Leader training and fidelity monitoring are the hallmarks of quality assurance for falls prevention programs that have been approved by the Administration for Community Living (ACL) as meeting strict evidence-based criteria for health promotion and disease prevention programs. Beneficial outcomes for older adults participating in evidence-based falls prevention programs depend on the program being implemented with fidelity.
At every phase of implementation of an evidence-based program, from recruitment to leader trainings, program delivery, and evaluation, fidelity is considered and monitored by all personnel involved including leaders, master trainers, and license holders or host organizations.
Conducting the programs with fidelity improves the quality of what is being delivered and ensures all the activities of the program are implemented correctly to benefit participants. As described below for each program, the training requirements and fidelity monitoring process vary from program to program based on the program’s research, evidence, and the most effective processes as developed by the program administrators.
Programs detailed in this fidelity hub:
Click on each program name to jump to their fidelity information in the table below.
- A Matter of Balance
- Bingocize
- Enhance®Fitness
- FallScape
- FallsTalk
- Healthy Steps for Older Adults
- Virtual Healthy Steps for Older Adults
- Healthy Steps in Motion
- Stepping On
- Tai Chi for Arthritis and Falls Prevention
This information is based on the survey responses received from the administrators and developers of respective programs and may not be consistent across all programs.
For ACL-approved Evidence Based Program Administrators and Developers: Please contact us at cha@ncoa.org to edit or update program information.
A Matter of Balance |
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Program administrator/developer |
MaineHealth |
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Contact email |
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Contact phone number |
207-661-7563 |
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Program landing pages |
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Program Implementation Requirements |
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License requirements for organizations |
Organizations need to be licensed with MaineHealth to offer A Matter of Balance |
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License requirements for instructors |
Organizations must have at minimum one Master Trainer on the License to manage the implementation of A Matter of Balance for that organization. Master Trainers are trained and certified by MaineHealth. |
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Modes of leader training |
The master trainer trainings are held online as well as in-person. |
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Required follow-up trainings for leaders |
Master trainers must attend annual master trainer meetings to maintain their certification. |
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Program-provided fidelity checklist |
Fidelity guidance document is distributed to master trainers. |
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Person responsible for fidelity review |
Master trainers |
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Timeline for fidelity review |
Fidelity is monitored with every session. Fidelity training is provided annually. |
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Program Delivery |
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Number of leaders |
2 leaders |
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Length of course |
4 or 8 weeks |
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Number of sessions |
2 hours per session 1 session per week for 8 weeks, or 2 session per week for 4 weeks 8 sessions for in-person MOB 9 sessions for virtual MOB |
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Class size |
8-12 people |
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Target population |
Adults who have a fear of falling and who have begun to limit their activity levels due to that fear. |
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Modes of program delivery |
In-person or virtually |
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Content required |
A curriculum |
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Materials for participants |
Participants receive a workbook to keep. |
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Bingocize |
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Program administrator/developer |
Western Kentucky University Center for Applied Science in Health & Aging |
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Contact email |
bingocize@wku.edu |
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Contact phone number |
270-745-2077 |
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Program landing pages |
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Program Implementation Requirements |
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License requirements for organizations |
Licensing cost—2-year license: $400 per organization for the first county. Each additional county cost: $300 for a 2-year license. |
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License requirements for instructors |
Training cost for initial 2-year license term:
For more information, visit www.wku.edu/bingocize/about_bingocize/ |
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Modes of leader training |
online, in-person, hybrid |
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Required follow-up trainings for leaders |
Training cost after initial 2-year license term:
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Program-provided fidelity checklist |
Available at wku.edu |
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Person responsible for fidelity review |
Each organization will designate a member to observe a new Bingocize® facilitator no later than the end of the second week of the 10-week workshop to ensure delivery fidelity. The observer should be an experienced Bingocize® facilitator and/or trained and certified in at least one other evidence-based program. For more information visit wku.edu |
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Timeline for fidelity review |
The organization will designate a member to observe the new Bingocize® facilitator no later than the end of the second week of the 10-week workshop to ensure delivery fidelity |
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Program Delivery |
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Number of leaders |
One trained leader for every 20 participants. |
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Length of course |
10 weeks |
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Number of sessions |
45 minutes to 1 hour per session 2 sessions per week for 10 weeks (total of 20 sessions) |
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Class size |
