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Matter of Balance Report
Written by Amanda Walker
Purpose of Class
A Matter of Balance (MoB) is a course designed to help participants identify risk factors for falls, manage
concerns about falls, and learn how to prevent falls. MoB is an Evidence-Based Program, which means
that it is based on research and has been proven to provide health benefits to participants. Because this
is an evidence-based course, participants are required to attend at least 5 of the 8 classes to benefit
from the material. Course participants will learn that falls and fear of falling are controllable.
Participants will also learn to set realistic goals to increase activity, to change their environment to
reduce fall risk factors, and to exercise to increase their strength and balance. Each two-hour session
covers a different topic about falls and includes group discussion activities, information and resource
sharing, and facilitator-lead exercises. Some weeks may even feature a special guest like a healthcare
professional. All in all, MoB is a comprehensive course aimed to increase health and safety in the lives of
adults.
Planning Process
Thanks to support from AmeriCorps and the City of Seattle, the PNA Village will deliver a Fall Prevention
program for our members in 2014-15. AmeriCorps Volunteer Coordinator and Fall Prevention Lead will
attend “A Matter of Balance” training and become a certified trainer in September 2014. The plan is to
present the course to village members in the Winter 2015, and again in the Spring 2015. A
communication plan was written to plan out the various steps in advertising the class, reserving rooms,
scheduling guest speakers, scheduling participants, and coordinating with Senior Services. (See Appendix
I.) After the initial training the AmeriCorps member received additional coaching in class facilitation and
presentation skills from a Village volunteer who specializes in trainings. The AmeriCorps member
studied the Lay Leader handbook and met with the coach every week for two months before she was to
present the course. The AmeriCorps member also observed 3 classes of a Matter of Balance course
already in progress, to gauge how a typical class should run. Village members were given priority when
signing up; non-village members were placed on a waiting list until a specified date, per each session,
about 2 weeks before the course started. All promotional material said the course was capped at 15, but
once 15 was reached there were some people who really wanted to join and they were admitted to the
course. Since the class did not fill up 15 spaces with village members, the people on the waiting list
made it into the course. Session 1 had 17 people registered and session 2 had 17 people registered.
Presenters
This course was presented by newly trained lay leader and AmeriCorps member from the PNA Village,
Amanda Walker and Rocky Jorgensen a Registered Nurse assigned from Senior Services. Rocky
Jorgensen is part of the Enhance Wellness program with Senior Services. Luckily each session had the
opportunity for special “health expert” guests to present. The health experts were Cindy Coffin-Greenig,
a Physical Therapist and Village Volunteer; and Lisa Stuebing, a personal trainer specializing in senior
fitness. The special guests each presented for 30 to 40 minutes in the later classes of both session 1 and
session 2. Lisa presented during the 5th
class in session 1 and the 6th
class in session2, while Cindy
presented in 8th
class in session 1 and the 7th
class in session 2. They were able to bring expertise and a
fresh face to the course that the participants really appreciated and learned from.

