Background: Falls are a significant source of early morbidity and mortality in the aging population, yet clinical changes that lead to increased fall risks often escape early identification and intervention. A device to measure postural control would facilitate evidence-based fall risk assessment. Objectives: Our objectives were to iteratively develop a prototype quantitative posture instrument (QuPI) to replace the weight scale and to assess barriers and facilitators of its implementation in a clinical setting. Methods: We undertook a formative evaluation and usability study of two QuPI prototypes in primary care, medical oncology, sports medicine, cardiology, and endocrinology outpatient clinics. Clinicians evaluated an initial QuPI prototype and completed a semi-structured interview to determine critical functionality, inform design, and assess usability. The QuPI was modified according to the results, and a new prototype was tested and evaluated. Results: Eighteen clinicians participated in both rounds of interviews. Clinicians who participated (referred to as participants) reported willingness to use the QuPI with all patients during the first round of interviews and stated they would replace their current weight scale with the modified QuPI during the second round of interviews. Participants identified design elements that were both facilitators and barriers to use. Usability scores for both prototypes were excellent. Despite several national guidelines for fall risk assessments, lack of consistent use of guidelines by care teams was found to be a barrier to effective fall risk assessments. Conclusion: The QuPI provides a new method for quantifying fall risks with good user acceptance, usability, and clinical feasibility without disrupting workflow. The QuPI supplemented and facilitated the use of standard algorithms for fall risk assessment. Greater education of the entire care team regarding evidence-based fall risk assessment will promote adherence to guidelines and fall prevention.

The authors have declared no competing interest.

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This study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed and approved by The Ohio State University Biomedical Sciences Institutional Review Board (study Number: 2018H0447) . At the time of the interview, the oral consent script was read by the interviewer to the participant, and the interviewer answered any questions from the participant. Once the participant agreed to continue, the interview began. Written consent was waived by the IRB for this study.

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Full transcriptions of the interviews analyzed in this study cannot be shared publicly to protect the privacy and anonymity of participants. If you wish to obtain access to this data, please contact the corresponding author.