Graduation Date


Document Type

Master's Thesis

Degree Name

Master of Science in Occupational Therapy

Department or Program

Occupational Therapy

Department or Program Chair

Ruth Ramsey, EdD, OTR/L

First Reader

Ruth Ramsey, EdD, OTR/L


Objective: The purpose of this study was to examine the effectiveness of a modified version of the Stepping On fall prevention program in increasing fall self-efficacy and awareness of fall risks in community-dwelling older adults.

Method: This research study utilized a quantitative, quasi-experimental pretest-posttest singlegroup design with a qualitative element. The fall prevention program was the intervention of this study. The Modified Falls Efficacy Scale (MFES) was a pre and post measurement tool. The Timed Up & Go Test (TUG), the Romberg test, and the Saint Louis University Mental Status Examination (SLUMS) were screening tools. Fourteen older adults aged 75 and above participated in the seven-session fall prevention program focusing on topics such as safe footwear, exercises, home hazards, medications, vision, and community mobility. Each weekly session included individualized short-term goal setting.

Results: Participants reported mean MFES pretest scores of 8.61 and posttest scores of 8.14. Although scores on the MFES showed a slight decrease in participant fall self-efficacy, this was not a statistically significant finding. Researcher-developed measures showed an increase in participants’ confidence in their ability to prevent falls. Participants reported they increased their weekly exercise routines and made home modifications after attending program sessions. Approximately 71% of participants reported exercising more as a result of the program and over half (64%) of participants reported making at least one home modification.

Conclusion: A multifactorial, client-centered approach regarding fall self-efficacy, physical activity, and home safety can decrease fall risk and support healthy occupational engagement in everyday living. Occupational therapy can play a critical role in helping older adults in community-based settings to increase their fall self-efficacy and awareness of fall risks.