8-20 people |
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Target population |
Sedentary older adults at all ability levels, in a variety of settings, including certified nursing facilities, assisted living, independent living, and community senior centers. |
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Modes of program delivery |
In-person, virtual, hybrid |
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Content required |
Participants (Bingocizers®) complete a series of strategically inserted exercises designed to increase or decrease the intensity and volume of exercise. Health education questions are also inserted into the game. Participants rest while numbers are called for the bingo game, then complete more strategically inserted exercises or health education questions, rest during number calling, and so on. This pattern is continued until a Bingocizer® wins the game. Curriculum reinforcements, e.g., Bingocize water bottles, night lights, etc., are awarded to winners. Some are included with the program. Additional games are played until all planned exercises are completed. |
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Materials for participants |
Resistance band, stress ball, curriculum materials, curriculum reinforcements |
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EnhanceFitness |
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Program administrator/developer |
Sound Generations |
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Contact email |
paiged@soundgenerations.org |
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Contact phone number |
206-268-6739 |
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Program landing pages |
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Program Implementation Requirements |
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License requirements for organizations |
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License requirements for instructors |
Remote trainings are usually held on Zoom. They consist of two 4-hour sessions over two days and a one-on-one teach back to be scheduled with the trainer shortly after the second day of training. In-person trainings are usually hosted by a licensed EnhanceFitness affiliate. They consist of one 8-hour session and one 4-hour session over two days, including a teach back. Remote trainings require the use of a webcam, such as on a desktop or laptop computer. Remote training cannot be performed using a cellphone handheld camera. We strongly recommend one computer per participant, but let us know if this is a challenge and we can work with you on options. Remote trainings have a maximum capacity of 10 attendees. In-person trainings are typically capped at 15 attendees. For more information on training requirements, visit projectenhance.org. |
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Modes of leader training |
In-person, virtual |
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Required follow-up trainings for leaders |
Online refresher is recommended if not taught in a year. This is required with full class teach back if a safety concern is reported. An EnhanceFitness Master Trainer provides mentoring support. |
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Program-provided fidelity checklist |
Available to licensed affiliates, master trainers, and leaders at projectenhance.org. |
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Person responsible for fidelity review |
Completion of training grants instructors and coordinators access to a secure login at projectenhance.org with a variety of resources focused on quality assurance and safety. These resources include full class video demonstrations, instructor monitoring and self-review forms, and curated American Council on Exercise (ACE) and National Center for Health, Physical Activity and Disability (NCHPAD) continuing education portals. Additionally, instructors have access to a moderated private instructor discussion group as well as updates to the EF Instructor Manual and EF Site Coordinator Implementation Guide. EF Master Trainers ensure program fidelity by providing support to new instructors and conducting on-site review of classes and instructors. For organizations that do not have their own EF Master Trainers, Project Enhance is available by phone, email and videoconference to instructors nationwide as a ready resource. Reports available in the EnhanceFitness Online Data Entry System identify programs with out-of-protocol scheduling, missing data, or unexpected assessment scores, prompting review of protocols with delivery organizations. |
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Timeline for fidelity review |
At outset and ongoing at various points per above |
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Program Delivery |
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Number of leaders |
In-person classes have one instructor Interactive classes have one instructor and a tech assistant for safety/support |
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Length of course |
16 weeks |
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Number of sessions |
1 hour per session 3 times a week for 16 weeks or ongoing |
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Class size |
Max 25 people in-person Max 12 via interactive video conference |
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Target population |
Older adults and people aging with disability from frail to fit. |
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Modes of program delivery |
In-person, remote via interactive video conference, hybrid |
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Content required |
Objective and subjective fitness assessment at baseline and 16 weeks + group exercise class comprised of warm up, cardiovascular work, cool down, dynamic and static balance exercises, upper and lower body strength training exercises with weights as appropriate, and stretching. |
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Materials for participants |
Chair, weights as appropriate |
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Back to the top
FallScape |
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Program Administrator/Developer |
Brookside Research & Development |
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Contact Email |
Info@fallscape.org |
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Contact phone number |
206-317-3173 |
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Program landing pages |
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Program Implementation Requirements |
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License requirements for organizations |
Completion of training results in one year license. Subsequent year license fees depend on the number of users. Continued license renewals maintain the license fee that was in use at the time of the initial training. |
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License requirements for instructors |
