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Rural Health Information Hub

North Dakota State University Extension

  • Project Title: Stepping On
  • Program Representative Interviewed: Dr. Jane Strommen, Gerontology Specialist
  • Location: Fargo, North Dakota
  • Program Overview: Stepping On is a multi-faceted falls prevention program that helps older adults build strength and assess risk factors to prevent falls. The program includes evidence-based strength and balance exercises, medication reviews, home modifications, and vision assessments. Classes are held in two-hour sessions once per week for seven weeks, co-led by two facilitators. The program is nationally licensed through the Wisconsin Institute for Healthy Aging, and the North Dakota State University (NDSU) Extension holds a license to operate the program in the state of North Dakota.

    NDSU Extension recruits trainers from across the state to lead classes in their local communities. To help expand the program into other rural areas, NDSU Extension uses a train-the-trainer approach and encourages their network of County Family and Community Wellness Agents and community partners to become trainers. Program trainers must complete a three-day Stepping On Leader Training prior to leading classes. A portion of the classes include physical therapists and occupational therapists to assist with exercises, as well as expert guest speakers who discuss specific risk factors related to falls. For example, pharmacists may attend classes to discuss how certain medications can increase the risks of falls.

    The Stepping On program can be adapted to fit participant and community interests. For example, some participants in rural North Dakota were interested in attending their grandchildren's sporting events, which involved climbing metal bleachers. To accommodate these interests, one NDSU Extension class took a trip to a local high school and worked with a physical therapist so that the older adults could practice navigating the bleachers.

    Participants interested in NDSU Extension's fall prevention programming can register online for free classes. Participants can also be referred to programs by health providers or family members. NDSU Extension has expanded its fall prevention programming to include additional evidence-based exercise programs, Tai Ji Quan: Moving for Better Balance and Fit & Strong.

Models represented by this program: