Stepping On: Building Confidence and Reducing Falls in Older Adults Modified from Wisconsin Protocols and Procedures for Leaders to Prepare Faith Community Nurses to Plan, Prepare for and Lead your Stepping On Workshop Materials are all available on: www.fcnntc.org/programs/steppingon or www.wihealthyaging.org or Leader: Plans, organizes and leads a Stepping On community workshop Local Area Coordinator (LAC): Individual coordinating the Stepping On Community Workshop, which may include coordinating marketing, recruiting, inviting and confirming guest experts, purchasing supplies, refreshments and materials for the workshop Also known as “Partner Organization.” Partner organization for MN FCNs include Vision Loss Resources, Olmsted County and HCMC Indicate final role and contribution here Sponsoring Agency: The agency that the Workshop Leader works form, or if Leader is a volunteer, the agency the volunteer Leader is doing workshop for May or may not be same as “Partner Organization” or the workshop site The “Sponsoring Agency” is the Faith Community Nurse Network for MN FCNs Evidence-Based Prevention Program State Coordinator (SC) – Provides technical assistance to program leaders and program coordinators; assists in the development of marketing toolkits and website; serves as liaison for Diabetes, Arthritis, Heart Disease and Stroke Prevention, Health Maintenance Organization Committees; and fosters relationships with organizations to grow the programs There is no named state coordinator in MN For the purpose of program support, marketing resources and website, the Program Director of the Faith Community Nurse Network will be the FCN general contact and support person Jessica Drecktrah, MHA, MN, RN, FCN Program Director, FCNN Jessica@fcnntc.org or 612-237-4639 Evidence-Based Prevention Program Coordinating Committee: Provides general direction and oversight for overall evidence-based prevention program grant activities Assists in facilitating relationship building between aging units, health care providers, and other local agencies and organizations to grow the programs See committee roster at end There is no evidenced coordinator in MN The FCNN Stepping On Program is supported, in part, by a Live Well at Home grant from Minnesota Department of Human Services For the purpose of program evaluation and support, the FCNN Program Director is working with WIHA and DHS to ensure that FCN nurses follow evidence-based program grant activities and program evaluation as indicated within current contractual agreements Wisconsin Institute for Healthy Aging: a public/private partnership with aging network, University of Wisconsin and health systems that provides permanent home for evidence-based prevention programs in Wisconsin; holds multi-site license for Stepping On; maintains policies and procedures for quality and fidelity; manages data collection; maintains lists of Leaders, trainings, workshops and fidelity; operates research arm (Community Academic Aging Research Network (CAARN) to identify needs, research solutions and disseminate evidence-based practices The Faith Community Nurse Network is a licensed provider of Stepping on through its relationship with WIHA Task Responsibility PLAN AND PREPARE FOR LOCAL WORKSHOPS 1A Identify space and dates for a workshop Leaders and LAC 1B Determine fee, if any LAC 1C Complete and submit Workshop Leader with Notification Form and send to WIHA Local Partner Alternatively, enter on-line on Survey Monkey If any info (dates, location, leader) changes, notify WIHA 1D Begin planning and implementation tasks Leader with for workshop Local Partner -Review and complete Planning and Implementation Checklist -Invite and confirm Guest Experts -Begin preparing Display, including Phrase Bubbles -Review Weights Information and make decision Re: purchase/provision of weights -Copy participant hand-outs, including Exercise Manuals and other materials for first session 1E Market/advertise workshop Local partner organization 1F Register participants Send Registration Confirmation Letter to Participants 1G Communicate with participants prior to workshop, to ensure each individual is appropriate for the workshop and to confirm registration (Optional) Local partner organization Document Note: Those noted with * are in Leader Toolkit and are also available on WIHA website: www.wihealthyaging.org Use either the Workshop Notification Form* Or enter information online at http://www.surveymonkey.com/s/soworkshop -Planning and Implementation Checklist* -Guest Expert Confirmation Letter* -Display Ideas* -Phrase bubbles* -Weights Information* -See Participant Handouts* on website -See Revised Exercise Log* (in toolkit) -Stepping On brochure* -Sample Press Release* -“Tell a Friend” letter* -Registration Form for Stepping On workshop* -Registration Form for Stepping On workshop* -Registrar’s Form* -Registration Confirmation Letter to Participants* Leader and local partner organization 1H Prepare signage for class 1I Notify participants and WIHA if class cancelled, rescheduled or postponed 1J Prepare your Data Collection and Evaluation Documents Leader or local partner organization Leader or local partner organization WIHA CONDUCT WORKSHOP, ADHERING TO MANUAL 2A Post signage, set up display, purchase and Leader and set out refreshments, weights and hand-outs Local Partner Organization 2B Review “Baseline Letter to Workshop Leader