FallScape Facilitators must have completed FallsTalk training and demonstrate FallsTalk expertise. Training requires one 6-hour in-person session, plus 1-3 webinars, depending on the training cohort. For more information, visit fallscape.org. |
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Modes of leader training |
Training is done in-person and by webinar, both modes are required due to the equipment used for the multimedia aspect of the FallScape intervention. |
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Required follow-up trainings for leaders |
Refresher training is conducted after each software upgrade; this ensures familiarity with new tools and resources. |
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Program-provided fidelity checklist |
The licensed software provided with training ensures program fidelity using built-in artificial intelligence algorithms. |
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Person responsible for fidelity review |
The site Master Facilitator or Local Administrator |
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Timeline for fidelity review |
The developers require upgrade training with new software releases and refresher training if there is a lapse in program performance. The Local Administrator or Master Facilitator may require additional demonstrations or training. |
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Program Delivery |
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Number of leaders |
FallScape is conducted one-on-one. A minimum of one FallScape Facilitator is required. Two to four may be involved if separate individuals conduct Screening, Initial Interview, Behavioral Intervention, and FallScape multimedia training elements. |
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Length of course |
Minimum of 4 weeks with a follow-up contact at 6 weeks is recommended, but it is not required. |
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Number of sessions |
Individual multimedia session length varies from 10-30 minutes, and for 1-3 sessions are conducted depending on the attention span of the older adult. Additionally, fully remote administration of the FallsTalk Interview and Behavioral Intervention components may extend the timeline up to 10 weeks. |
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Class size |
1 person |
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Target population |
Older adults at risk for falls. |
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Modes of program delivery |
Fully or partially remote or in-person delivery |
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Content required |
FallScape is a combination of individualized multimedia scripted content, health education and interactive Client resources. |
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Materials for participants |
Clients are provided with individualized multimedia training sessions, a customized workbook, reports, and materials created by the FallScape software. |
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FallsTalk |
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Program administrator/developer |
Brookside Research & Development |
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Contact email |
Info@fallscape.org |
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Contact phone number |
206-317-3173 |
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Program landing pages |
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Program Implementation Requirements |
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License requirements for organizations |
Completion of training results in one year license. Subsequent year license fees depend on the number of users. Continued license renewals maintain the license fee that was in use at the time of the initial training. |
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License requirements for instructors |
Local Administrator: one webinar or in-person session |
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Modes of leader training |
Trainees can elect online webinar, in-person, or hybrid training. |
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Required follow-up trainings for leaders |
Follow-up training is conducted during the last 2-3 sessions of training, assuring that the Interviewer or Facilitator has actual client experience. Refresher training is conducted after each software upgrade; this ensures familiarity with new tools and resources. |
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Program-provided fidelity checklist |
The licensed software provided with training ensures program fidelity using built-in artificial intelligence algorithms. |
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Person responsible for fidelity review |
The site Master Facilitator or Local Administrator |
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Timeline for fidelity review |
The developers require upgrade training with new software releases and refresher training if there is a lapse in program performance. The Local Administrator or Master Facilitator may require additional demonstrations or training. |
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Program Delivery |
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Number of leaders |
FallsTalk is conducted one-on-one, so a minimum of one FallsTalk Facilitator is required. Two to three may be involved if a separate screening and/or initial interview is conducted. |
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Length of course |
A minimum of 4 weeks, fully remote administration may extend the timeline. A follow-up contact at 6 weeks is recommended but is not required. |
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Number of sessions |
Individual session length varies from 5-60 minutes depending on session type (Screening, Interview, or Check-in) and Facilitator skill level. |
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Class size |
1 person |
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Target population |
Older adults at risk for falls |
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Modes of program delivery |
Fully or partially remote, virtual or in-person delivery |
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Content required |
A combination of health education, scripted content, and interactive Client resources |
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Materials for participants |
Clients are provided with a customized workbook, reports and materials created by the FallsTalk software. |
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Healthy Steps for Older Adults (HSOA) |
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Program administrator/developer |
Pennsylvania Department of Aging (PDA) |
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Contact email |
Licensing for Healthy Steps for Older Adults and Healthy Steps in Motion has temporarily been suspended. Please contact the Pennsylvania Department of Aging directly for updates. Existing Licensees: charris@deringconsulting.com All others: wellness@pa.gov |
