Multidisciplinary Stakeholder Perspectives on the Design Needs of a Smart Walker for Fall Prevention Among Older...

Falls among older adults remain a critical patient safety concern globally. Conventional walkers frequently fail to accommodate end-user needs, particularly in low-to-middle-income country (LMIC) settings. Understanding stakeholder design requirements is essential for developing contextually appropriate, technology-enhanced assistive devices.

To explore multidisciplinary stakeholder perspectives on the design requirements for a sensor-integrated smart walker for fall prevention among older adults in Indonesia.

A qualitative descriptive approach was employed within the empathize and define phases of a design thinking framework. Purposive sampling recruited 13 participants across three stakeholder groups: older adult walker users (n=5), informal caregivers (n=5), and healthcare professionals (n=3). Semi-structured interviews were conducted between October and December 2025 in Bandung, West Java. Data were analyzed using Braun and Clarke's reflexive thematic analysis. Cognitive screening used a standardized, licenced assessment tool.

Twenty themes were identified across stakeholder groups: seven from older adults, eight from caregivers, and five from healthcare professionals. Convergent needs included a pre-impact fall warning system, design simplicity, structural durability, and affordability. Culturally specific findings included the Sundanese preference for human-accompanied walking (papah), rejection of wheeled designs, and narrow-bathroom (jamban) navigation challenges. Healthcare professionals emphasized BPJS affordability constraints and regulatory integration. Nine prioritized design requirements were derived from cross-stakeholder synthesis.

These findings establish an empirically grounded, culturally responsive design foundation for the TEMAN JALAN smart walker - demonstrating that effective assistive technology for LMIC settings requires ground-up needs assessment rather than adaptation of high-income-country prototypes. The identified requirements will directly inform the subsequent ideation, prototyping, and clinical testing phases of this design thinking project, with implications for allied health-led innovation in fall prevention globally.