall risk awareness, and enhanced self-efficacy. Interventions incorporating cultural tailoring and digital literacy support demonstrated higher engagement and adherence. CONCLUSIONS: e-Counseling appears to be a promising and scalable approach for fall prevention in older adults, with benefits across physical and behavioral domains. Future research should focus on long-term effectiveness, equitable access in low- and middle-income settings, and integration into routine health care systems.

References

1. 1.Safarina, L., Kosasih, C. E., Pramukti, I., & Nursjamsi, N. (2026). e-Counseling for Fall Prevention in Older Adults: Scoping Review. JMIR Aging. https://doi.org/10.2196/78444