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Course Agenda
A Matter of Balance emphasizes practical strategies to reduce fear of falling and increase activity levels.
Participants learn to:
 view falls and fear of falling as controllable
 set realistic goals to increase activity
 change their environment to reduce fall risk factors
 exercise to increase strength and balance.
Session 1 classes will be presented on Tuesdays, March 3, 10, 17, 24, 31 and April 7, 14, 21 from
12:15pm to 2:15pm, located at the PNA Center.
Session 2 classes will be presented Thursdays May 7, 14, 21, 28 and June 4, 11, 18, 25 from 10:30am to
12:30pm, located at the Greenwood Senior Center.
Topics and learning goals covered during each session:
Class 1: Introduction to the Program
Goals
 Explain how class will work, welcome group members, and make them feel comfortable
 Introduce group members to the concept of helpful and unhelpful beliefs about falls and
concerns about falling
Class 2: Exploring Thoughts and Concerns About Falling
Goals
 Learn that there are different ways to think about falls and concerns about falls
 Realize the importance of recognizing our core beliefs about falls before we are able to
change them
Class 3: Exercise and Fall Prevention
Goals
 Understand the importance of exercise in preventing falls
 Identify the barriers to exercise for older adults
 Identify which exercises are best suited for fall prevention
 Experience MoB exercises as an example of activity well suited for fall prevention
Class 4: Assertiveness and Fall Prevention
Goals
 Recognize three important physical risk factors for falls: low blood pressure, leg weakness,
and poor flexibility and balance
 Understand exercises that can be used to prevent falls due to low blood pressure, leg
weakness, and poor flexibility/balance
 Recognize the relationship between assertive behavior and fall prevention
Class 5: Managing Concerns About Falling
Goals
 Learn how to use Personal Action Planners to staret an exercise program
 Learn about balance exercises that can be used as part of an individualized exercise program
 Recognize misconceptions and unhelpful thoughts about falling and the effect those
thoughts have on feelings and actions
 Learn how to shift from self-defeating thoughts to self-motivating thoughts

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Class 6: Recognizing Fall-ty Habits
Goals
 Review goals for MOB class and plan topics for next few classes
 Determine which activities are and are not fall risk-taking behaviors
 Prioritize risk-taking behaviors to be addressed and changed
 Identify thoughts that help change behavior
 Learn ways to shift from negative to positive or helpful thinking
Class 7: Recognizing Fall Hazards in the Home and Community
Goals
 Recognize potential fall hazards often present in the home and community
 Identify strategies to reduce physical hazards in the home and community
 Recognize the relationship between assertive behavior and fall prevention
Class 8: Practicing No Fall-ty Habits/Putting It All Together
Goals
 Practice assertiveness skills in locating and using resources for fall prevention and seeking
help after a fall
 Model and practice behaviors in order to eliminate risk-taking behaviors
 Review material discussed during the class
 Recognize physical and psychological changes that have resulted from participating in a
Matter of Balance and how they have affected fear of falling.
Each 2 hour class covers a different topic surrounding falls and is comprised of group discussion
activities, information and resource sharing, and facilitator lead exercises. A Matter of Balance is what is
known as an Evidence-Based Program, this means that it is based on research and has been proven to
help prevent the occurrence of falls in older adults. Because this is an evidence-based course,
attendance of at least 80% of the classes is required for the participants to benefit from the material.
Participants
There were a total of 34 participants who started the MoB course with 26 completing the course and
the post survey. Session 1 had a completion rate of 65% and Session 2 had a completion rate of 88%, see
table 1. The participants were made up of 20 Village members, 13 Greenwood Senior Center members
and 1 nonaffiliated community member. All participants were over the age of 60 and ranging from 65 to
91, the median age was 76 and the average age was 78. Despite the average and median skewing older,
the younger the participant the more likely they were to complete the course, see table 2. More
participants in the older bracket ended up either dropping out or not completing the course, while the
younger brackets had a higher rate of completion. Of the 34 participants, only 3 were men, all 3
completed the course. 25 of the participants lived alone while 9 lived with one other person. Only one
participant lived 13 miles from the center, indicating that most of the participants lived in the Phinney
area or a nearby neighborhood, all in about a 5 mile radius of the presentation sites. All but 4 of the 34
participants considered themselves Caucasian, non-Hispanic.
Table 1 Number of
Participants
Number who
Completed
Percent who
Completed
Session
1 17 11 65%
2 17 15 88%

