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Healthy Steps for Older Adults (HSOA)

Program Description 

Healthy Steps for Older Adults (HSOA), a program for adults ages 50 years and older and adults of any age with a 

disability, provides screening, assessment, and education to reduce the incidence of falls. The 4-hour 

intervention is offered to interested individuals at senior centers and allied sites. First, participants complete a 

screening questionnaire regarding their current level of physical activity and factors that may impede their 

activity. Next, participants complete a series of three fall risk assessments: the “timed up and go” (TUG), the 

chair stand, and the one-legged stand. Based on their performance on the assessments, participants receive an 

age- and gender-adjusted score indicating their risk for falling. 

Following the screening and assessment, participants attend a 2.5-hour workshop educating them about various 

aspects of fall prevention, including home safety modifications, safe footwear, nutrition for bone health, 

exercise, medication management, and communication with their physician about fall prevention. As part of the 

workshop, certified instructors discuss the results of the screening questionnaire and physical assessments with 

participants, then give suggestions for an appropriate exercise program for each fitness level. For example, for a 

participant with a physical assessment score indicating a low risk for falls, the instructor may suggest a walking 

program; for a participant at moderate or high risk for falls, a balance and strengthening class, a home physical 

therapy program, or an aquatics program may be more appropriate. Each participant also receives a 64-page 

document, A Guide for Preventing Falls. 

After obtaining signed permission from each participant, HSOA staff notify each participant’s physician about his 

or her risk for falls. The notification conveys that screening was done and describes the older adult’s fall risk and 

any other reported risk factors for falls (e.g., taking over four medications, not exercising regularly, having poor 

eyesight). The physician is encouraged to keep the fall risk assessment on file in the patient’s chart and use it to 

discuss a prevention plan with the patient the next time he or she visits the office. Each participant is contacted 

4 weeks after the program to determine if he or she has adopted any new behaviors to reduce the risk of falling. 

Participants in the study reviewed for this summary were older adults ages 50 years and older. 

Descriptive Information 

Areas of Interest Health and wellness 

Outcomes 

Review Date: May 2015 

 Incidence of falls 

 Frequency of self-reported hospital and emergency department (ED) use 

 Costs associated with hospital and ED use 

Ages 

 50–60 (Older adult) 

 61–74 (Older adult) 

 75–84 (Older adult) 

 85+ (Older adult) 
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Genders  Female 

 Male 

Races/Ethnicities 

 Black or African American 

 Hispanic or Latino 

 White 

Settings 

 Church 

 Community-based organization 

 Senior center 

 Other community settings 

Geographic Locations 

 Urban 

 Suburban 

 Rural and/or frontier 

Funding Partially/fully funded by National Institutes of Health 

Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the 

developer. 

Implementation History 

Since the Pennsylvania Department of Aging (PDA) developed HSOA in 2005, the 

program has been implemented in 42 of the 67 counties in the State. It has been 

offered at an estimated 326 senior community centers, 50 senior apartment 

complexes, several independent community and/or religious organizations, YMCAs, a 

hospital, and 2 universities. Approximately 35,000 older adults have received the 

intervention. 

Adaptations 

Some program materials (i.e., participant guide, consent and release form, 

registration form, referral form, workshop evaluation form) have been translated into 

Spanish. 

Quality of Research 

Review Date: May 2015 

Documents Reviewed 

The documents below were reviewed for Quality of Research. The research point of contact can provide 

information regarding the studies reviewed and the availability of additional materials, including those from 

more recent studies that may have been conducted. 

Study 1 

Albert, S. M., King, J., Boudreau, R., Prasad, T., Lin, C. J., & Newman, A. B. (2014). Primary prevention of falls: 

Effectiveness of a statewide program. American Journal of Public Health, 104(5), e77–e84. PubMed abstract 

available at http://www.ncbi.nlm.nih.gov/pubmed/24625164 

Albert, S. M., Raviotta, J., & Lin, R. J. (2015). Cost effectiveness of a statewide falls prevention program: Healthy 

Steps for Older Adults, Pennsylvania. Manuscript submitted for publication. 
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Supplementary Materials 

