What Is the "Stepping On" Program?

Medically Reviewed by Poonam Sachdev on June 27, 2022
4 min read

Falls can be dangerous for anyone, especially the vulnerable elderly, who are often part of community-based organizations. These organizations want to prevent falling, and to do so, they need evidence-based programs that help the elderly population. Sometimes, it is hard to find a program that is good for clients, has tools in place, is affordable, and has training available. 

Fortunately, the Stepping On program can promote fall prevention. The Stepping On program implements proven fall-prevention programs based on the goals and needs of the clients.

The Stepping On exercise program consists of a workshop that meets two hours a week for seven weeks. Workshops are led by a health professional and a peer leader: someone concerned about falls and very similar in background to the potential clients. Also, experts that are local to your area may attend to provide information on exercise, safety, vision, and medication. 

The two trained facilitators are usually network professionals, fitness instructors, or health providers. The combination changes depending on the program model chosen.

The program uses a group-type format. It is held in person in the community facility. It involves seven sessions, with accessibility adaptations available. It is available in English, and a Spanish version is under development.

Stepping On is endorsed by the Centers for Disease Control because it has a multifactorial, one-of-a-kind approach. The small group, seven sessions, and community-based workshop for fall prevention are based on behavior change. It is also based on principles of adult education, and a preventative framework. Four crucial domains are addressed by the Stepping On Program:

  • Your strength and balance
  • A review of medications you take
  • Vision review
  • Home improvements for your safety 

The target audience for the program is adults over the age of 60 who are cognitively coherent, live in their own dwelling, and do not use a scooter, wheelchair, or walker inside of the home.

Falls are a significant danger to the independence and health of older adults. Annually, one in three adults over 65 experience falls, and those who fall are more than likely to fall again. Falls are the leading cause of non-life-threatening issues in older adults. One of ten falls causes devastating injuries like a hip fracture. There is physical and emotional pain, and recovery in a long-term facility could take at least a year. Some of those affected may never live alone again. 

Many times, falls are deadly. In older adults, falls are the leading cause of fatal injuries, killing about 25,000 elderly Americans a year. This number has been constantly rising in the US over the last decade. However, falls are preventable. The elderly population is increasing, and more programs need to be in place that teach how to avoid falls. 

The Stepping On program has demonstrated success in preventing falls. 

The program teaches simple and fun balance and strength training and explains how vision and medication contribute to falls, ways to keep from falling when out and about, how to choose safe footwear, and how to eliminate home hazards.

With aging, comes the inevitability of falls. Falls do occur, most often in older adults because risk factors increase with age. Risk factors for falling could involve a biological issue, a behavior problem, or some type of influence from the environment:

  • Biological risk factors: Muscle weakness, balance problems, side effects of medications or interactions, vision changes or loss, neuropathy or loss of sensation in your feet, and chronic ailments like stroke and arthritis     
  • Behavioral risk factors: risky movements like standing on a chair, inactivity, alcohol use, or use of improper equipment for support
  • Environmental risk factors: Poor lighting, no stair rails for support, tripping over clutter, lack of support bars outside of or inside of the shower or tub, or public spaces not designed to help those in need

Most of the time, two or more risk factors come into play and cause a fall. An example would be poor lighting and clutter. The more risk factors in the home, the greater the risk of falling. 

Like most people, you probably pay close attention to avoid falls, but you may not know about some of the increased risk factors of falling. Stepping On addresses these factors and gives information and strategies concerning how to avoid falling.

Studies have shown that the Stepping On program produces a 31% reduction in fall risk. This program may be for you if: 

  • You are 60 years or older. 
  • You are fearful of falling.
  • You live at home.
  • You do not have dementia.
  • You have had a fall in the past year.

Breaking down complex behavioral changes and interventions into practice can come with a loss of effectiveness and fidelity. The CDC has found, though, that this community-based fall prevention intervention program has convincing scientific results of effectiveness. 

These interventions have been summarized, and the CDC compiled them into a publication: A CDC Compendium of Effective Fall Interventions: What Works for Community-Dwelling Older Adults. The CDC wants the help community-based organizations decode this information and implement these proven fall-prevention interventions. 

In 2021, Stepping On was approved for remote delivery development. Now, the Stepping On national license holder Wisconsin Institute for Healthy Aging is building more training packages and complete dissemination packages for those who currently hold a license. This will also be for future license holders seeking to train individuals via Stepping On Online. 

Master trainers, current license holders, and facilitators of Stepping On are now eligible to apply for training. If you think that the Stepping On program is for you, contact your local coordinator, the CDC, or the Stepping On webpage directly.