Leaders re: Evaluation.” Make and distribute to each participant: -Information Sheet about Evaluation of Stepping On; and -Baseline Questionnaire 2C Administer Baseline Questionnaire Answer any questions Review each questionnaire for completeness Ask participants to complete any missing sections Collect completed Baseline Questionnaires 2D Make copies of the first three pages of Leader, or each participant’s Baseline Questionnaire county aging unit Signage* -Attendance Log* (for Leader) -Baseline Letter to Workshop Leaders re: Evaluation* (one for each participant) -Information Sheet about Evaluation of Stepping On* (one for each participant) -Baseline Questionnaire* (one for each participant) -Signage* -Display Ideas* -Baseline Letter to Workshop Leaders re: Evaluation* (one copy for leader) -Information Sheet about Evaluation of Stepping On* (one copy for each participant) -Baseline Questionnaire* (one copy for each participant) Baseline Questionnaire* Baseline Questionnaire* 2E If you are affiliated with a county aging unit, enter in the attendance information and some of the information from the first three (3) pages of the Baseline Questionnaire (demographic information) into SAMS, the “Social Assistance Management System.” (You will be entering the data required by NAPIS and nothing more Enter in “n” for HNR and “0” for ADL/IDL.) If you are not a county aging unit, and/or not have the capacity to enter it into SAMS, please contact the EBPP Statewide Coordinator for guidance or assistance 2F Enter all participant names onto Attendance Log and record attendance each session 2G Conduct workshop sessions, using appropriate materials, guest experts, display items, weights, etc -Review and adhere to Wisconsin Policies for Facilitation of Stepping On Participant Workshops Leader, or county aging unit Baseline Questionnaire* (first pages) Leader Attendance Log* Leader -Exercise Manual (make copies from Leader Manuals) -Hand-outs, as appropriate (make copies from Leader Manuals) -Display Ideas* -Weights Information* -Wisconsin Policies for the Facilitation of Stepping On Participant Workshop Exercise Log (or use Revised Exercise Log* in toolkit) 2H Collect Exercise Log weekly from each Leader participant and review These not need to be sent to WIHA 2I Optional At the close of Session 7, Leader distribute the Participant Evaluation to each participant, ask them to complete it and then collect them These are for your own personal review You not need to make copies or send them to WIHA 2J Send the following to WIHA after the last Leader Participant Evaluation* -Baseline Questionnaire* session: -Completed Baseline Questionnaires -Photocopy of the Attendance Log Send to: WIHA Data, 1414 MacArthur Road, Suite B, Madison, WI 53714 2K Plan Booster Reunion Session Send out invitations Host session -Attendance Log* Booster Reunion Invitation* EBPP Coordinating Committee Contact Information Betsy Abramson WIHA Deputy Director 1414 MacArthur Road, Suite B Madison, WI 53714 608-243-5691 betsy.abramson@wihealthyaging.org Jill Ballard GWAAR 1311 Spruce Drive Plover, WI 54467 608-243-5689 jill.ballard@gwaar.org Linda Cieslik Milwaukee County Dept on Aging 1220 W Vliet Street Milwaukee, WI 53205 414-289-6874 Linda.Cieslik@milwaukeecounty.com Lyndsay DeKeyser GWAAR 2900 Curry Lane, Suite 414 Green Bay, WI 54311 800-991-5578 lyndsay.dekeyser@gwaar.org Anne Hvizdak DHS EBPP Statewide Coordinator 3104e Lake Helen Drive Rosholt, WI 54473 715-677-3037 Anne.Hvizdak@wisconsin.gov Kelly Johnson WIHA Data Coordinator 1414 MacArthur Road, Suite B Madison, WI 53714 608-243-5689 kljohnson@medicine.wisc.edu Janell Keeter GWAAR 9671 Mill Road Hazelhurst, WI 54531 608-228-8086 janell.keeter@gwaar.org Valeree Lecey GWAAR 125 N Executive Dr., Suite 207 Brookfield, WI 53005 262-432-7978 valeree.lecey@gwaar.org Jennifer Lefeber Milwaukee County Dept on Aging 1220 W Vliet Street Milwaukee, WI 53205 414-289-6352 Jennifer.Lefeber@milwaukeecounty.com Jane Mahoney, M.D UW School of Medicine & Public Health 310 North Midvale Blvd., Suite 205 Madison, WI 53705 608-263-7324 Jm2@medicine.wisc.edu Barbara Murray WIHA Program Assistant 1414 MacArthur Road, Suite B Madison, WI 53714 608-243-5690 barbara.murray@wihealthyaging.org Sherri Ohly Milwaukee Area Health Education Center 2224 W Kilbourn Avenue Milwaukee, WI 53233 414-344-0675 ext 226 sohly@milahec.org Florence Petri Oneida Nation 2907 S Overland Road Oneida, WI 54155 920-869-2448 FPETRI@oneidanation.org Ana Paula Soares Core El Centro 611 West National, Suite 409 Milwaukee, WI 53204 414-384-2673 anapaula26soares@gmail.com Janie Riebe Dane County AAA 2322 South Park Street, Suite A Madison, WI 53713 608-261-9700 Riebe@countyofdane.com Lynne Robertson Safe Communities & Dane County Area Agency on Aging 608-836-9810 Lynnerob@charter.net Gail Schwersenska BADR/DLTC/DHS W Wilson; Room 450 Madison, WI 53703 608-266-7803 gail.schwersenska@wisconsin.gov Becky Turpin DHS W Wilson; Room 450 Madison, WI 53703 608-266-3008 rebecca.turpin@wisconsin.gov Pam VanKampen GWAAR 1351 Valley View Drive Eau Claire, WI 54701 715-836-3916 pam.vankampen@gwaar.org If you have any questions, please contact: Wisconsin Institute for Healthy Aging 1414 MacArthur Road; Suite B Madison, WI 53714 608-243-5690 Fax: 1-866-341-1278 info@wihealthyaging.org www.wihealthyaging.org Thank you for your assistance in implementing and measuring the success of Stepping On