Evidenced-based A Matter of Balance is designed to reduce fear of falling and increase activity levels among older adults who manifest this concern. This nationally recognized program was developed and evaluated in the 1990’s by The Roybal Center for Enhancement of Late-Life Function at Boston University with a grant from the National Institute on Aging. Professionally led, utilizing physical therapists, occupational therapists, registered nurses, and social workers, this evidence-based, small group health promotion program for older adults uses cognitive-behavioral techniques to reduce the fear of falling. Participant outcomes from the randomized clinical trial included significant improvements in falls management, falls self-efficacy, falls control, increased activity levels and reduction in social isolation. From a community perspective, utilization of healthcare professionals as course instructors made the intervention expensive and difficult to sustain. In 2003, The Administration on Aging awarded several agencies on the east coast funding to translate A Matter of Balance into a program that uses volunteer lay leaders as facilitators instead of healthcare professionals and to serve as an innovative national model for addressing falls prevention.
The core elements of AMOB include (a) cognitive restructuring and behavioral activities that promote the belief that falls and concerns about falling are controllable., (b) enhancing falls self efficacy and falls management by helping participants set realistic goals for increasing activity, (c) promoting changes in their home environment, and (d) teaching exercises are known to reduce the risk of falling by increasing strength and balance. Utilizing a train-the-trainer model, the Partnership for Healthy Aging (PFHA) in Portland, Maine, adopted the program as the “A Matter of Balance/Volunteer Lay Leader model and has made it available to thousands of older adults across 43 states.