1. 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.

2. 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.

3. 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

4. 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

5. 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.

6. 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

7. 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

8. 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

9. 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

10. 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.

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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)

17. 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

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

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

21. BA

22. 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.

23. 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.

24. 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

25. 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

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

27. ? ? ? Questions ? ? ? Betsy Abramson 608-243-5691
Valeree Lecey
Anne Hvizdak
Betsy – WIHA Deputy Director, Anne – EBPP Statewide Coordinator, Jill – GWAAR T.A. and a MT,

28. 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