State Falls Prevention Coalitions play an essential role in reducing falls and improving the health and safety of older adults. With 1 in 4 older adults reporting a fall each year, falls are common and require focused attention.¹

Coalitions bring together cross-sector partners to address the complex and multifaceted issue of falls. High-performing state falls prevention coalitions:

• Influence state-level policies
• Improve access to evidence-based programs
• Coordinate referral pathways
• Strengthen community capacity to support older adults

Establishing a successful coalition requires time and dedication. Coalition work is twofold—it involves consistently strengthening the coalition’s internal structure, such as roles, processes, and decision-making practices, while also conducting the collaborative activities that members are united to carry forward. To be effective, coalitions must routinely invest in both sides: maintaining a clear, functional organizational foundation and coordinating the programs and initiatives that advance the coalition’s mission.

NCOA's designation of a coalition as “active” signifies that the coalition has established an operational foundation and is equipped to influence programs, policies, and practices that reduce falls and fall-related injuries among older adults. While becoming an “active” state falls prevention coalition is a significant milestone, it should not be viewed as the finish line. High‑performing coalitions advance far beyond these foundational requirements to effect significant improvements in their state’s capacity to address falls.

What does it mean to be an active state falls prevention coalition?

To meet NCOA’s criteria as an active state coalition, the collaborative must have all of the following components in place:

• Established leadership
• Committed, varied membership that regularly attends meetings
• Open membership for new partners
• Established schedule of assembly and meeting structure
• A clearly defined focus on falls prevention
• Specific goals and objectives
• Knowledge of the state's resources and needs related to falls prevention
• Ongoing involvement in activities that raise awareness of and increase access to falls prevention

These elements ensure that a coalition is not just a network of people sharing information and resources, but rather, a coordinated, strategic body that is capable of collective action.

How to build your coalition’s foundation and become “active”

NCOA’s criteria for an active state falls prevention coalition is designed to help developing coalitions establish the foundational structure and processes needed to effect meaningful and lasting change. While establishing a foundation is essential, coalition structure and processes may shift over time as partners, priorities, and resources change. A key strength of coalitions is the ability to nimbly adjust to changing circumstances. This flexibility also requires that coalitions routinely revisit the active coalition criteria to ensure they are maintaining their active status.

The following strategies and tips are based on NCOA’s active coalition criteria to support state falls prevention coalitions working to establish or maintain active status.

1. Establish leadership: Coalition leadership provides inspiration, direction, and guidance, and ensures follow-through on activities. Depending on a coalition’s culture, capacity, and size, there are a variety of leadership structures that can be employed. Common leadership structures include: single chairs, co-chairs, executive committees, shared leadership, committee-based models, or a combination of these approaches. It is common for leadership roles to shift over time as membership grows or direction changes. Effective leadership strikes a balance between providing structure while also allowing for flexibility.

2. Build and sustain membership: Recruiting committed, cross-sector partners is essential. Start by identifying and engaging prospective members who have a stake in falls prevention. Use the State Falls Prevention Coalition Member Checklist to brainstorm prospective fields to target for recruitment. 

• All interactions can be an opportunity for member recruitment. Use ongoing and varied recruitment strategies such as inclusions in newsletters, promotions during presentations, and personal invitations.
• Create resources for new members that help orient members to the coalition’s goals, processes, expectations, and different levels of engagement.
• Remember: recruitment is continuous, and coalitions grow gradually over time.
• While fluctuations in attendance are expected, maintaining consistent participation from most attendees is important so that work can move forward and the group does not have to routinely start fresh.

3. Establish assembly and meeting structure: A predictable meeting cadence helps maintain engagement and accountability.

• Hosting monthly full membership meetings is recommended for developing and recently established coalitions. Monthly touchpoints enable consistent communication, rapport-building, and timely follow-through.
• Create meeting agendas that ensure meetings are productive, action-oriented, and fun. While sharing resources and providing space for member updates can have relevance, coalitions should remain cautious that they do not devolve into a platform for sharing and updating and lose their focus on conducting activities that influence programs, policies, and practices that reduce falls.

4. Maintain a clearly defined focus on falls prevention: Coalitions may address falls in tandem with other related issues such as osteoporosis, physical activity, or healthy aging, but to be classified as an active state falls prevention coalition, falls prevention must remain a predominant focus.

