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Partnership for Healthy Aging 


Fidelity: Keep All of Your Ducks in a Row
by Patti League, RN, A Matter of Balance Lead Trainer 

As a Master Trainer for the Matter of Balance Volunteer Lay Leader Model program (MOB/VLL), you know the importance of maintaining program fidelity. We like to use the analogy of making sure "a duck remains a duck” when referring to fidelity. 

The core elements to maintain fidelity to the MOB/VLL program include:

Additional Fidelity Tips


  • Exercises: Follow the directions in the Coach Handbook when leading all the exercises. Mention coaching tips when leading the exercises.

  • The "Leg Lift to the Side" exercise is done with the toe on the ground. Change the name of this exercise to "Leg Slide to the Side."

  • Exercises should be done in the order in the book. This requires the participants to transition from sitting to standing, which is a very important exercise in itself.

  • No music during exercises since this may make it difficult for participants to hear the instructions or they may keep the beat and work outside their comfort zone.


  • Coaching observations should always be prearranged with each class. It allows for the coach to prepare class participants for this visit.

  • Coach Update should be done at least yearly by each Master Trainer to refresh and educate your coaches. This is an opportunity to recognize their contributions to your program.

Guest Healthcare Professional Visit
  • Guest Healthcare Professional visit should be arranged for each class. Master Trainers should arrange this for their coaches.

  • Session 4 or 7 are a natural fit but any session can accommodate this visit. The Guest Healthcare Professional should always review how to get up from the floor using Handout 7.3.

  • Refer to the new Guest Healthcare Professional Job Responsibilities handout.





The National Council on Aging (NCOA) Center for Healthy Aging defines fidelity as "being faithful to the elements of the program, in the way it was intended to be delivered."
This includes maintaining the essential core elements of the program and delivering the program consistently across program leaders and sites.

Download the Matter of Balance Core Elements to Maintain Fidelity Handout (pdf)

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