Albert, S. M., Edelstein, O., King, J., Flatt, J., Lin, C. J., Boudreau, R., & Newman, A. B. (2015). Assessing the 

quality of a non-randomized pragmatic trial for primary prevention of falls among older adults. Prevention 

Science, 16(2), 31–40. PubMed abstract available at http://www.ncbi.nlm.nih.gov/pubmed/24488533 

Albert, S. M., King, J., & Keene, R. M. (2015). Assessment of an interactive voice response system for identifying 

falls in a statewide sample of older adults. Preventive Medicine, 71, 31–36. PubMed abstract available at 

http://www.ncbi.nlm.nih.gov/pubmed/25514548 

Albert, S., & Shelton, L. (2015). Healthy Steps for Older Adults: A statewide approach to preventing falls. Today’s 

Geriatric Medicine, 8(1), 24–27. 

Edelstein, O., Pater, K., Sharma, R., & Albert, S. M. (2014). Influence of urban residence on use of psychotropic 

medications in Pennsylvania USA: Cross-sectional comparison of older adults attending senior centers. Drugs & 

Aging, 31(2), 141–148. PubMed abstract available at http://www.ncbi.nlm.nih.gov/pubmed/24357135 

Stahl, S. T., & Albert, S. M. (2015). Gender differences in physical activity patterns among older adults who fall. 

Preventive Medicine, 71, 94–100. PubMed abstract available at

http://www.ncbi.nlm.nih.gov/pubmed/25535677 

Outcomes 

Outcome 1: Incidence of falls 

Description of Measures 

Incidence of falls was measured two ways: (1) fall-months (i.e., months in which 

participants reported a fall) per 100 person-months of follow-up and (2) fall-months 

per 100 person-months of follow-up adjusted for level of physical activity. (The 

adjustment for level of physical activity was made because greater physical activity 

may put an older adult at greater risk for falls.) Information on falls in the past 30 days 

and physical activity in the past week was collected from participants for up to 12 

months of follow-up (with a median of 7.5 months of follow-up). 

An interactive voice response system was used to elicit information on falls and 

physical activity during a monthly telephone call. Participants were registered in a 

Web-based system and were automatically dialed every 30 days beginning 30 days 

after their baseline interview. A human voice posed questions, which respondents 

answered by pressing buttons on their telephone. With respect to falls, respondents 

were asked the following: “Think about the last 30 days. Did you fall in the last 30 

days, that is, end up on the floor or ground because you were unable to stop yourself? 

Press 1 for yes, 2 for no.” When participants reported a fall, the system generated an 

e-mail message to the research team, which followed up with a telephone interview 

to collect information about the fall, including when and where it occurred. 

For information on physical activity, respondents were asked to think about their

number of active days in the preceding 7 days. Active days were defined as days when 

participants “walked, or did exercises, or did a hobby or volunteer work that involved 
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being on your feet for at least 30 minutes.” Respondents pressed the number on their 

telephone corresponding to their number of active days (e.g., pressing 1 if they had 

been active on 1 day). 

Using reports of physical activity, an “active month” equivalent was constructed (e.g., 

a participant reporting 4 of 7 days of activity in the preceding week would have 16 

days of activity in the month and contribute 0.53 months). 

Key Findings 

The study compared adults ages 50 and older who completed HSOA at various senior 

center sites with a comparison group of older adults from the same sites who did not 

complete the program but participated in other center activities. After adjustments 

were made for sociodemographic characteristics and fall risk factors, such as selfreported balance, falls in the preceding year, and self-reported physical activity, 

findings included the following: 

 The incidence rate (i.e., number of fall-months per 100 person-months) was lower 

for the HSOA group than the comparison group over time (p < .05). Participation 

in HSOA was associated with a 17% reduction in this incidence rate. 

 The incidence rate (i.e., number of fall-months per 100 person-months) adjusted 

for physical activity was lower for the HSOA group than the comparison group 

over time (p < .01). Participation in HSOA was associated with a 19% reduction in 

this adjusted incidence rate. 

