The purpose of the Information Cover Sheet is to collect data about the Falls Prevention Program offered, type of site, leader/instructor/coach information, and start and end dates.
The purpose of the Host Organization Information Form is to collect information about host organizations and program(s) offered.
Check the 2018-2021 Prevention and Public Health Fund (PPHF) – Chronic Disease Self-Management Education (CDSME) Reporting Calendar.
Welcome to NCOA’s Aging Mastery Starter Kit! Use this guide along with the kit to create your own path to aging well.
Optional survey questions capture data elements that ACL Falls Prevention Grantees may wish to collect over and above the grant-required data elements. These fields are not included on the OMB-approved data collection forms, but you may add them to the Participant Information Form (pre-survey) and Participant Post Program Survey.
Use this post-program survey to evaluate your falls prevention program.
The purpose of the Participant Information Form is to collect participant demographics, health and disability status, falls history, risk factors, and outcomes information before a participant begins a falls prevention program.
This log serves to capture the number of sessions or intervention dose that each Falls Prevention Program participant is completing. This log should be filled in by the person delivering the program (e.g. leader/instructor/coach etc.).
The Group Leader Script is designed to be read/paraphrased to program participants prior to their completion of the Participant Information Survey to explain the purpose of the data collection and its voluntary nature.