Presented by the Wisconsin Institute for Healthy Aging, Wisconsin Department of Health Services, and their partners Betsy – welcome. Webinar for potential leaders, sponsoring organizations or other partners in the Living Well with Chronic Conditions high-level evidence-based health promotion program.

Why is Stepping On Needed? 1 in 3 adults aged 65+ falls every year Falls-related injuries are the leading cause of death in Wisconsin for older persons Majority of falls occur at home Falls are not a normal part of aging; they are preventable Betsy – not to mention emotional….. CAN be prevented if use multi-facotiral approach.

Consequences of Falls 40% of nursing home admissions had a fall in the prior 30 days WI Hospital and ED visits = $800M each year 70% of costs are borne by Medicare & Medicaid Cost of doctor visits, time off work, caregivers, etc., in addition to ED costs Emotional toll Fear of falling leads to reduced activity and isolation, causing and increased risk for falls Betsy

The Stepping On Program Developed in Australia by Dr. Lindy Clemson, OT Tested/implemented in community setting 2-hour sessions once a week for 7 weeks Follow-up home visit Follow-up booster session 8-12 participants Led by 2 trained Leaders Valeree

Stepping On Evidence-based Meets AoA’s highest standard Developed by Dr. Lindy Clemson and Megan Swann Brought to U.S. by UW’s Dr. Jane Mahoney Developed over years of: pilot-testing refinement evaluative research VAL Super quick. Means researched in randomized clinical trials. PROVEN to work when implemented same way.

Stepping On’s Core Principles Facilitation to effect behavior change Decision-making as a process Principles of adult education Self-efficacy as a tool for change Mastery experience as a tool for change Group process Preventive Framework Val

Outcomes Intervention group: 31% reduction in falls Maintained confidence in more mobile ADL tasks Used more protective behaviors After 14 months 59% still doing exercises 70% followed up with home visit recommendations More subjects had vision checks Less likely to start taking new psychotropic drug Val

Target Population Age 60+ At risk of falling Has fallen in past year or has a fear of falling Lives in own home or apartment Cognitively intact Walks independently or with cane; walker occasionally or for outdoor use Speaks and understands English or the language in which the class is being provided VAl

Stepping On is CDC-Approved because it’s “Multifactorial” Strength and Balance Exercises Vision Medication Review Home Modification VAL Guest experts of PT, Vision specialist, Community Mobility Specialist, Pharmacist

Topics Building trust, risk appraisal Strength and balance exercises, homework Home hazards and safety modifications Community safety Bone health Medication management Sleep medication alternatives Safe footwear and safe clothing Vision and falls VAL Guest Experts assist with some of these.

Stepping On: By the Week 1. Introduction, Overview, Choosing What to Cover 2. The Exercises and Moving About Safely 3. Advancing Exercises and Home Hazards 4. Vision and Falls, Community Safety and Footwear 5. Medication Management, Bone Health and Sleeping Better 6. Getting Out and About 7. Review and Plan Ahead VAL

Dissemination in Wisconsin Began in Wisconsin in 2007 Range of agencies offer the workshop Range of sites host the workshops Range of professionals or lay individuals who serve as leaders VAL

Leader Qualifications and Characteristics Health care provider, aging network professional, public health educator, or fitness instructor Experience leading groups of older adults Can demonstrate exercises, modify, and advance Comfortable tightly following manual Betsy

Leader Expectations Attend entire 3 full-day Leader training Work with a sponsoring organization Lead workshops in pairs, both trained or 1 + peer Lead at least 2 workshops each year Follow program manual Secure and distribute weights to workshop participants Prepare and use a Stepping On Display Copy and distribute Exercise Manual and handouts Invite, prepare, and host 4 guest experts Follow WIHA administrative protocols Betsy

Are You Ready? Identify the local sponsoring organization Have 2 individuals trained or ready to be trained as Leaders Communicate with the local ADRC/aging unit to coordinate Together, review the Planning Guide (see next slides) VAL– Who are Leaders or individuals willing to be leaders? Who is sponsoring org? Do you have a “team” ready, willing and able to take on these tasks? Or will the Leader(s) be able to handle it all on their own. Consider – next slide

Stepping On Leader & Local Partner Organization Planning Guide Identify local sponsoring organization If not the county ADRC/aging unit, make contact with it Identify 2 Leaders – already trained or need training? Select dates and times for first workshop Select and reserve site, room, room arrangement Will workshop be free or a fee? What agency will submit workshop notification to WIHA? What agency will receive workshop registrations? Continued... VAL - Consider: public transportation availability? Parking? Accessibility to people with disabilities? Storage space? A-V and flipcharts? Refreshment supplies (coffee pot, cups, pitchers)

Stepping On Planning Guide, cont’d Outreach and Marketing See WIHA website materials – don’t reinvent the wheel Presentations Health care provider recommendations Supplies needed Display Exercise Manual and other weekly handouts Projector / DVD player Easels, blank flipchart pads Refreshments Data Collection materials Funding Needed? VAL OUTREACH and MARKETING: perosnal invites, brochures, posters, presentations, radio, newspaper, newsletter – PERSONAL REFERRALS

BA See? From website, hover over FOR LEADERS ONLY, then click on SO

Website for Leaders www.wihealthyaging.org Click on FOR LEADERS AND COORDINATORS Click on Stepping On BA

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Betsy: The WIHA website’s public site also lists all the workshops available to the public. They’re listed in the order they start, but as you can see, anyone can sort them by type of workshop, or by county.

Support for Leaders WIHA website Listserv WIHA Leader Newsletter Regular Leader conference calls or meetings where available Technical assistance Leader Coaching and Fidelity Coaching Healthy Aging Summit VAL – WIHA and partners have developed significant support for Leaders and counties as they implement their workshops.

Leader Training Come in pairs, or alone only if county already has a trained Leader with whom to partner 3 full days – must attend all to learn: Evidence base for falls prevention Underpinning concepts of Stepping On Curriculum for Stepping On Group facilitation techniques, including practice Marketing, recruiting, partnership strategies Learn WIHA protocols and support available During first workshop, may have fidelity coaching session Betsy

Leader Training – To Apply: Leader Application – link on WIHA website Complete application; pay fee Commit to requirements Attend in pairs, unless already a leader in county With Sponsoring Organization, complete Planning Guide 20-person limit Betsy

WIHA Collects Data On: Leaders Workshops Participants Why? Funders Policymakers Program planning Betsy – you may need it locally when seeking partners or support

? ? ? Questions ? ? ? Betsy Abramson 608-243-5691 betsy.abramson@wihealthyaging.org Valeree Lecey 262-785-2577 valeree.lecey@gwaar.org Anne Hvizdak 715-677-3037 anne.hvizdak@dhs.wisconsin.gov Betsy – WIHA Deputy Director, Anne – EBPP Statewide Coordinator, Jill – GWAAR T.A. and a MT,

We look forward to working with you to expand Stepping On in Wisconsin THANK YOU! We look forward to working with you to expand Stepping On in Wisconsin