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Contact phone number |
Existing Licensees: 717-234-0567 |
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Program landing pages |
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Program Implementation Requirements |
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License requirements for organizations |
Organizations must purchase and sign an annual (1 year) contract/license with the Pennsylvania Department of Aging. |
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License requirements for instructors |
HSOA Certified Workshop Leaders (CWLs) become HSOA certified when they complete 3 hours of online training via self-directed learning modules and complete 16 hours (two 8-hour days) by a PDA approved Master Trainer at the licensed provider's site. HSOA CWLs must recertify every 5 years by retaking all required training. HSOA CWLs are not required to have any previous certifications, licensures, or educational background to take the HSOA CWL training. |
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Modes of leader training |
HSOA CWLs are trained in-person with the prerequisite online self-directed training. |
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Required follow-up trainings for leaders |
HSOA CWLs must recertify every 5 years by retaking the entire 16-hour course (2-day training) from a HSOA Master Trainer Organization and may not conduct HSOA unless under an active HSOA license. |
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Program-provided fidelity checklist |
Included in the HSOA CWL Program Manual, available to individuals who take the CWL training |
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Person responsible for fidelity review |
Program providers monitor compliance of all HSOA CWLs in their organization and work with the Master Trainer Organization on any compliance, training, or coaching issues. PDA reviews and discusses with the Master Trainer Organization the results of field monitoring. |
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Timeline for fidelity review |
Program providers collect and review data for each workshop but should review the fidelity checklist with HSOA CWLs on an annual basis. The Master Trainer Organization conducts random field monitoring quarterly. |
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Program Delivery |
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Number of leaders |
One HSOA CWL is the base requirement. Two are recommended as a best practice. Spotters, who do not need to be certified, are required for the physical skills screenings and exercise demonstration portions of the program. The program recommends 1 spotter for every 3-5 participants. |
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Length of course |
HSOA is delivered in two 2-hour sessions. However, it is recommended that HSOA CWLs plan on an additional 30 minutes for each session depending on the number of participants and special needs to complete all portions of the program. The two HSOA sessions may be completed in 1 day or over 2 days; however, the 2 sessions may not be delivered more than one week apart. |
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Number of sessions |
Two 2-hour workshops. However, it is recommended that CWLs plan on additional 30 minutes to accommodate for size of class or special needs of participants. The sessions may not be delivered more than one week apart. |
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Class size |
Up to 25 people. No minimum. The program recommends a minimum of 8 people from a discussion standpoint. |
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Target population |
Adults age 60 and over. Note: would be appropriate for 50 and over to prevent frailty due to early onset of arthritis, or other bone or joint concerns. Program materials available in English and Spanish. |
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Modes of program delivery |
In-person, virtual (see vHSOA) |
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Content required |
All of the content is scripted. Content delivery includes small and large group discussion, storytelling, role play, participant-led activities, and lecture. Content includes home safety, talking with health professionals, medicine safety, healthy eating, exercise education, a physical skills screening test for each participant, and exercise demonstration. |
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Materials for participants |
HSOA participant guide and handouts |
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Back to the top
Virtual Healthy Steps for Older Adults (vHSOA) |
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Program administrator/developer |
Pennsylvania Department of Aging (PDA) |
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Contact email |
Existing licensees: charris@deringconsulting.com All others: wellness@pa.gov |
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Contact phone number |
Existing licensees: 717-234-0567 |
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Program landing page |
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Program implementation Requirements |
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License requirements for organizations |
Organizations must purchase and sign an annual (1 year) contract/license with the Pennsylvania Department of Aging. |
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License requirements for instructors |
vHSOA licensing requirements are the same as HSOA licensing requirements; HSOA Certified Workshop Leaders (CWLs) who want to provide vHSOA must first complete the 3 hours of online training learning modules and 16 hours of virtual Master Trainer Organization led training. This is done over 4 days of 4-hour sessions. Recertification is completed every 5 years. If an HSOA CWL is trained both for vHSOA and in-person HSOA they may recertify either by attending a vHSOA training or in-person HSOA once every 5 years. However, a vHSOA CWL must first be trained in in-person HSOA to conduct an in-person HSOA. |
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Modes of leader training |
vHSOA CWLS receive 16 hours of virtual training by the Master Trainer Organization over four 4-hour days with a prerequisite online self-directed training. |
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Required follow-up trainings for leaders |
vHSOA recertification is completed every 5 years by retaking the entire 16-hour VIRTUAL training. If a HSOA CWL is trained both for vHSOA and in-person HSOA they may recertify either by attending a vHSOA training or in-person HSOA once every 5 years. |
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Program-provided fidelity checklist |
Included in the vHSOA CWL Program Manual, available to individuals who take the vHSOA CWL training. |