 Among participants reporting fair or poor balance, the incidence rate (number of 

fall-months per 100 person-months) adjusted for physical activity was lower for 

the HSOA group than the comparison group (p = .015). Among participants 

reporting better balance, differences between the HSOA and comparison group 

were smaller and nonsignificant but favored the HSOA group. 

Studies Measuring 

Outcome Study 1 

Study Designs Quasi-experimental 

Quality of Research Rating 

(0.0–4.0 scale) 2.9 

Outcome 2: Frequency of self-reported hospital and emergency department (ED) use 

Description of Measures 

Frequency of self-reported hospital and ED use was assessed with monthly telephone 

calls using an interactive voice response system. Participants were registered in a 

Web-based system and were automatically dialed every 30 days beginning 30 days 

after their baseline interview to complete questions on self-reported falls and hospital 

and emergency department use over the prior month. A human voice posed 

questions, which respondents answered by pressing buttons on the telephone (for 

example, the instructions were “press 1 for yes, 2 for no”).

The analysis included all hospital and ED episodes rather just episodes linked to falls. 

Data were categorized in the following way: falls = 0, 1, 2+; hospitalizations = 0, 1, 2+; 

ED visits = 0, 1, 2+. 
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Key Findings 

The study compared adults ages 50 and older who completed HSOA at various senior 

center sites with a comparison group of older adults from the same sites who did not 

complete the program but participated in other center activities. Across the follow-up 

period, the proportion of participants experiencing one or more hospitalizations 

(irrespective of ED treatment) was lower among the HSOA group than comparison 

group (11.3% vs. 14.8%; p = .04). In general, a higher proportion of comparison group 

participants than HSOA participants were in the high-utilization categories. For 

example, a higher proportion of comparison group participants than HSOA 

participants had 2+ ED or any hospital episodes over the 12 months (17.6% vs. 14.7%), 

but this difference was not statistically significant. Also, HSOA participants had fewer 

hospital visits than comparison group participants when they were matched for 

number of falls. For example, among participants reporting 2+ falls, a hospitalization 

was reported by 16.3% of the HSOA group and 24.8% of the comparison group, but this 

difference was also not statistically significant. 

Studies Measuring 

Outcome Study 1 

Study Designs Quasi-experimental 

Quality of Research Rating 

(0.0–4.0 scale) 2.8 

 

Outcome 3: Costs associated with hospital and ED use 

Description of Measures 

Costs associated with hospital and ED use were assessed with monthly telephone 

calls using an interactive voice response system. Participants were registered in a 

Web-based system and were automatically dialed every 30 days beginning 30 days 

after their baseline interview to complete questions on self-reported falls and hospital 

and emergency department use over the prior month. A human voice posed 

questions, which respondents answered by pressing buttons on the telephone (for 

example, the instructions were “press 1 for yes, 2 for no”).

The analysis included all hospital and ED episodes rather just episodes linked to falls. 

For each participant, the total cost, including the cost of the intervention, 

hospitalizations, and ED visits, was calculated. 

Data were categorized in the following way: falls = 0, 1, 2+; hospitalizations = 0, 1, 2+; 

and ED visits = 0, 1, 2+. Costs for hospitalization and ED treatment were calculated 

using the mean cost of the medical events in Pennsylvania during the study period: 

$18,083 for hospitalization and $1,100 for ED treatment. 

Key Findings 

The study compared adults ages 50 and older who completed HSOA at various senior 

center sites with a comparison group of older adults from the same sites who did not 

complete the program but participated in other center activities. The estimated costs 

per participant were $2,928 for the HSOA group and $3,914 for the comparison 

condition (p = .03), a savings of $986 on average per person. 

Studies Measuring Study 1 
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Outcome

Study Designs Quasi-experimental 

Quality of Research Rating 

(0.0–4.0 scale) 2.8 

Study Populations 

The following populations were identified in the studies reviewed for Quality of Research. 