Tip! If your coalition is part of a broader network, ensure that falls-related goals and strategies are clearly articulated. As your coalition evolves, it may become apparent that the larger structure is limiting the coalition’s impact, and that stepping away from the larger network is required to enable the coalition’s growth and effectiveness.

5. Develop goals and objectives: Coalition goals should be actionable and describe how the group will work to reduce falls. Each goal should be broken down into specific objectives that outline the immediate milestones needed for success. Effective coalitions set goals that combine long‑term impact with early wins, as early successes help build momentum and sustain participation. Examples of early wins include:

• Recruiting a specific number of members
• Launching a website or webpage
• Joining national observances like Falls Prevention Awareness Week
• Creating by-laws and a community agreement

In addition to early wins, long-term goals (i.e., those that can be achieved within 1-3 years) help build camaraderie and establish direction. Examples of long-term goals include:

• Establish a referral system
• Train a specific number of providers to complete CDC’s STEADI falls risk assessment
• Conduct a landscape assessment

Tip! Use the SMART framework to ensure your objectives are specific, measurable, achievable, relevant, and time-bound. Creating SMART objectives also simplifies evaluation after the goal has been completed.

6. Build knowledge of resources and state needs: Understanding the state's current falls prevention landscape anchors the coalition in evidence-informed thinking and reduces duplication of effort. Knowledge of state resources and needs can be derived from:

• Personal experience
• Literature reviews
• Data analysis
• Landscape assessments or surveys

Start by gathering existing information (i.e., reports, datasets, previous initiatives) and build from there. Gathering information can also double as a relationship-building and member recruitment strategy. Learn more about strategies for accessing and leveraging falls prevention data.

7. Maintain ongoing involvement in falls prevention activities: Active state falls prevention coalitions continually participate in activities that raise awareness, enhance capacity, and strengthen systems to address falls. Such activities might include:

• Offering or promoting evidence-based programs
• Developing referral networks
• Hosting awareness and screening events

Use what you know about your state’s assets and needs to determine the activities your coalition will prioritize. For instance, if coalition members from across the state routinely describe that providers lack awareness about how to lead discussions about falls and screen for falls risk with their older adult patients, consider hosting a training series for providers using tools like the CDC STEADI toolkit. To ensure alignment between your goals and activities, make sure you set a goal related to the number of providers you would like to train.

Contacting NCOA once your coalition has built its foundation

To be officially distinguished as an active state falls prevention coalition by NCOA, reach out to NCOA at fallsfree@ncoa.org with a description of the following:

• A brief (2–3 sentence) overview of the coalition
• Description of your coalition’s leadership structure
• Leadership contact information
• Description of key partners and members
• Statement of coalition goals and objectives
• Brief description of your state’s falls prevention resources and needs
• Description of how your coalition is involved in activities to raise awareness of and increase access to falls prevention programs. Include a description of evidence-based programs offered by your coalition, if applicable.
• What strategies are in place to ensure your coalition’s long-term sustainability?
• Coalition website URL (if available)
• Coalition strategic plan (if available)
• Any additional documents that demonstrate coalition function and impact

NCOA will review this information for alignment with the active coalition criteria.

Being an active coalition is just the beginning

While achieving active status is an important milestone, it is not the end point. Rather, it signals that your coalition is ready to continue to grow, deepen its partnerships, strengthen its influence, and expand its impact across the state.

Once your coalition is established, sustaining the coalition requires a careful balance between maintaining the coalition’s structure and processes while simultaneously advancing the coalition’s initiatives and activities. Central to both of these efforts is ensuring your coalition has the resources and capacity needed to function effectively and achieve its goals. Strategies such as identifying and pursuing funding, securing sponsorships for activities, embedding the coalition’s work into the ongoing efforts of member organizations, and advocating for state-level support can provide the resources necessary for continued impact.

Resources to support coalition development and sustainability

• Guide to State Coalition Building for Falls Prevention: Discover a compendium of practical tools, resources, and strategies to assist state falls prevention coalition building and sustainability efforts.
• University of Kansas Community Toolbox: KU’s Toolbox includes a wealth of information and examples from existing collaboratives to support developing coalitions and community building initiatives.

Photo credit: Knoxville-Knox County Senior Safety Task Force. Kentucky—FPAW 2025

This project is 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 $2,500,000 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.

Sources

1. Centers for Disease Control and Prevention. Older Adult Falls Data. Found on the internet at https://www.cdc.gov/falls/data-research/index.html