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Person responsible for fidelity review |
Program providers monitor compliance of all HSOA CWLs in their organization and work with the Master Trainer Organization on any compliance, training, or coaching issues. PDA reviews and discusses with the Master Trainer Organization the results of field monitoring. |
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Timeline for fidelity review |
Program providers collect and review data for each workshop but should review the fidelity checklist with vHSOA CWLs on an annual basis. The Master Trainer Organization conducts random field monitoring quarterly. |
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Program Delivery |
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Number of leaders |
One HSOA CWL is the base requirement. Two are recommended as a best practice. Spotters, who do not need to be certified, are required for the physical skills screenings and exercise demonstration portions of the program. The program recommends 1 spotter for every 3-5 participants. |
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Length of course |
vHSOA is delivered in two 2-hour sessions. However, it is recommended that CWLs plan on an additional 30 minutes for each session to allow for connecting participants to the virtual platform and setting up camera to demonstrate exercises. The sessions may not be delivered more than one week apart. |
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Number of sessions |
vHSOA is delivered in two 2-hour sessions. The sessions may not be delivered more than one week apart. |
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Class size |
Up to 25 people. The program recommends 12-16 from a virtual screen management best practice. No minimum. The program recommends a minimum of 8 people from a discussion standpoint. |
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Target population |
Adults age 60 and over. Note: would be appropriate for 50 and over to prevent frailty due to early onset of arthritis, or other bone or joint concerns. Program materials available in English and Spanish. |
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Modes of program delivery |
Virtual. Special considerations for a hybrid format would need prior approval from Master Trainer Organization. |
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Content required |
All of the content is scripted. Content delivery includes small and large group discussion, storytelling, role play, participant-led activities, and lecture. Content includes home safety, talking with health professionals, medicine safety, healthy eating, exercise education, a physical skills screening test for each participant, and exercise demonstration. |
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Materials for participants |
Guide and handouts (when providing a virtual program technology capability and access need considered). |
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Back to the top
Healthy Steps in Motion |
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Program administrator/developer |
Pennsylvania Department of Aging (PDA) |
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Contact email |
Existing licensees: charris@deringconsulting.com All others: wellness@pa.gov |
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Contact phone number |
Existing licensees: 717-234-0567 |
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Program landing page |
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Program Implementation Requirements |
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License requirements for organizations |
Organizations must purchase and sign an annual (1 year) contract/license with the Pennsylvania Department of Aging. |
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License requirements for instructors |
HSIM Certified Workshop Leaders (CWLs) become certified to provide the program must complete 16 hours of instructor-led classroom training delivered at the licensed provider’s site by the Master Trainer Organization. CWLs must recertify every three years. Re-certification requires HSIM CWLs to take 16 hours of instructor-led classroom training by the PDA approved Master Trainer Organization. Staff, volunteers, and other laypeople can become CWLs. There are no prerequisite certifications, licensures, or educational requirements to take the HSIM certified workshop leader trainings. |
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Modes of leader training |
In-person |
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Required follow-up trainings for leaders |
Take the full 16 hours training conducted by a Master Trainer Organization every three years to stay certified. HSIM CWLs may not conduct a HSIM workshop unless under a licensed entity. |
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Program-provided fidelity checklist |
Included in the HSIM CWL Program Manual, available to individuals who take the HSIM CWL training. |
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Person responsible for fidelity review |
Program providers monitor compliance of all HSIM CWLs in their organization and work with the Master Trainer Organization on any compliance, training, or coaching issues. PDA reviews and discusses with the Master Trainer Organization the results of field monitoring. |
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Timeline for fidelity review |
Program providers collect and review data for each workshop but should review the fidelity checklist with HSIM CWLs on an annual basis. The Master Trainer Organization conducts random field monitoring quarterly. |
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Program Delivery |
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Number of leaders |
One HSIM CWL is the base requirement. Two are recommended as a best practice. Spotters, who do not need to be certified, are required for the physical skills screenings and exercise demonstration portions of the program. The program recommends 1 spotter for every 3-5 participants. |
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Length of course |
4 or 8 weeks |
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Number of sessions |
60 to 75 minutes |
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Class size |
Up to 25 people. No minimum. The program recommends a minimum of 8 people from a discussion standpoint |
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Target population |
Adults age 60 and over. Note: would be appropriate for 50 and over to prevent frailty due to early onset of arthritis, or other bone or joint concerns. Program materials available in English and Spanish. |
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Modes of program delivery |
In-person for safety and fidelity, a high degree of participant monitoring and coaching is required to ensure that form and intensity are accurate and productive for all participants. |
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Content required |
