Bingocize® Research

Bingocize® is an evidence-based, game-centered health promotion program that integrates structured exercise, health education, and the familiar game of bingo to improve physical function, reduce falls risk, enhance health activation, and promote social engagement among older adults. Implementation is supported by a standardized online facilitator training and a turnkey materials kit (Movement & Motivation Kit), which together ensure safe, consistent delivery across settings. Curriculum reinforcements are incorporated during sessions to reinforce key health education concepts such as falls prevention, physical activity, and safety awareness.
Bingocize® is typically delivered in two 45–60-minute sessions per week over 6–12 weeks, depending on the selected workshop. Sessions embed strength, balance, gait, endurance, and range-of-motion exercises within bingo gameplay, along with targeted health education questions focused on falls prevention, chronic disease self-management, and healthy aging. Exercises are adaptable for seated or standing participation and scalable across a wide range of physical and cognitive abilities, enabling implementation in community senior centers, assisted living, long-term care, and nursing home settings.

Physical Function, Mobility, and Falls Risk Outcomes
Across multiple controlled and quasi-experimental investigations, Bingocize® has demonstrated significant improvements in physical and functional outcomes directly associated with falls risk. Studies involving community-dwelling older adults report improvements in handgrip strength, balance, gait speed, functional mobility, fear of falling, positive affect, and quality of life when compared with traditional bingo or non-exercise control conditions. Additional studies using both paper-based and mobile-app formats demonstrate improvements in gait performance, including clinically meaningful increases in gait speed associated with reduced fall risk.
Large-scale, multi-site evaluations involving hundreds of older adults across dozens of facilities further demonstrate significant improvements in falls risk indicators, physical activity levels, and social isolation, supporting the scalability and generalizability of Bingocize® beyond small pilot samples.

Economic Impact: Modeled Cost Avoidance
In addition to clinical outcomes, Bingocize® results suggest potential downstream economic benefits through reduced fall events and fall-related acute care utilization. In a pilot cohort of 11 community-dwelling older adults completing a 10-week Bingocize® program, participants demonstrated statistically significant improvements in Timed Up and Go (TUG: 11.77 → 8.62 seconds) and 360° turn time (3.00 → 2.12 seconds)—functional domains strongly associated with fall risk.
Using a published community fall rate of 0.714 falls/person-year, the responder subgroup would be expected to experience approximately 1.812 falls over a 12-week period (expected value for population-level forecasting). Applying conservative 10–30% fall-reduction scenarios yields an estimated 0.18–0.54 falls prevented over 12 weeks. When translated into national mean acute-care costs, this corresponds to approximately $201–$605 in avoided emergency department costs or $3,382–$10,146 in avoided hospitalization costs over the same period. Although individuals do not experience fractional falls, fractional values are standard in economic modeling and represent expected reductions across people and time, which become meaningful when scaled across facilities and longer implementation periods.

Health Knowledge, Health Activation, and Social Engagement
Bingocize® also produces significant improvements in health knowledge and patient activation, defined as the knowledge, skills, and confidence to manage one’s own health. Studies using the Patient Activation Measure (PAM-10) demonstrate significant pre–post increases following Bingocize® participation, with attendance rates exceeding 90%, indicating strong engagement and feasibility.
A defining feature of Bingocize® is its demonstrated ability to promote meaningful social engagement, rather than passive participation. Research conducted in nursing home settings led to the development and validation of the Fun and Social Engagement Evaluation (FUSE), which shows moderate-to-strong reliability and documents high levels of smiling, laughing, verbal interaction, and peer engagement during sessions. Longitudinal attendance data from over 1,100 nursing home residents across 25 facilities further demonstrate that residents of all ages and cognitive abilities can successfully participate in Bingocize®, with attendance influenced by facility-level factors rather than cognitive impairment.

Intergenerational and Workforce Development Outcomes
Bingocize® also functions as an effective intergenerational service-learning platform. Multiple investigations report that undergraduate students assisting with Bingocize® delivery demonstrate more positive attitudes toward aging, increased empathy, and greater interest in aging-related careers across interprofessional disciplines including kinesiology, communication disorders, social work, and physical therapy.

Summary
Collectively, the Bingocize® evidence base demonstrates that the program is a scalable, adaptable, and empirically supported intervention that improves physical function, reduces falls risk, enhances health activation, strengthens social engagement, and shows plausible economic value through avoided fall-related health care utilization. By embedding evidence-based exercise and education within a socially meaningful game format, Bingocize® addresses both clinical and economic priorities for healthy aging across community and long-term care settings.


Bibliography 
Crandall, K. J., Fairman, C., & Anderson, D. (2013). Bingocize: Combining exercise and bingo to improve functional fitness and reduce fall risks in older adults. KAHPERD Journal, 50(2), 50.
Crandall, K. J., & Steenbergen, K. I. (2015). Older adults’ functional performance and health knowledge after a combination exercise, health education, and bingo game. Gerontology & Geriatric Medicine, 1, 1–8.
Dispennette, A. K., Schafer, M. A., Shake, M., Clark, B., Macy, G. B., Vanover, S., & Crandall, K. J. (2019). Effects of a game-centered health promotion program on fall risk, health knowledge, and quality of life in community-dwelling older adults. International Journal of Exercise Science, 12(4), 1149–1160.
Falls, D. G., Shake, M., Norris, E., Arnett, S., Taylor, J., & Crandall, K. J. (2018). Bingocize®: Utilizing a mobile application to improve gait in community-dwelling older adults. American Journal of Recreation Therapy, 17(2), 9–19.
Crandall, K. J., Shake, M., & Ziegler, U. (2019). Assessing the impact of a game-centered mobile app on community-dwelling older adults’ health activation. OBM Integrative and Complementary Medicine, 4(3). https://doi.org/10.21926/obm.icm.1903041
Neils-Strunjas, J., Crandall, K. J., Ding, X., Gabbard, A., Rassi, S., & Otto, S. (2021). Facilitators and barriers to attendance in a nursing home exercise program. Journal of the American Medical Directors Association, 22, 803–808.
Neils-Strunjas, J., Crandall, K. J., Weiler, B., Gabbard, A., Wood, C., & Ding, X. (2021). Measurement of social engagement of nursing home residents during an exercise program. Perspectives of the ASHA Special Interest Groups, 6, 1–9. https://doi.org/10.1044/2021_PERSP-20-00302
Neils-Strunjas, J., Crandall, K. J., Shackelford, J., Dispennette, K., Stevens, L. R., & Glascock, A. (2020). Students report more positive attitudes toward older adults following an interprofessional service-learning course. Gerontology & Geriatrics Education, 41(2), 175–185. https://doi.org/10.1080/02701960.2018.1479262
Doolittle, A., Sullivan, D., & Crandall, K. J. (2024). Student reflections on an intergenerational service-learning program: Bingocize®. Professional Development: The International Journal of Continuing Social Work Education, 27(1), 25–32.
Crandall, K. J., & Neils-Strunjas, J. (2019). A game-based health program for improving functional health and social engagement in long-term care residents. Journal of Aging and Long-Term Care, 2(2), 15–19. https://doi.org/10.5505/jaltc.2019.29392