{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T18:46:43Z","timestamp":1764355603257,"version":"3.46.0"},"reference-count":87,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"unspecified","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Innovation Committee at the Federal Joint Committee","award":["01NVF21107"],"award-info":[{"award-number":["01NVF21107"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,22]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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\u2014a conventional centre-based exercise programme and a hybrid telemedical programme combining in-person and tablet-supported training\u2014against a wait-list control group in reducing falls and fall-related injuries among community-dwelling older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This study is a pragmatic three-arm, parallel-group, randomised controlled superiority trial with a 1:1:1 allocation ratio. Participants (\u226565 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\u2009months via standardised questionnaires, with a subgroup undergoing physical performance testing and sensor-based activity monitoring. Analyses will follow an intention-to-treat approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>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\u2019 Organisations (BAGSO). A publicly accessible website will provide ongoing access to study information and findings in plain language.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>DRKS00032878, German Clinical Trials Register<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-105969","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T18:40:31Z","timestamp":1764355231000},"page":"e105969","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Conventional and tablet-supported physical training to reduce falls and fall-related injuries in community-dwelling older adults: protocol of the randomised SURE-footed into the future Fall Intervention Trial (SURE-FIT)"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0717-5746","authenticated-orcid":false,"given":"Daniel","family":"Schoene","sequence":"first","affiliation":[{"name":"Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany"},{"name":"Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michaela","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Finger","sequence":"additional","affiliation":[{"name":"Department of Telemedicine, Robert Bosch Hospital, Stuttgart, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nils Axel","family":"Lahmann","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Medical Gerontology, Geriatrics Research Group, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"},{"name":"Faculty of Natural Sciences, MSB Medical School Berlin GmbH, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathrin","family":"Raeder","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Medical Gerontology, Geriatrics Research Group, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Vorwerg-Gall","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Medical Gerontology, Geriatrics Research Group, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5711-6862","authenticated-orcid":false,"given":"Hans-Helmut","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Universitatsklinikum Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0176-7989","authenticated-orcid":false,"given":"Thomas","family":"Grochtdreis","sequence":"additional","affiliation":[{"name":"Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Universitatsklinikum Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"St\u00f6ger","sequence":"additional","affiliation":[{"name":"Social Insurance for Agriculture, Forestry, and Horticulture, Kassel, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Handschuh","sequence":"additional","affiliation":[{"name":"German Association of Cities and Municipalities, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Unseld","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietrich","family":"Rothenbacher","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany"},{"name":"Center for Trauma Research, Ulm University, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gisela","family":"B\u00fcchele","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kilian","family":"Rapp","sequence":"additional","affiliation":[{"name":"Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"2025112810401359000_15.11.e105969.1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/28.2.121"},{"key":"2025112810401359000_15.11.e105969.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2012.07.188"},{"key":"2025112810401359000_15.11.e105969.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-009-1100-1"},{"key":"2025112810401359000_15.11.e105969.4","doi-asserted-by":"crossref","unstructured":"Lord SR , Sherrington C , Hicks C . 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