All of the content is scripted. Content delivery includes group discussion, lecture, exercise demonstration, physical skills screening and coaching. |
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Materials for participants |
HSIM Participant Guide and handouts. |
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Stepping On |
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Program administrator/developer |
Wisconsin Institute for Healthy Aging |
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Contact email |
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Contact phone number |
608-243-5690 |
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Program landing page |
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Program Implementation Requirements |
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License requirements for organizations |
2022 fees:
Fee increases if affiliates are added. WIHA has developed a path for license holder leaders to become master Trainers so that going forward, the license holder organization can train their own next set of Stepping On Leaders. For more information, visit wihealthyaging.org. |
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License requirements for instructors |
Qualifications to become a Stepping On Leader:
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Modes of leader training |
In-person, virtual (both offered) |
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Required follow-up trainings for leaders |
In order to maintain certification, leaders must facilitate at least 1 workshop per 12-month period. If/when curriculum updates are made, leaders must attend an update training as applicable. |
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Program-provided fidelity checklist |
During facilitator trainings, the fidelity checklist is used during practice facilitation. In addition, a key elements quiz is distributed and scored. |
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Person responsible for fidelity review |
Master Trainers conducting a facilitator training are responsible for conducting fidelity coaching sessions for trainees of that training. |
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Timeline for fidelity review |
A fidelity check is scheduled for one of the first sessions of the first workshop to observe the facilitator and provide feedback. In addition, fidelity checks are done for the following circumstances:
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Program Delivery |
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Number of leaders |
2 |
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Length of course |
7 weeks plus 2 follow-ups |
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Number of sessions |
2 hour per session x 7 session |
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Class size |
In-person 10-14 people. Virtual 6-10 people. |
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Target population |
Adults age 60+ (average age well into 70’s) who are: community-dwelling (not in nursing home or assisted living); do not use a scooter, wheelchair, or walker indoors (a cane is fine, and if use a walker only when leave the home, also fine); and are cognitively intact. If participating online, must have a laptop with camera and adequate space. |
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Modes of program delivery |
In-person, virtual |
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Content required |
Scripted content plus 4 guest experts |
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Materials for participants |
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Back to the top
Tai Chi for Arthritis and Falls Prevention |
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Program administrator/developer |
Tai Chi for Health Institute |
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Contact email |
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Contact phone number |
734-558-6283 |
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Program landing pages |
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Program implementation Requirements |
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License requirements for organizations |
Every instructor must have a current two-year certificate from Tai Chi for Health Institute |
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License requirements for instructors |
For more information, visit taichiforhealthinstitute.org |
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Modes of leader training |
Online Lessons, In-Person, Hybrid, Virtual Platform (Zoom) |
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Required follow-up trainings for leaders |
In addition to optional Skills Training In-person or on Zoom, there are many workshops available for the instructors to enhance what they know. However, they must update their certificate every two years. |
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Program-provided fidelity checklist |
Distributed at Instructor Certification workshops or as required. |
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Person responsible for fidelity review |
The instructor’s skills that maintain fidelity are reviewed every two years or at enhancement trainings by TCHI. However, grantee agencies are encouraged to review their instructor’s teaching efficacy. |
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Timeline for fidelity review |
Every two years or more frequently during enhancement trainings (Instructors Skills Trainings) |
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Program Delivery |
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Number of leaders |
One instructor for every 12 participants is best. However, this is upon the instructor’s discretion |
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Length of course |
Minimum of 16 hours (8 weeks x 2 classes) in a session; however, the greater majority extend up to 24 hours (12 weeks x 2 classes) for a more comfortable session. 16 hours attendance is minimum. |
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Number of sessions |
1 hour/session x 16 sessions or 24 sessions |
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Class size |
Comfortably 10-15 people. However, it is the discretion of the instructor. |
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Target population |
Anyone seeking health care management through a safe and evidence-based program. |
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Modes of program delivery |
Online, In-Person, Hybrid, Virtual (Zoom) |
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Content required |
Exercise |
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Materials for participants |
Comfortable, loose clothing and flat-soled shoes. |
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This project was supported, in part by grant number 90FPSG0051 from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.
