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Presently, there is an increasing trend in the world population over 65 years, especially in Europe, which implies an increase in the number of detected cases of frailty and falls. Frailty is a multifactorial problem and people with frailty need simultaneous, coordinated, and stable health and social care, adjusted to the principle of continuity of care. The models of social healthcare generate a social and economic problem that is necessary and urgent to address. According to the World Health Organization (WHO), prevention strategies to be adopted by health systems should be aimed at the identification of risk factors, since one in three older adults suffers at least one fall per year, constituting one of the main geriatric syndromes and the second world cause of accidental or unintentional death. A fall also implies a deterioration in the autonomy of the elderly, decreasing their quality of life and that of their social environment, increasing their frailty. Despite the benefits and potential of biomechanical technologies to improve the assessment of frailty and risk of falling of elder people, it is undeniable that their applications are still limited to research and academic scopes. Experts have not brought down the technical and methodological barriers yet, being these methodologies mostly unknown by the majority of students of medicine and healthcare professionals. The aim of this project was the development and implementation of an online free access course to assure students, specialists, and professionals of medicine, who want to improve their skills, a worthy education and training regarding the applicability of biomechanical technology in the context of treatment of frailty and, especially, to reduce the number of falls in advanced aging people. The consortium of this project is composed of four partners with interdisciplinary skills to guarantee the achievement of the project goals. The University of Lisbon (UL), the Instituto de Biomecánica de València (IBV), and the Istituto Nazionale di Riposo e Cura per Anziani (INRCA) will guarantee access to the main body of knowledge of the course. UL is a recognized university with extensive experience in pedagogic elaboration and adaptation of formative contents for the development of online training courses using open-source platforms. IBV is a European leading research center focused on biomechanics and its application in medicine. INRCA is a research institution on aging that has education and translation of research output in clinical practice among its missions. The adaptation of the training contents to the requirements of project key stakeholders is assured with the participation of the European General Practice Research Network (EGPRN). EGPRN is an international reference institution that represents Primary Attention Medicine in Europe. Therefore, EGPRN will play a key role in the harmonization of contents, scopes, and applicability of project results. The consortium was also assembled considering the experience and capabilities for EU-wide dissemination. All partners are experienced in dissemination activities at the national and international levels. The project spanned for 2 years and all the tasks were developed and implemented under the scope of three Intellectual Outputs: - O1. Curriculum of the Fall-In-Age course. - O2. Pilot Course integrated in the e-learning platform. - O3. Final version of the online courses in English, Portuguese, Spanish, and Italian. Project results are to enrich medical students and professionals on the optimization of assessment processes of frailty and risk of falling in older people. This allows them to increase the use of current biomechanical-based technologies, which, consequently, leads to an upgrade in current prevention methodologies. Furthermore, promoting a web-based open access online course, complemented with work-based learning and apprenticeship-type training, contributes to a better standardization and qualification of target users, which, ultimately, provides them with new employment opportunities. The project had also a positive impact on the participating organizations. The experience of participating in this project contributed to the reinforcement of the internationalization strategy of all partners. Partners strengthen their position in this field, acting as a reference center on the application of biomechanical technologies among stakeholders. By exploiting the online course, all partners can increase and improve their training course portfolio, gaining visibility among target users and potential future customers. But, above all, this project's most positive impact is, undoubtedly, on the group of elderly people, as the improvement of the methodologies for the prevention of frailty and reducing the risk of falling certainly results in the improvement of the independence and quality of life of these people.

BACKGROUND By the year 2030, estimates suggest that there will be 74.7 million people with different forms of dementias worldwide. There is no cure for dementia, but several non-pharmaceutical interventions are constantly tested and updated to improve patients quality of life. These include, for instance, interventions to increase communication skills, reduce agitation and stress management, and use of new technology. Unfortunately today direct care workers are systematically excluded by accessing such up-to-date evidence to improve their work. This group of workers paradoxically face the highest demanding work situations, being at the same time the most burdened group and the least trained one. Vocational training opportunities for them are totally inadequate OBJECTIVES OF THE PROJECT iDO project mission is to make evidence-based knowledge available for workers in dementia care, reaching professionals who are normally excluded from training opportunities. The project objectives are to: 1) design and develop in close collaboration with people with dementia and their caregivers an innovative training package to promote the acquisition of skills and competences; 2) test the training package with an appropriate number of direct care workers in five EU countries, especially for evaluating its impact on their motivation and inclusion in learning activities; 3) finalize the training package incorporating all feedbacks from end-users; 4) disseminate and scale up the intellectual outputs at a wider EU level, ensuring the sustainability of project results. NUMBER AND PROFILE OF PARTICIPANTSIn an interactive, stepwise co-design and co-production process, we included approx. 2800 participants, including direct care workers (primary target group), people with dementia, their family caregivers, professionals engaged in dementia care (secondary target group) as well as adult studying to qualify as health care and social services professionals. A similar number of men and women were included, aged 20-87. ACTIVITIES AND METHODOLOGY The training package aimed at addressing current barriers to training opportunities among our primary target group, includes eight modules comprising: • testimonial videos created by caregivers and people with dementia explaining their needs and aspirations (Intellectual Output, IO1); • a series of training videos by expert professionals on dementia care good practices, advices and tips on how to improve daily practice routines and address the needs expressed by users (IO2);- In the end of each module a short quiz has to be passed in order to unlock the serious game described below • an interactive serious game was developed in order to enable direct care workers to manage virtually a series of case scenarios and to learn through problem-solving activities (IO3). The game comprises different scenarios common in daily life. The response to the scenarios are measured in terms of dementia care outcomes and can be followed on the screen while playing. Focus group interviews with people with dementia and their family caregivers were held in Sweden, Italy, Greece and Portugal. The findings were analysed applying manifest content analysis and were used as the basis for the development of the testimonial and expert videos (IO1and IO2) MOOC (IO4) and the serious game (IO3). Data for the dementia care outcome indicators in the serious game (IO3) were generated by means of a review of randomised controlled trials published during the previous ten years. Data from the studies were extracted using regression analyses to generate the outcome indicators.All material is included in the Massive Open Online Course (MOOC) (IO4) developed and implemented on the Udemy platform. RESULTS AND IMPACT The iDO MOOC (on Udemy) and serious game is publicly available and usable by mobile devices, free of charge in English, Greek, Italian, Lithuanian, Portuguese and Swedish. The MOOC comprises 8 modules on state-of-the-art dementia knowledge, each of them ending with at short quiz, where correct answers unlock more advanced parts of the game. The game and the MOOC are connected via the website idoproject.eu. The MOOC and game seems to improve direct care workers empathy and understanding towards people with dementia and their family carers; it improves their knowledge, skills and competences on dementia care and provides practical tips of best practices interventions in dementia. The game and MOOC have been used by 800+ users and the evaluation of the training package is positive. LONGER TERM BENEFITSConsidering the longer term benefits of iDO results, they are not possible to evaluate yet. However, with the increasing shortage of time possible to allocate for staff education and training, online training tools such as the iDO platform are requested, with high potential to benefit staff, persons with dementia and their caregivers positively.