SAFER Karachi - A Fall Prevention Intervention

Summary

The goal of this pilot study is to evaluate the feasibility, acceptability, and short-term effects of a culturally adapted and strengthened fall prevention program in older adults aged 60 years and above living in urban Karachi, Pakistan. The study aims to understand whether a structured, community-based intervention can improve mobility, confidence, and overall well-being, while reducing the risk of falls.

The main questions it aims to answer are:

1. Is the adapted and strengthened fall prevention program feasible and acceptable for older adults in Karachi?
2. Does participation in the program improve mobility, balance, fall-related self-efficacy, and emotional well-being among participants?

Participants will:

1. Take part in a 7-week group-based fall prevention program that includes strength and balance exercises, home safety education, medication awareness, and behavioural strategies
2. Receive a follow-up home visit to reinforce safety practices and environmental modifications
3. Attend a booster session after 3 months to support continued engagement
4. Complete assessments at baseline and follow-up, including mobility, cognitive function, quality of life, and emotional well-being
5. Maintain monthly fall logs to report any fall incidents during the study period

Conditions

• Accidental Falls
• Falls
• Falls Injury
• Mobility Difficulty
• Mobility and Independence
• Aged 60 Years or Older

Interventions

BEHAVIORAL

Stepping On Fall Prevention Program

This intervention is a culturally adapted and contextually strengthened version of the evidence-based Stepping On fall prevention program, tailored for older adults in a low-resource urban setting. Unlike standard implementations, this version incorporates context-specific modifications based on local environmental, social, and health system realities in Karachi. Key distinguishing features include structured facilitator training to ensure standardized delivery, physiotherapist-informed guidance for exercise components to enhance safety, and integration of supportive tools to improve participant adherence and engagement. The intervention also includes follow-up reinforcement through home visits and a booster session to support sustained behaviour change. These adaptations are designed to improve feasibility, acceptability, and scalability of the intervention within resource-constrained settings while retaining the core evidence-based components of the original program.

Sponsors & Collaborators

• Fogarty International Center of the National Institute of Health

  collaborator NIH

• Aga Khan University

  lead OTHER

Principal Investigators

• Sonia Sameen, MSc. · Aga Khan University

Study Design

Allocation

NA

Purpose

OTHER

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

60 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2025-09-01

Primary Completion

2026-04-30

Completion

2026-07-31

Countries

• Pakistan

Study Locations