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-Replication Guide

Developing a Community-Based Falls Prevention Program:  A Replication Guide from Johnson County, Iowa Sure Steps

This replicable model (completed in 2013) was developed with grant support from the Wellmark Foundation. It is designed to suggest steps you might take to develop and carry out a falls prevention program in your community. Interwoven into this are the steps we took and the lessons we learned. We hope that your journey will be as meaningful to you as our journey has been for us. These materials are in the public domain and may be adapted freely.

Elder Services, Inc., the other Sure Steps coalition members and Wellmark make no warrants and accept no liability in relation to the use of these materials.

Components of The Sure Steps Replication Guide:

The Sure Steps Replication Guide was completed January 7, 2013. To request a digital copy of the guide (278 pages), or any of its components (listed below), please contact Johnson County Aging Services at 319-356-6090 or visit

Sure Steps Replication Guide

Appendix A:  General Project (includes Sure Steps Grant-Written Summary, Sure Steps Membership, Project Timeline Template, Sure Steps Project Presentation)

Appendix B:  Public Awareness  (includes: CDC- What You Can Do, CDC- Home Safety Checklist, Sure Steps general brochure, Falls are Common and Costly, Health Problems and Falls Risks, Osteoporosis and Falls, Basic Falls Prevention slides, Falls Prevention Week, Falls Prevention Week Proclamation, Give the Gift of Home Safety, This Winter do something to prevent falls (bookmark), Program Evaluation sample, Opinion Articles)

Appendix C:  Physical Activity  (includes: NIA-insert forms, Fitness Screening- Protocol, Fitness Screening- Recording Form, Fitness Screening- Result Tables, Fitness Screening- Reference, Matter of Balance-Brochure, Matter of Balance- Coaching Recruitment, 8 Foot Up and Go Test)

Appendix D:  Risk Assessment  (includes: Personal Risk Assessment, Activity-Based-Confidence (ABC) Scale, Barthel Index of ADLs, OASIS ADL/IADL, PHQ-9 Depression Screen, GDS-Geriatric Depression Scale, Mini-Cog Mental Assessment, MAHC-10, Home Safety Evaluation, Risk Assessment Recommendations, Daily Exercise Guide, Medications and Falls Risk, 8-Foot Up and Go Test, Assessment Request Form-sample)

Appendix E & F: Transition Care & Sustainability  (includes:  Transition Brochure, Recruitment Letter)

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