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Falls are a major health concern in the older adult (OA) population. While there is research on falls and their prevention, research on how low fall efficacy (FE) impacts the occupational engagement of the OA population is limited. FE is defined as the confidence a person has in his/her ability to complete a task without falling (Tinetti & Powell, 1993). A qualitative study was conducted using a phenomenological approach to explore the lived experiences of OAs with low FE and the impact on occupational performance. Participants who scored ≤ 6 on the Modified Fall Efficacy Scale (MFES) engaged in a semi-structured interview, that explored the relationship between low FE and participation in occupations. Researchers asked open-ended questions to explore the activities impacted by participants low FE. A constant comparison method was utilized to analyze the interviews. The findings suggested that participants discontinued certain occupations due to a poor fit between the environment and the occupational challenges. However, those who experienced a good fit between the environment and the occupational challenges continued to participate in the activity using environmental modifications when needed. The occupations that had the lowest average scores on the MFES were occupations that mandated a narrow base of support (BOS) and the shifting of one’s weight. Therefore, occupational performance was impacted by the demands of the activity, the functional ability of the person, and environmental modifications.


Occupational Therapy

Faculty Advisor

Susan Morris, PhD, OTR/L

Publication Date



San Rafael, CA


Fall efficacy, occupational engagement, occupational participation, older adults, community-dwelling


Occupational Therapy

The Impact of Fall Efficacy on Occupational Performance in Community-Dwelling Older Adults