Background: Falls among older adults remain a critical patient safety concern globally. Conventional walkers frequently fail to accommodate end-user needs, particularly in low-to-middle-income country (LMIC) settings. Understanding stakeholder design requirements is essential for developing contextually appropriate, technology-enhanced assistive devices. Objective: To explore multidisciplinary stakeholder perspectives on the design requirements for a sensor-integrated smart walker for fall prevention among older adults in Indonesia. Methods: A qualitative descriptive approach was employed within the empathize and define phases of a design thinking framework. Purposive sampling recruited 13 participants across three stakeholder groups: older adult walker users (n=5), informal caregivers (n=5), and healthcare professionals (n=3). Semi-structured interviews were conducted between October and December 2025 in Bandung, West Java. Data were analyzed using Braun and Clarke’s reflexive thematic analysis. Cognitive screening used a standardized, licenced assessment tool. Results: Twenty themes were identified across stakeholder groups: seven from older adults, eight from caregivers, and five from healthcare professionals. Convergent needs included a pre-impact fall warning system, design simplicity, structural durability, and affordability. Culturally specific findings included the Sundanese preference for human-accompanied walking (papah), rejection of wheeled designs, and narrow-bathroom (jamban) navigation challenges. Healthcare professionals emphasized BPJS affordability constraints and regulatory integration. Nine prioritized design requirements were derived from cross-stakeholder synthesis. Conclusion: These findings establish an empirically grounded, culturally responsive design foundation for the TEMAN JALAN smart walker — demonstrating that effective assistive technology for LMIC settings requires ground-up needs assessment rather than adaptation of high-income-country prototypes. The identified requirements will directly inform the subsequent ideation, prototyping, and clinical testing phases of this design thinking project, with implications for allied health-led innovation in fall prevention globally. Plain Language Summary: Falls are among the most dangerous and common accidents experienced by older adults. Walking frames (walkers) help prevent falls, but the standard designs currently available in Indonesia are often too bulky for small bathrooms, lack any form of warning system, and do not consider local living conditions. This study asked older adults who use walkers daily, their caregivers, nurses, and a doctor specializing in elderly care about what they need from a better walker. Interviews took place at a residential care home and a hospital clinic in Bandung, Indonesia. Older adults said they feel safer with a walker but struggle in tight bathroom spaces and wish for an alarm that warns them before they fall. Some preferred being physically guided by another person — a cultural practice called papah in the Sundanese community. Caregivers reported that walkers reduced their physical workload but emphasized that proper training was essential during the first days of use. Nurses and the doctor stressed that most patients rely on government health insurance (BPJS) and cannot afford expensive devices, and that any new technology must fit into hospital procedures. These perspectives are now being used to design a smart walker called TEMAN JALAN that uses motion sensors to detect when someone is about to fall and sends alerts to caregivers. Keywords: older adults, fall prevention, walker, design thinking, qualitative research, stakeholder perspectives, assistive technology, allied health
Dharmansyah et al. (Fri,) studied this question.