Introduction:
Falls are a growing global public health concern. We conducted an implementation evaluation of a digital falls prevention (FaME/OTAGO strength and balance) program known as, ‘KOKU’ for community-dwelling older adults aged ≥55 with support from Care Providers.

Methods:
Qualitative evaluation was guided by the NASSS Framework. Online training was given to Care Managers who cascaded the training to carers who then trained 46 eligible older participants to use KOKU (3 times per-week, over 12 weeks). 

Data collection included observations, records and telephone interviews (11 users; 9 Carers/Managers) to explore multiple perspectives. Data were analysed following inductive and deductive approaches.

Results:
Older participants (n=46) from 6 Care Providers (Mean age 76; range 56-99) participated. Themes identified across the NASSS domains were (1) Condition: KOKU was implemented with participants with a wide range of conditions; suitability was guided by perception of benefits, safety and willingness to use (2) Technology: Carers and users reported minimal training was required. Those unfamiliar with technology needed initial support that reduced over time. (3) Value: Positive outcomes (physical, psychological) were reported by majority of participants (4) Adopter System: Training and clear messaging to users was deemed important (5) Organisation: staff capacity and readiness to innovate affected uptake (6) Wider Context: staff shortages was the main implementation challenge (7) Embedding/adapting over time: Post study implementation has continued indicating the high demand for falls prevention services.

Key conclusions:
A digital falls prevention program may be a safe and suitable option for community-dwelling older adults in receipt of care support.

Keywords digital: falls prevention; older adults; strength and balance exercises; implementation science