Study Age Gender Race/Ethnicity 

Study 1 

 50–60 (Older adult) 

 61–74 (Older adult) 

 75–84 (Older adult)

 85+ (Older adult) 

 79% Female 

 21% Male 

 88.2% White 

 9.6% Black or African 

American 

 2.2% Hispanic or Latino

Quality of Research Ratings by Criteria (0.0–4.0 scale) 

Criterion 

Ratings 

Outcome 1 Outcome 2 Outcome 3 

Reliability of Measures 2.5 2.5 2.5 

Validity of Measures 2.8 2.3 2.3 

Intervention Fidelity 3.3 3.0 3.0 

Missing Data and Attrition 3.2 3.0 3.0 

Potential Confounding 

Variables 3.0 2.8 2.8 

Appropriateness of 

Analysis 3.3 3.3 3.4 

Overall Rating 2.9 2.8 2.8 
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Study Strengths 

The study included an interactive voice response mechanism for obtaining monthly self-reports of falls and 

hospital/ED use, which minimized problems with event recall. A comparison of a subset of participants showed 

substantial concordance between falls reported in an interactive voice response assessment and an in-person 

telephone assessment in the same month. Fidelity was enhanced across all sites by standardized training for HSOA 

staff in conducting the assessments, providing appropriate physician notifications, and adhering to program 

guidelines on falls education; monitoring of data entry; and select interviews with participants. Nearly all participants 

(97%) completing the baseline provided one or more monthly follow-up assessments, with a median of 7.5 months of 

follow-up and a completion rate of 80%. The study used a quasi-experimental design but compared the groups at 

baseline and found no differences between them in measures of health or fall risk factors. Further, the study 

controlled for some confounding variables (e.g., retrospective reports of falls during the previous year). The study 

had a large sample size and used appropriate analyses. 

Study Weaknesses 

Although there was concordance between falls reported using the voice response assessment and an in-person 

telephone assessment, the lack of pilot testing of the new technology raised issues about reliability (e.g., to 

determine how older adults would use or react to the technology relative to in-person calls). The documents reviewed 

did not adequately describe how well self-reported falls and health services utilization compare with objective 

measures, raising issues about the validity of these self-reports. All-cause hospital and ED utilization was used in the 

analysis rather than utilization linked specifically to falls. The study did not compare the attrited group with those who 

responded to one or more monthly calls. Potential unexplored confounds could have affected hospital and ED use, 

including geographic variation in access to services and insurance status (e.g., Medicare, Medicaid, commercial 

insurance). Costs were calculated using the mean costs of medical events in Pennsylvania during the study period 

without any adjustments for regional or local differences. 

Readiness for Dissemination 

Review Date: May 2015 

Materials Reviewed 

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can 

provide information regarding implementation of the program and the availability of additional, updated, or 

new materials. 

Albert, S. (2011). Comparative effectiveness of a statewide program for primary prevention of falls in older adults 

[PowerPoint slides]. Pittsburgh, PA: University of Pittsburgh. 

Dering Consulting Group. (2013). HSOA master trainer [Workbook]. Camp Hill, PA: Author. 

Dering Consulting Group. (n.d.). Healthy Steps for Older Adults master trainer PowerPoint slides. Available at 

http://deringconsulting.com/subpage.php?link=HSOA 
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Dering Consulting Group. (n.d.). Session evaluation: Train the trainer for Healthy Steps for Older Adults. Camp 

Hill, PA: Author. 

Dering Consulting Group & Pennsylvania Department of Aging. (n.d.). Healthy Steps for Older Adults: Agenda. 

Dering Consulting Group, Primetime Health, & Pennsylvania Department of Aging. (n.d.). Certificate of 

achievement. Camp Hill, PA: Author. 

Healthy Steps for Older Adults. (2012). Healthy Steps for Older Adults: Registration form. 

Healthy Steps for Older Adults. (2012). Healthy Steps Program physical skill screening program. 

Healthy Steps for Older Adults. (2012). HSOA four week follow-up form. 

Healthy Steps for Older Adults. (2012). The Pennsylvania Healthy Steps Program: Referral form. 

Healthy Steps for Older Adults. (2012). Workshop evaluation form. 

Healthy Steps for Older Adults. (2013). Healthy Steps for Older Adults consent and release form. 

Healthy Steps for Older Adults. (2015). Healthy Steps for Older Adults: Physician detailing packet. 

Healthy Steps for Older Adults. (2015). HSOA trainer evaluation form. 

Healthy Steps for Older Adults. (n.d.). Press release template. 

