Enhancing Accessibility and Confidence Through Innovative Training

“A Matter of Balance” stands as a pivotal program offered by UT Extension, designed to address and manage the concerns surrounding falls among participants. Initially conceived to be delivered entirely through in-person training, the unforeseen challenges of COVID-19 necessitated a swift adaptation. This led to the creation of a comprehensive website, supplemented by strategic social media engagement and Zoom sessions, to facilitate both virtual and hybrid training solutions. This initiative underscores our commitment to accessibility and the well-being of our community, ensuring that vital training can continue uninterrupted, regardless of external circumstances.

Leadership and Innovation in Program Development

Strategic Project Leadership

Oversaw the entire creative project lifecycle, from its inception to successful deployment, adapting swiftly to changing needs due to COVID-19.

Implemented strategic creative direction to navigate the project through unprecedented times, ensuring the program’s objectives were met innovatively.

Creative Excellence and Team Dynamics

Directed design efforts, developing branding, design, and content that resonated with the program’s mission and audience.

Led a talented team of creatives, fostering a collaborative environment to drive the project forward with creativity and purpose.

Resource Management and Quality Control

Managed creative funding efficiently, allocating resources to maximize impact and reach of the program.

Upheld the highest standards of quality across all project facets, from digital platforms to training materials, ensuring a seamless and enriching user experience.

Engagement and Communication

Maintained open lines of communication with a broad spectrum of stakeholders, from internal teams to external partners, ensuring collaborative success and alignment with project goals.

Handled project scope and reporting with diligence, offering transparency and accountability throughout the development process.

Digital Strategy and Outreach

Spearheaded the web development and UI/UX design, creating an intuitive and user-friendly platform that supports virtual and hybrid training formats.

Optimized online visibility through targeted SEO practices, enhancing the program’s accessibility to those in need.

Orchestrated a custom content management system and provided technical consulting, ensuring the platform’s reliability and ease of use.

Leveraged social media and social marketing to extend the program’s reach, engaging with the community and promoting the availability of virtual training options.

Content Creation and Research

Directed the production of engaging graphic design and photography, visually capturing the essence of the program and its benefits.

Conducted thorough research to inform content development, ensuring all materials were informative, accurate, and supportive of the program’s goals.

The “A Matter of Balance” program exemplifies UT Extension’s adaptability and dedication to community health and safety. Through strategic leadership, innovative digital solutions, and a commitment to quality and accessibility, we have successfully transformed a challenge into an opportunity, providing valuable training to those managing concerns about falls in a flexible and inclusive manner.

Relevance

Falls are the leading cause of unintentional injury death among older adults who make up nearly 17% of Tennessee’s population. About 30% of older adults in Tennessee fall each year. Of these, approximately, one-third will sustain life-threatening injuries, such as hip fractures and traumatic brain injuries. Rural residence is increasingly risky for the nearly 40% of older adults living in Tennessee’s rural areas. Tennessee leads the nation in rural hospital closures per capita and is 2nd nationally in number of rural hospitals closed. Rural hospital closures leave vulnerable older adults without access to emergency care after a fall and limited healthcare access during recovery. This makes increasing access to fall prevention programs critically important for rural older adults. 

In Tennessee, falls among older adults amount to $885 million in total costs, including $623 million to Medicare, $141 million to Medicaid, and $121 million in private or out-of-pocket costs. Tennessee’s fall death rate of 66 per 100,000 older adults translates to more than 3,000 deaths over a five-year period – 3,000 deaths that may have been prevented or delayed with improved access to evidence-based prevention. 

Response

Fear of falling and low confidence in one’s balance are risk factors for falling. Fear causes people to limit physical activity and reduce social activities. Reduced physical activity leads to declines in physical functioning and increased fall risk. Community-based fall prevention programs, like A Matter of Balance (MOB), help older adults maintain their independence and increase confidence in ability to prevent and manage falls. MOB is an 8-session evidence-based program designed to help people manage concerns about falls and increase physical activity. Participants learn to set realistic goals to increase activity, change their environment to reduce fall risk factors, and learn simple exercises to increase strength and balance. UT Extension is implementing MOB in communities across Tennessee through a 3-year, $286,214 fall prevention grant from the Administration for Community Living. 

MOB classes are co-facilitated by teams of two trained instructors called Coaches. Since April 2021, 63 new MOB coaches were trained, bringing the total number of UT Extension-affiliated Coaches to 70 and expanding potential program access from six to 56 counties. The group of 70 trained MOB Coaches includes 58 agents and 12 volunteers. Twenty-five Coaches (18 agents, 7 volunteers) conducted 18 MOB workshops in 2021. In-person workshops were conducted in 12 counties; 1 virtual workshop was conducted. 

Results

Eighteen MOB workshops in 2021 reached 192 participants, with estimated medical cost savings for program completers totaling $180,096. 

Paired-samples pre- and post-class surveys indicated the following positive changes in participant outcomes: 

• 22% improved overall health
• 33% decreased fear of falling
• 48% increased confidence to reduce falls
• 51% increased confidence to manage a fall
• 51% increased confidence in ability to improve balance 
• 43% increased confidence in ability to increase physical strength
• 27% reported fall concerns interfered less with social activities

As a result of participating in A Matter of Balance:

• 95% of participants were more comfortable talking to a healthcare provider about falls; 92% were more comfortable talking to family and friends
• 95% were more comfortable increasing physical activity and plan to continue exercising
• 77% made safety modifications in their home
• 82% felt more satisfied with life 
• 99% would recommend the program to a friend or relative

Public Value Statement

Through UT Extension, Matter of Balance (MOB) Coaches are trained and teach fall prevention programs in Tennessee communities. MOB Coaches increase program access, particularly for rural older adults. When older adults participate in MOB, they increase knowledge, reduce fear, and increase physical activity, which reduces fall risk. Because older adults experience fewer falls, they have fewer serious injuries and maintain independent living, resulting in public cost savings for Medicare and costly long-term care.