""""""""Stepping On"""""""" is an effective fall prevention intervention that has been tested in Australia. However, data regarding the use of this intervention in the United States are lacking. This study will examine several questions regarding dissemination including feasibility in rural versus urban settings, feasibility of uptake by different community organizations such as parish nurse, senior housing, or senior center, feasibility and effectiveness of home visit versus phone call following the 7-week class sessions, and effectiveness of the model when delivered by a professional without a health degree. Adherence and outcomes may vary according to different implementation settings, leaders, and populations served. We propose to develop """"""""Stepping On"""""""" for a United States setting, maintaining fidelity with the original program. Our process will begin with focus groups to evaluate existing materials and advise on revisions. In addition, we will seek input from leaders and learners who have piloted """"""""Stepping On"""""""" previously in several Wisconsin sites. Content experts will assist with refinement of materials, and all materials and evaluation tools will again be tested with the focus group. We will pilot implementation in our first setting then revise materials. We will then implement and evaluate """"""""Stepping On"""""""" in three community settings in Wisconsin. In all settings, we will evaluate feasibility of implementation, population served, fidelity to the original model, participant attendance, participant adherence with exercise logs and recommendations, and participant outcomes. In the first setting, a senior apartment community, """"""""Stepping On"""""""" will be implemented by a health-degree professional leader and then by a non-health-degree professional leader. The second and third sites will test implementation by a parish nurse and by a senior center, with one location being urban, and one rural. The first group in each setting will receive a home visit following their 7 sessions, and the second a phone call instead of the home visit. Based on our findings from these evaluations, we will produce a final package of """"""""Stepping On"""""""" for broad dissemination and use nationwide. This proposal builds on our previous collaboration with Dr. Clemson in implementing """"""""Stepping On"""""""" in Wisconsin. In addition, we bring to this proposal a strong history of academic-community partnerships in falls prevention, which has resulted in high quality, fruitful research. Lastly, we bring an established track record in dissemination research in injury prevention through the Injury Research Center in Milwaukee, Wisconsin.