Healthy Steps for Older Adults Train-the-Trainer and Master Trainer [Information sheet] 

Healthy Steps Programs Provider Authorization 

Independent Drug Information Service, Alosa Foundation, Pennsylvania Department of Aging, & Pharmaceutical 

Assistance Contract for the Elderly. (2014). Preventing falls in the elderly: What primary care clinicians can do to 

reduce injury and death [Activity booklet]. Boston, MA: Alosa Foundation. 

Independent Drug Information Service, Alosa Foundation, Pennsylvania Department of Aging, & Pharmaceutical 

Assistance Contract for the Elderly. (2014). Preventing falls in the elderly: What primary care clinicians can do to 

reduce injury and death [Charts and graphs booklet]. Boston, MA: Alosa Foundation. 

Independent Drug Information Service, Alosa Foundation, & Pharmaceutical Assistance Contract for the Elderly. 

(2014). Evaluate gait and mobility using the TUG test. Boston, MA: Alosa Foundation. 

Independent Drug Information Service, Alosa Foundation, & Pharmaceutical Assistance Contract for the Elderly. 

(2014). Preventing falls in the elderly: Home safety checklist. Boston, MA: Alosa Foundation. 
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Long Term Living Training Institute (LTLTI) Web site with access to the HSOA Training Modules, 

http://www.ltltrainingpa.org/

Pennsylvania Department of Aging. (2006). Pennsylvania’s Healthy Steps for Older Adults: A guide to preventing 

falls (2nd ed.). Berkeley, CA: The Regents of the University of California. 

Pennsylvania Department of Aging. (2013). Train-the-trainer: Evaluation comments. 

Pennsylvania Department of Aging. (n.d.). Email template for recruitment. Harrisburg, PA: Author. 

Pennsylvania Department of Aging. (n.d.). Working to keep the commonwealth falls free [Brochure]. Harrisburg, 

PA: Author. 

Pennsylvania Department of Aging, Pharmaceutical Assistance Contract for the Elderly, Independent Drug 

Information Service, & Alosa Foundation. (2014). Preventing falls and mobility problems [Brochure]. Boston, MA: 

Alosa Foundation. 

Pennsylvania Department of Aging & PrimeTime Health. (2013). Dear doctor letter. 

Pennsylvania Department of Aging & PrimeTime Health. (2013). Dear doctor letter: Fax cover sheet. 

Pennsylvania Department of Aging & PrimeTime Health. (n.d.). Pennsylvania’s Healthy Steps for Older Adults: 

Preventing falls [Flier]. 

Pennsylvania Department of Aging & PrimeTime Health. (n.d.). Stay active: Health promotion and education for 

older adults. Harrisburg, PA: Pennsylvania Department of Aging Education & Outreach Office. 

Program Web site, http://www.aging.pa.gov/aging-services/health-wellness/Pages/Healthy-Steps-for-OlderAdults.aspx 

University of California, Berkeley, & Pennsylvania Department of Aging. (2006). Train-the-trainer for Healthy 

Steps for Older Adults. Berkeley, CA: The Regents of the University of California. 

University of Pittsburgh, Center for Aging and Population Health Web site, 

http://www.caph.pitt.edu/programs/falls-prevention/
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Readiness for Dissemination Ratings by Criteria (0.0–4.0 scale) 

Criterion Rating 

Implementation Materials 3.9 

Training and Support 3.8 

Quality Assurance 3.7 

Overall Rating 3.8

 

Dissemination Strengths 

The participant guide is well-written and presented in a format that is easy to understand and appropriate for older 

adults. It contains guides and checklists for exercises, diet, home safety, medication safety, and communication with 

one’s physician. For the three physical screening tests that are described, instructions on how to implement the tests, 

score them, and share results with participants are clearly defined. The train-the-trainer manual identifies the roles 

and responsibilities of all program implementers and offers guidance on participant recruitment, workshop 

preparation, and data collection and management. Program fidelity is strengthened through a combination of 

required online and in-person trainings for implementers as well as an annual field observation. Ongoing support is 

available by the developer via phone, email, webinars, and unlimited access to training videos. The in-person portion 

of the training provides a hands-on approach for workshop leaders to demonstrate knowledge of the program and 

practice administering physical screenings. Training is also available for master trainers once a year. Quality assurance 

is strengthened through the use of data-driven decisionmaking; implementers are instructed on how to use 

questionnaires, evaluations, and referral forms to meet the needs of the participants. In addition, implementers enter 

participant data into a Web-based system, which allows the developer to track program outcomes. 

