Expert Consensus on Developing the Components of a Home-Based Rehabilitation Program for Managing Urinary Incontinence Among Jordanian Women Aged 55 Years and Older: A Modified e-Delphi Study

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) is common among older women in Jordan and is often not discussed owing to embarrassment and social stigma. Home-based conservative programs may offer a practical and acceptable approach to symptom management. This study was aimed at reaching expert consensus on the essential components of a culturally appropriate, home-based multimodal pelvic health program for Jordanian women aged 55 years and older, using a modified e-Delphi method.

METHODS: A two-round modified e-Delphi study was conducted with Jordanian physiotherapists experienced in women's health. In Round 1, experts rated 34 evidence-based items covering pelvic floor muscle training, bladder training, behavioral and lifestyle adjustments, pelvic health education, breathing and postural exercise, adherence support, delivery format, and dosage. Items were rated on a six-point Likert scale, and consensus was defined as ≥ 75% agreement. Items that did not reach consensus were revised and re-rated in Round 2, along with one new subcomponent suggested by the experts.

RESULTS: Nineteen experts completed both rounds. In Round 1, 32 of 34 items reached consensus. In Round 2, the newly proposed subcomponent, whole-body and core strengthening, achieved full consensus. Although weight management did not reach the predefined consensus threshold, it was retained in the final program owing to its clinical importance and evidence-based relevance. Printed educational materials did not achieve consensus and were excluded. The final program consisted of 33 expert-validated components.

CONCLUSIONS: This study established expert consensus on the components of a culturally tailored home-based pelvic health program for older Jordanian women with UI. These components provide a practical foundation for program development.