Fall Prevention and Reduction of Fall Risk in Older Adults: Efficacy of Stepping on Program

Purpose: Does involvement in the falls prevention program "Stepping On" reduce risks and mitigate falls prevention in older adults? Falls are the leading cause of accidental injury and death of individuals 65 and older. Falls contribute to the leading cause of loss of independent living in older adults. The Stepping On Program was originally developed by Australian Dr. Lindy Clemson and is an evidence-based healthy aging program approved by the U.S. Administration on Aging and the Centers for Disease Control and Prevention. The Wisconsin Institute for Healthy Aging provides training as well as issues licenses for operation of Stepping On North America. The target population of the Stepping On Program are community residing, cognitively intact, older adults who are at a risk of falling, have a fear of falling, or have fallen once or more in a year. The Stepping On Program consists of seven weeks falls prevention workshops lasting two hours each week; a home visit or follow-up phone call by the program leader; and a two hour booster session three months following the seven week program. Desired outcomes of the Stepping On Program include increased knowledge of factors contributing to falls, identification of how environment can be changed in order to eliminate or reduce falls, and overall reduction of falls by older adults.

Methods: A descriptive study using a reflective framework in which past participants of Stepping On falls prevention program in a senior citizen center in the United States answered survey questions pertaining to effectiveness of program three months to one year after completion of program. Subjects were non-randomly selected. The survey consisting of 14 questions was distributed by hand to past participants aged 55 to 75 years of age. Surveys were distributed and collected over four weeks. Participants' were anonymous. (n=11). Two IRB applications were submitted and approved.

Results: Seventy three percent of those surveyed were 75 years of age or older. Eighty-two percent of participants indicated participation in an exercise program helped prevent falls. Out of those surveyed, 64% had not fallen in the past 12 months but continue to worry about falling. A year past completion of Stepping On, 36% of the participants experienced falls caused by imbalance.

Conclusion: Of those surveyed who participated in the Stepping On Program resulted in 64% reduction of falls over one year. Eighty-two percent of participants indicated participation in an exercise program helped them to prevent falls. (Exercise is an integral tactic for falls reduction and prevention in the Stepping On Program). An evaluation of the Stepping On Program was published in the September 2004 issue of the Journal of American Geriatrics Society. Clemson (2004) found those completing Stepping On experienced 31% reduction of falls; thus concluding that the Stepping On Program is effective in preventing falls in community residing older adults. Sixty-four percent reduction of falls over one year of those surveyed is a positive indicator that the Stepping On Program is contributing to reducing risk and mitigating falls in older community residing adults in the United States.