Dissemination Weaknesses 

Although the developer supports implementation of the program outside of Pennsylvania, several of the program 

materials are written specifically for implementers in the State. In addition, it is unclear how the data entry forms will 

work for sites in other States, as the forms are meant to be submitted to the State of Pennsylvania. It is also unclear 

whether implementation sites have access to the data entry system to monitor their own data for program 

improvement. 

Costs 

The cost information below was provided by the developer. Although this cost information may have been 

updated by the developer since the time of review, it may not reflect the current costs or availability of items 

(including newly developed or discontinued items). The implementation point of contact can provide current 

information and discuss implementation requirements. 
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Implementation Materials 

Item Description Cost 

Required by 

Developer 

Initial program enrollment (includes 1 year of 

licensing and site registration, use of Web-based data 

management system, program monitoring, startup 

kit of 25 participant guides, unlimited access to online 

resources such as videos and trainings, participation 

in webinars, and program updates) 

Contact the developer Yes 

Annual site license renewal (includes everything 

listed above except startup kit of 25 participant 

guides) 

Contact the developer Yes 

Three prerequisite online training modules plus a 2-

day, on- or offsite training (includes train-the-trainer 

manual, participant guide, and all program forms) 

For onsite training, the cost is a flat 

fee for a group of up to 25 people, 

plus travel expenses; for offsite 

training (provided in Pennsylvania), 

the cost is per person for a 

minimum of 10 people; contact the 

developer 

Yes 

Participant guides Contact the developer; discounts 

for bulk orders available Yes 

Train-the-trainer manuals Contact the developer No

Marketing DVD, Healthy Steps Fall Prevention 

Program $12 each No

Phone and email guidance and consultation on topics 

such as individual program implementation, 

recruitment, marketing, and best practices 

Contact the developer No

Additional Information 

If fewer than 10 people register for offsite training, the training may be cancelled with full refunds given. 

Translational Work 

Healthy Steps for Older Adults, which began as a demonstration project developed by the Pennsylvania 

Department of Aging and Health Research for Action at the University of California, Berkeley, was pilot-tested in 

three Pennsylvania counties from 2005 to 2006 to address concerns for the State’s rise in baby boomers and the 

resulting potential for an increase in falls. The project resulted in a two-part comprehensive falls prevention 

program. The first was designed to screen older adults and provide fall prevention education. The second 

provided opportunities for older adults to improve their strength and balance through participation in an 
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exercise program called Healthy Steps in Motion. From this project, A Guide to Preventing Falls was revised and 

published in both English and Spanish to promote implementation throughout Pennsylvania. 

PDA, in partnership with the Pennsylvania Department of Welfare, has engaged more than 35,000 older adults 

in Pennsylvania in HSOA since 2005. Now a statewide initiative, HSOA has been nationally recognized with the 

American Public Health Association Award, the National Health Information Award, the Council of State 

Government Silver Award, and the National Media Bronze Award. HSOA has also attracted attention from other 

entities interested in forming partnerships with PDA. For example, through a partnership between PDA’s 

Education and Outreach Office and Pennsylvania’s Prescription Assistance Program for older adults, a toolkit and 

continuing education model were developed to educate physicians on fall prevention. Other States have also 

expressed interest in implementing the intervention. Given the growing interest in HSOA, plans are underway to 

expand the HSOA Master Trainer training to sites outside of Pennsylvania. 

