Evidence-Based Program: Stepping On

Stepping On is endorsed by the CDC because its one-of-a-kind multifactorial approach, a seven session small group community-based falls prevention workshop, based on behavior change, preventative framework and principles of adult education, focusing on four critical domains: balance and strength exercises; medication review; vision review; and home modifications.

The Wisconsin Institute for Healthy Aging (WIHA) is the national Stepping On license holder and disseminates the program and provides support to license holders and facilitators throughout the nation. The program is available for in-person or virtual delivery.

• Target audience: Older adults who are without a diagnosed cognitive impairment, live independently, do not use a walker indoors (outdoor walker use OK, cane indoors or outdoors OK) and do not need a wheelchair.
• Health outcomes: Stepping On has been researched and proven to decrease falls by 31%. Fewer falls mean fewer injuries, fewer visits to the emergency room, fewer hospitalizations, and fewer deaths due to a fall. Read the original research article. 
• Delivered by: Two 3-day trained facilitators including trained lay/peer leaders, fitness instructors, physical therapists, occupational therapists, aging network professionals, or health care providers. Another model includes 1 trained facilitator who has completed the 3 -day in person training and one peer leader.
• Program type: Group

“The program is more than exercises. Pharmacists to know what drugs are correlated with falls, learning about safety with the paramedics… Learning how to be aware of your surroundings [in] your house, other people’s houses, [and the] outside environment, especially sidewalks… The class has so many facets, you learn so many different things on how to be safe.” - Jane Bannerman, Dane County

• Format: In-person in community, Remote
• Length: 7 weeks, one 2-hour session per week. Including a follow-up phone call or home visit and 3-month booster session.
• Training: Remote, in-person
• Professional required: Yes- Guest experts are required throughout the seven sessions including an exercise expert, medication expert, vision expert and community safety expert.

[My favorite part of facilitating Stepping On is] when people start realizing that the exercises can make a difference! It’s fulfilling and it makes such a difference to people’s lives. One thing I always tell the class is “we don’t wake up in the morning and say, ‘today I’m going to fall’. We don’t plan it. So, we have to think about ways to prevent it. Kathy (age 62) Stepping On Peer Facilitator, Outagamie County, WI

• Accessibility adaptations available: We developed these tools to help you adapt your Stepping On workshop to accommodate people with sensory impairments such as low vision or vision loss and hearing impairments. The audio recordings give a detailed explanation of each Stepping On exercise for participants with vision impairments. These can be shared with any Stepping On participant for their home practice and use.
• Cultural adaptations available: A Tribal Adaptation Booklet is available with approved adaptations to offer Stepping On in tribal communities.
• Available in languages other than English: Spanish (Pisando Fuerte), has been delivered in Hmong/Lao.
• Data collection: Sites are required to submit Stepping On data following each workshop
• Topic(s):
  • Falls Prevention
  • Physical Acitivity
  • Medication Management

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