Exercise-based interventions are well-established in reducing falls and fall-related injuries, but adherence and accessibility remain key challenges, particularly in rural areas. While conventional in-person training is widely used, digital interventions may offer scalable solutions to enhance engagement and reach. However, pragmatic trials evaluating the real-world effectiveness of conventional and digitally supported fall prevention interventions are lacking, limiting the evidence base for their implementation in routine healthcare settings. The SURE-Footed into the Future Fall Intervention Trial (SURE-FIT) aims to compare the effectiveness of two structured fall prevention interventions—a conventional centre-based exercise programme and a hybrid telemedical programme combining in-person and tablet-supported training—against a wait-list control group in reducing falls and fall-related injuries among community-dwelling older adults.
This study is a pragmatic three-arm, parallel-group, randomised controlled superiority trial with a 1:1:1 allocation ratio. Participants (≥65 years, community-dwelling, planned n=2778) will be randomly assigned to (1) conventional centre-based training supplemented with printed materials for home-based continuation (conventional group), (2) a hybrid model integrating centre-based and tablet-supported training for continuation (tablet group) or (3) a wait-list control group. The intervention includes a 9-week supervised phase followed by 43 weeks of independent home-based training. The primary outcomes are the incidence rate of falls and fall-related injuries over 12 months. Secondary outcomes include physical functioning, physical activity, concerns about falling, loneliness and the risk of low protein intake. A process evaluation will assess intervention feasibility and implementation. Additionally, qualitative interviews will be conducted with participants, course instructors and municipal stakeholders to explore experiences, facilitators and challenges related to programme participation and implementation. A health-economic evaluation will be conducted to assess the cost-effectiveness of the structured fall prevention interventions. Data collection will take place at baseline and every 3 months via standardised questionnaires, with a subgroup undergoing physical performance testing and sensor-based activity monitoring. Analyses will follow an intention-to-treat approach.
Ethical approval has been granted by the Ethics Committee of Ulm University (271/23). Written informed consent will be obtained from all participants before enrolment. Study findings will be disseminated through peer-reviewed publications, scientific conferences and national fall prevention initiatives. Additionally, results will be shared with key municipal representatives, and the German National Association of Senior Citizens’ Organisations (BAGSO). A publicly accessible website will provide ongoing access to study information and findings in plain language.
DRKS00032878, German Clinical Trials Register
In a rapidly evolving world shaped by digital transformation, digital technologies are increasingly being used in healthcare. To use them effectively, nursing staff, patients and their caregivers need the appropriate skills. To date, digital literacy in general, digital skills and (digital) technologies have played a minor role in German nursing curricula. In addition, little is known about the use of technology in nursing education and about effective ways to enhance digital competence. This scoping review aims to identify current literature on innovative and experiential-based teaching and learning methods for developing competence in technology and digitalisation for nurses and informal caregivers, as well as digital technologies that are being used in this educational context.
This scoping review, which will be designed and conceptualised using the Joanna Briggs Institute methodology for conducting scoping reviews, will take place from April 2025 to January 2026. The search will be conducted on the databases CINAHL, Emcare, Embase, Medline and ERIC. Screening and extraction will be peer reviewed and follow predefined criteria, as well as opportunities for free-text responses. The extracted data will be analysed using absolute and relative frequencies. Free-text responses will be analysed using qualitative content Analysis.
As an ethics vote is not required to conduct a scoping review, this will not be obtained. The results will be disseminated via open access publication in a peer-reviewed journal and through presentations at conferences.