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Table 2 Number of
Participants
Number who
Completed
Percent who
Completed
Age Group
< 65 1 1 100%
65-74 13 12 92%
75-84 12 10 83%
85+ 8 3 38%
Appendix II shows the full results of the demographics for Session 1 and Session 2.
Outcomes
Participant were asked to fill out a survey during the first class. The pre survey consisted of 4
demographic questions and 7 questions about their thoughts and perceptions concerning falls. The
same seven question were on the post survey which was given at the last class, or earlier if the
participant indicated that they could not attend the final class. Member’s names were connected to the
responses to determine if there was any change between the two surveys. Upon completion and
analysis there was demonstrated learning, an improvement in at least one question from pre to post
survey, in all participants who completed the course. This was determined by tracking each participants’
answer from the pre survey to the post survey. The analysis below is from the sessions as a whole
looking at the 26 participants who completed the MoB course.
In looking at an the amount of exercise a participant was engaged in, it seems that participants who
were already exercising 3 or more times each week were more likely to complete the program, with an
83% completion rate, while people who were exercising less than 3 times each week were less likely to
complete the program. See table 3.
Table 3 Number of
Participants
Number who
Completed
Percent who
Completed
Amount of exercise
per week
n = 34 n = 26
<3 times/week 10 6 60%
3+ times/week 24 20 83%
Of the 26 participants who completed the course 11 participants attended all 8 classes in the series,
while 35% of participants attended 7 of the 8 classes. All but one person attended the recommended 5
classes, the number of classes did not seem to alter that participant’s learning from the material, as the
participant showed improvement in 3 of the 7 questions with no change among the other 4 questions.
Participants were encouraged to attend as many classes as they could. See table 4
Table 4 Number of
Participants
Number of all
Participants
Percent who
Completed
Classes attended n = 26
4+ Classes 1 26 100%
5+ Classes 3 25 96%
6+ Classes 2 22 85%
7+ Classes 9 20 77%
8 Classes 11 11 42%

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Table 5, 6 and 7 outline the changes in responses from the pre-survey to the post survey. In all but one
area, at least 50% of participants indicated an improvement in their thoughts about falls. Most notably
the 62% increase in participants’ feeling that they would be able to protect themselves if they were to
fall since completing the MoB course. In looking at the participants opinion of them becoming steadier
on their feet there was only a 31% increase with most participants not changing their answer between
the pre and post survey. This question also had the largest decrease with 12% of participants feeling that
perhaps they couldn’t become steadier on their feet. Perhaps more emphasis could be put on the
benefits to exercise and how it can help with the issue of steadiness in older adults.
Changes from Baseline to end of Program. Table 5
How sure are you that… Number Percent
I can find a way to get up if I fall n = 26
Increase 14 54%
No Change 11 42%
Decrease 1 4%
I can find a way to reduce falls
Increase 15 58%
No Change 10 38%
Decrease 1 4%
I can protect myself if I fall
Increase 16 62%
No Change 8 31%
Decrease 2 8%
I can increase my physical strength
Increase 14 54%
No Change 11 42%
Decrease 1 4%
I can become steadier on my feet
Increase 8 31%
No Change 15 58%
Decrease 3 12%
On the question about concerns of falls interfering with social activities the decrease is a more desirable
outcome. The way the question is worded, in increase shows that participants are more concerned or
fearful about falls and thus alter their behavior. 31% of participants indicated that they were less
concerned about falls after completing the MoB course. See table 6.
Changes from Baseline to end of Program. Table 6
To what extent has your concern
about falling interfered with your
normal social activities
Number Percent
Increase 3 12%
No Change 15 58%
Decrease 8 31%

