A Matter of Balance

A Matter of Balance is an evidence-based health promotion group program for older adults that uses cognitive-behavioral techniques to reduce the fear of falling. The program was originally developed by the Roybal Center for Research in Applied Gerontology at Boston University and the New England Research Institutes with funding from the National Institute on Aging. The program is a comprehensive approach to maximizing activity engagement and function and reducing fall risks, and is designed for small groups of older adults living independently in community settings or senior housing. Coping strategies are taught that focus on the fear of falling and ways to reduce the risk of falling, including changing attitudes and self-efficacy, as well as exercising to improve balance and strength. A replication model of the original program has been developed for easy implementation in community settings. The Matter of Balance/Volunteer Lay Leader (MOB/VLL) program is a replication of the original MOB program using volunteer lay leaders as facilitators.

The Matter of Balance/Volunteer Lay Leader (MOB/VLL) program is designed to reduce the fear of falling, stop the fear of falling cycle, and improve the activity levels among community-dwelling older adults. The goal of the program is to use volunteer lay leaders as facilitators, in order to make the program affordable to offer in the community setting.

When following up one year after the program, participants reported significant gains in fall management and there was a trend to increased exercise level as well. In addition, participants sustained a reduction in monthly falls.

A study was conducted to examine whether A Matter of Balance, a cognitive-behavioral program previously found to be efficacious in a randomized clinical trial (RCT), could be translated into a community-based volunteer lay leader model and achieve outcomes comparable to those found in the RCT. Overall, there are strong indications that A Matter of Balance, facilitated by volunteer lay leaders, benefits the older adults who participate in several ways. According to evaluations, key measures of success for participants include improvements in their (1) Confidence concerning their ability to manage the risk of falls and actual falls by increasing physical strength; (2) Steadiness and ability to find a way to get up if a fall occurs (i.e., fall management); (3) Confidence about performing everyday activities such as going up and down stairs, reaching into cabinets or closets, or carrying bundles from the store (i.e., fall efficacy); (4) Beliefs about their ability to prevent falls and overcome their fear of falling (fall control); and (5) Level of regular exercise.

Participants made significant gains in all of these areas six weeks after participating in A Matter of Balance/VLL. Six months following the class, participants reported a decrease in monthly falls, in addition to sustaining their gains with regard to fall management, efficacy, and control and exercise levels.

One full year after taking A Matter of Balance/VLL, participants reported sustained significant gains in fall management and there was a trend to increased exercise level as well. In addition, participants sustained a reduction in monthly falls a full year after participating in MOB/VLL.