Enhancing Successful Adoption and Effective Outcomes in Fall

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					A Matter of Balance/Lay Leader

                 Patti League
  MaineHealth’s Partnership for Healthy Aging
    Program Manager A Matter of Balance
          Thursday, June 10, 2010
     A Matter of Balance

 8 session class designed to reduce the fear of
  falling and increase the activity levels of older
  adults who have concerns about falls.
 AoA funded translational research to developed
  lay leader model.
 Outcomes demonstrate significant improvement
   – falls self-efficacy
   – falls control
   – falls management
   – exercise level (6 months)
   – monthly falls (12 months)
     A Matter of Balance Class

Designed to benefit community-dwelling older adults who:
     Are concerned about falls
     Have sustained a fall in the past
     Restrict activities because of concerns about falling
     Are interested in improving flexibility, balance and
     Are age 60 or older, ambulatory and able to problem-
During 8 two-hour classes, participants learn:
     To view falls and fear of falling as controllable
     To set realistic goals for increasing activity
     To change their environment to reduce fall risk factors
     To promote exercise to increase strength and balance
      A Matter of Balance

What Happens During Sessions?
• Group discussion
• Problem-solving
• Skill building
• Assertiveness training
• Sharing practical solutions
• Videotapes
• Exercise training
     Cognitive Restructuring
          (Bandura and Lachman, 1997)

• Method of turning negative thoughts into
  positive thoughts
• Need to define barriers, obstacles when
  engaging in a new behavior
• Identify strategies for overcoming the
• Plan realistic/feasible experiences so you
  can experience success
     A Matter of Balance
 Volunteer Lay Leader Model

Model Program Adaptations:
 Classes taught by volunteer lay leaders, called coaches,
  instead of healthcare professionals
 Participant workbook developed and coach manual
 Exercises modified
 Healthcare connection via guest therapist

Maintaining Fidelity:
 Eight hours of coach training based on original MOB
  leader manual
 Master Trainer observes coaches during training and
  while leading a MOB/VLL class
 Use of a mentor model - new volunteer is paired with an
  experienced coach
 Communication, support and sharing outcomes
Dissemination of A Matter of Balance
    Volunteer Lay Leader Model


                   30 Master Trainer Sites
                   83 Master Trainers
                   > 1400 Participants

                   33 States, BC
                   350 Master Trainer sites,
                   750 Master Trainers
                   >15,000 Participants
  Strategic Partners
 Maine’s Department of Health and
  Human Services, Office of Elder
 Maine Center for Disease Control and
 Area Agencies on Aging
 MaineHealth’s Partnership for Healthy
     Evidence-Based Health Promotion Programs

                     Living Well
         (Chronic Disease Self Management Program)

EnhanceFitness                      EnhanceWellness

                                        Healthy IDEAS
 A Matter of Balance
Healthy Choices for ME
Evidence - Based Program Sites

    Living Well (CDSMP)
    Host Organizations
    Living Well (CDSMP)
    Implementation Sites

    Matter of Balance
    Master Trainer Sites
♦   EnhanceFitness Sites
♥   EnhanceWellness

Healthy IDEAs - statewide        ♦
             03.29.10                        ♦
Maine Program Goals

  Create core capacity
  Statewide infrastructure
  Expand access to rural and
   underserved areas
  Develop network of volunteers
  Understand system of
   communication and referral patterns
  Healthy Choices for ME

  For more information contact:

      Ann Clark clarka@mainehealth.org


Visit the State of Maine Office of Elder Services
                     National Outcomes
       (classes conducted February 12th, 2007 and August 13, 2008)

Significant increases in the seven variables
    I can protect myself if I fall
    I can find a way to reduce falls
    I can become more steady on my feet
    I can protect myself if I fall
    I can increase my physical strength
    I do not exercise or walk regularly, but I have been
     thinking about starting; I having been doing
     moderate exercise three or more times per week
    During the last four weeks to what extent has your
     concern about falling interfered with your normal
     social activities?

   Data from: Forty-three organizations from fourteen states
                                     A Matter of Balance/Volunteer Lay Leader
                                       6 weeks              6 months             12 months
                                 Falls Efficacy***     Falls Efficacy***     Falls Efficacy **

                                 Falls                 Falls Management*** Falls
                                 Management***                             Management***
                                 Falls Control **      Falls Control *       Falls Control *

                                 Exercise level ***    Exercise level *      Exercise level NS
                                 modified PACE         modified PACE         PACE

                                 Concern about         Concern about         Concern about
Healy, T. C., Peng, C.,          falling interfering   falling interfering   falling interfering
Haynes, P., McMahon, E.,
Botler, J. & Gross, L. (2008).   with Social           with Social           with Social
The Feasibility and
Effectiveness of Translating     Activities **         Activities *          Activities +
A Matter of Balance into a
Volunteer Lay Leader Model.
Journal of Applied
Gerontology, 27 (1), 34-51.      Monthly Falls NS      Monthly Falls***      Monthly Falls***
(Significant Outcomes in Bold)
                                 + Marginal p= .0516 *p<.05 **p<.01 ***p<.001
Class Evaluation Results
• 97 % - more comfortable talking about fear of
• 97 % - feel comfortable increasing activity
• 99 % - plan to continue exercising
• 98 %- would recommend A Matter of Balance

            What are Mainers are saying?
“I'm more aware of my surroundings and have made
   changes accordingly. To slow down and ask for help
   when needed.”
“Setting goals. Changing attitudes about exercises.”
“I have become much more confident and I look and think
   about what I am going to do.”
Contact Information

 Partnership for Healthy Aging
  465 Congress St, Suite 701
      Portland, ME 04101

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