Since 2009, evaluations of HSOA workshops implemented by Area Agencies on Aging (AAA) and other senior 

sites throughout Pennsylvania have been conducted annually by Dering Consulting Group. These evaluations 

show that HSOA participants tend to be mostly White, female, and ages 70–79, with an annual income of less 

than $25,000. The 2011, 2012, and 2013 evaluation reports summarize data collected from the State’s online 

databases on the implementation of HSOA workshops conducted in 50 of the 67 counties in Pennsylvania with 

approximately 19,950 adults ages 50 and older. Data are gathered using the following instruments: 

• Registration Questionnaire administered prior to the first workshop to assess participants’ demographics, 

medical risk factors for falls, initial physical activity levels, and quality-of-life issues 

• Physical Skills Assessment of three fall risk factors––gait, muscle strength, and balance––conducted by staff 

and volunteers 

• Feedback Survey completed by participants at the conclusion of the HSOA workshop to measure knowledge 

gains and program satisfaction 

• Referral Form completed by HSOA staff to recommend participants for visits to medical providers or other 

fall prevention services 

• Four-Week Follow-Up Interview Form completed by staff, volunteers, or participants to identify changes 

participants have made in home safety, physical activity, health care visits, nutrition, and referrals after 

attending the workshop 

Across the 3 years of Dering Consulting Group’s evaluation, HSOA program participants reported worrying about 

falling before participating in the HSOA workshop. After the workshop, they reported satisfaction with the 

information on exercises to prevent falling and regarded becoming more active as a very helpful prevention 

strategy. Findings also demonstrate that HSOA staff provide referrals for physician visits or medication reviews 

to program participants who request additional information. At the 4-week follow up interview, HSOA 

participants reported modifying their home environments to mitigate fall hazards, visiting their doctors to 

discuss concerns, reviewing their medications with their doctor or pharmacist, eating healthier foods, and 

stretching and exercising more. Program recruitment is conducted through outreach by senior center staff, 

referrals from AAA staff and housing facility staff, referrals from health care providers, flyers, newspapers, and a 

mailed brochure. 
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Efforts to reach minority groups such as Hispanic/Latino older adults have been implemented by several AAAs in 

Pennsylvania by recruiting staff to facilitate HSOA workshops in Spanish, offering HSOA to Foster Grandparent 

Volunteers, and conducting workshops after Sunday services at a local Hispanic/Latino church. 

Site With 

Translational 

Work 

Articles Describing Site’s Translational Work, by Category 

Planning/ 

Partners Adoption 

Reach/ 

Recruitment Implementation Effectiveness Maintenance 

25 

Pennsylvania 

AAAs serving 

4,341 older 

adults 

Article 1 Article 1 Article 1 Article 1 Article 1 —

30 

Pennsylvania 

AAAs serving 

3,652 older 

adults 

Article 2 Article 2 Article 2 Article 2 Article 2 —

35 

Pennsylvania 

AAAs serving 

2,962 older 

adults 

Article 3 Article 3 Article 3 Article 3 Article 3 —

AAA sites 

throughout 

Pennsylvania 

Article 4 Article 4 Article 4 Article 4 Article 4 —

Article 

Number Article Reference 

1 

Dering Consulting Group. (2012, June). Healthy Steps for Older Adults. 2010–2011 Statewide 

AAA/Senior Center Partnership Final Evaluation Report. Unpublished manuscript. 

2 

Dering Consulting Group. (2013, June). Healthy Steps for Older Adults. 2011–2012 Statewide 

AAA/Senior Center Partnership Final Evaluation Report. Unpublished manuscript. 

3 

Dering Consulting Group. (2014, June). Healthy Steps for Older Adults. 2012–2013 Statewide 

AAA/Senior Center Partnership Final Evaluation Report. Unpublished manuscript. 

4 Healthy Steps for Older Adults Translation & Dissemination. (n.d.). Unpublished manuscript. 
14

Contacts 

To learn more about implementation, contact: 

Education & Outreach Office, Pennsylvania 

Department of Aging 

(717) 783-1550 

RA-AIPRIMETIMEHEALTH@pa.gov 

To learn more about research, contact: 

Steven M. Albert, Ph.D. 

Graduate School of Public Health, University of 

Pittsburgh 

(412) 624-3100 

smalbert@pitt.edu 

Additional program information can be obtained through the following Web site: 

http://www.aging.pa.gov/aging-services/health-wellness/Pages/Healthy-Steps-for-Older-Adults.aspx