When people participate in evidence-based programs like A Matter of Balance, they gain immediate benefits for their daily lives, like reducing their fall risk and increasing their sense of confidence. But a common question arises after the final session: What happens next? 

While many participants report positive experiences and improved outcomes in the days after attending an event, the challenge lies in continuing that momentum long after the program has ended. Although a six-month follow-up by the program directors is ideal, it is sometimes skipped due to limited staff capacity or funding constraints. Still, some creative strategies are showing that committing to ongoing engagement not only reinforces outcomes but also fosters social connections. 

Beyond the eight sessions: The birth of an alumni group

A 2024 study confirmed what many facilitators had already observed: AMOB is not only effective in preventing falls, but also in decreasing social isolation. Many participants complete the eight-week program feeling more connected and supported than when they started. For some, referrals to other evidence-based falls prevention programs are helpful, but other people express a strong desire to stay connected with their original group. 

Recognizing a need for continued engagement, experience consultant Ayden Jones launched a virtual A Matter of Balance alumni group during the 2022 ACL Falls Prevention grant at Stony Brook Medicine. Developed as a best practice under that grant, the alumni group has become a model for ongoing participant support and will now continue through the 2024 ACL Falls Prevention grantee, the NY State YMCA Foundation.  

Designed to keep the connection going and reinforce positive habits, the group meets monthly and is open to anyone who has completed the program within the past year. About 50 former participants are on the invite list, and an average of 10 attend each session—some regularly, others when their schedule allows. 

Alumni meetings: more than a check-in

• Social Connection: Attendees share updates, challenges, and successes. In one session, a participant expressed concern about visiting a relative whose home lacked safe entry access. The conversation quickly turned into a supportive group problem-solving discussion, with others offering advice and empathy. When she returned the next month, the group followed up to hear how her visit went.

Participant testimonial: “I have benefitted from this Embracing Balance alumni group in many ways. Some of them are reminding me how important wearing the proper shoes are and ensuring mats and rugs are, in some way, immobile on the floor. And, for me, almost as important as the reminders of how to prevent falling, the socializing with other people of similar age with similar issues." -Elli

• Reinforcing Health Behaviors: A Matter Of Balance encourages participants to complete a fall prevention checkup every six months. These alumni meetings are an excellent opportunity to send falls check-up reminders to those who completed the program more than six months ago.

Participant testimonial: “Having a way to keep connected with those in your same situation continually reinforces what you’ve learned in the class and allows you more opportunity to learn from the experiences of others. It also removes the stigma associated with falls that you might encounter in speaking with those who have not experienced the trauma a fall can cause.” Robert

• Leadership Development: The meetings are also an opportunity to identify and recruit future coaches. As someone who completed the program themselves, and with trust and rapport already established, participants are more open to stepping into a leadership role. NCOA supports alumni groups in their recruitment and leadership development EBP leaders who can contribute their talents, skills, and experiences.

You can explore strategies for engaging and supporting volunteers as program leaders in Tips for Recruiting and Supporting Volunteers as Evidence-Based Program Leaders.

• Flexible and Participant-Led Structure: While Ayden organizes the agenda and shares relevant content, participants often suggest topics or invite speakers. Some months follow seasonal themes (e.g., winter weather safety), while others are informal and driven by attendees' interests.

Growing the program: Virtual and beyond

To keep the meetings personal and manageable, Ayden has recently started dividing the alumni into smaller groups. YMCA participants will eventually have their own dedicated alumni group once workshops end. Beyond the monthly meetings, participants also stay connected through a private Facebook group where they exchange tips, meeting reminders, and words of encouragement.

Currently, all meetings are virtual, but Ayden hopes to host in-person events or even an alumni summit in the future. She envisions senior centers as ideal locations for in-person alumni groups, as many participants already gather there informally after their original program sessions.

Overcoming barriers to retention and access 

Despite the successes, retention remains the biggest challenge. Monthly meetings are held on a consistent schedule, the first Wednesday of each month, but attendance still fluctuates. Small changes in how or when reminders are sent can significantly impact turnout. Technology, while occasionally a hurdle, is rarely a major issue. While some people express initial hesitancy about using virtual meeting platforms like Zoom at the beginning of AMOB, by the time they graduate to the alumni group, they usually feel more confident. Occasionally, technical difficulties arise, but overall digital literacy improves with time and practice. 

A Lasting Impact

Participant testimonial: “The Alumni Group has been an invaluable wellspring of resources, support, and camaraderie."

These virtual alumni groups not only extend the benefits of the original program, but they also highlight just how impactful AMOB can be in participants’ everyday lives. One alum skipped an alumni meeting because she was enjoying time gardening—a hobby she credited to the confidence and strength gained through A Matter Of Balance and her continued involvement in the alumni group. This kind of follow-up is more than a feel-good bonus—it’s a powerful testament to the long-term value of evidence-based falls prevention programs. And it answers the question: “They did the program—then what?”

With intentional follow-up and a little creativity, the answer can be: They thrive.

This project was supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $10,000,000 with 100 percent funding by ACL/HHS.  The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS or the U.S. Government.