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There was not a large increase in exercising from the pre to post survey, only 4 participants indicated an
increase in their exercise. Most of the participants stayed within the “no change” category. This could be
indicative of the results from table 3, showing that a majority of the participants were already exercising
or walking 3 or more times per week, and thus there was no change from pre to post survey. See table
7.
Changes from Baseline to end of Program. Table 7
How often are you walking or
exercising now?
Number Percent
Increase 4 15%
No Change 19 77%
Decrease 3 8%
Overall the results show that participants are learning from the Matter of Balance course. The majority
of the results show that participants either improved in their score or did not change from the pre to
post survey. Despite the few decreases from pre to post results it would seem that the Matter of
Balance course does facilitate growth and a change in opinion concerning falls for older adults.
See Appendix III for results from the pre and post survey for both sessions.
Recommendations
2015 was the first year the Village AmeriCorps member was required to present the A Matter of Balance
course, therefore all promotional material, documentation, and planning material were created this
year. Initially the AmeriCorps member was planning to present A Matter of Balance in January, however
she was hospitalized at the end of September and was out for 3 weeks, thus pushing all plans back by
about a month. The lay leader training was in September and ultimately it was about 5 months between
training and the presentation of the course. It is suggested that the next AmeriCorps present A Matter of
Balance sooner so that there isn’t such a large gap between training and presenting. When prospective
participants call about the class it should be explained that the class is like a support group for people
who have fears or concerns about falling, with an exercise component and information sharing to
combat the negative thoughts around falling. In the first session 5 people dropped out because the
course was too slow, repetitive, or they already had access to similar programing in their assisted living
facility. While some attrition is to be expected, giving as much information as possible is important to
avoid sign-ups from people who may not need the course. Also is it suggested that the AmeriCorps
member and the co-facilitator make time to plan who will present which topics for each class. A short
phone call the day before each class was a solution the two co-facilitators made between Session 1 and
Session 2. Trying to figure it out before or during class was not very successful. Taking time to really
learn the material will make for a more successful course, the participants will appreciate it and so will
the co-presenter.

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Appendix I: Fall Prevention Program Communication Plan
Objective Method Implementer Deliverable Date
1. Training  Receive training in
Matter of Balance
 Vol. Coor. &
Senior Services
 Receive
training
materials and
certification
 Sept.2014x
2. Communication
plan
 Generate interest in a
Fall Prevention
course.
 Gauge member
interest in Fall
Prevention course,
best days/time to
schedule
 “More information”
article in Blog and
village newsletter
 Ad placed on Village
webpage
 Vol. Coor. &
Newsletter
 Vol. Coor.
 Vol. Coor
 Anna Maria-
webmaster
 Fall/Winter
Village newsletter
article
 Article in PNA
Review
 Survey monkey to
members-best
times
 Blog & newsletter
article
 Change Village
Website
 Sept.2014x
 Nov 2014x
 Oct.2014x
 Dec 2014x
3. Planning/scheduling  Get rooms booked for
Session 1 (Mar-Apr)
and Session 2 (May-
Jun)
 Contact SS letting
them know when
MoB will be
presented
 Notify members when
MoB will be
presented
 Observe some MoB
classes, to see how a
typical class should
go.
 Vol. Coor &
Emily/Cat/Terry
 Vol.Coor
 Vol. Coor &
MSSTs
 Senior Services
&Vol. Coor
 Room
confirmations
 Email SS
 Email/mail
members, post
online, flyer, and
newsletter
 Attending the
classes on specific
dates
 Dec. 2014x
 Dec 2014x
 Jan-Febx
2015
 Feb 2015x
4. Coordination with
guest speakers
 Contact and confirm
their interest in
presenting with MoB
 Vol. Coor.
 Lisa
Stuebing(Coach)
 Cindy Coffin-
Greenig (PT)
 Email
 In-person
meetings
 Jan 2015x
5. Present MoB  Get members
registered and
confirmed for MoB;
Wait list
 Vol. Coor.  At least 16
members
registered for
each session
 Feb 2015x
 March-
June 2015

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 Assemble materials
from Senior Services
and present MoB
 Vol. Coor &
Senior Services
Vol.
 All materials
present at
sessions
6. Collect and
assemble data
 Hand out surveys to
MoB participants
 Beginning survey
 Ending survey
 Report data for
AmeriCorps
Outcomes
 A/C Q2
 A/C Q3
 A/C Q4 – leave data
for 9/15 report
 Vol. Coor  Survey results
 Collect from
100% participants
 Submit data for
quarterly reports
 July 2015
3/16/15x
6/13/15x
Appendix II
Session 1 Participants

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Session 2 Participants

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Appendix III
Session 1 Pre-survey Results

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Session 1: Post-survey Results

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Session 2 Pre-survey Results

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Session 2 Post Survey Results

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