Seniors partaking in a fall prevention exercise

Fall Prevention | A Matter of Balance

Many older adults experience a fear of falling. People who develop this fear often limit their activities, which can result in physical weakness, making the risk of falling even greater. A Matter of Balance is a program designed to reduce the fear of falling and increase activity levels among older adults. A Matter of Balance community classes can be offered both in-person and virtually. The in-person Matter of Balance includes 8 two-hour sessions, and the virtual A Matter of Balance includes 9 two-hour sessions. Both the in-person and virtual sessions are led by two trained facilitators for a small group of 8-12 participants. This nationally recognized program was developed at the Roybal Center at Boston University.

MaineHealth provides Master Trainer Training Sessions that prepare organizations to offer A Matter of Balance in their communities. Master Trainers are responsible for teaching the Matter of Balance curriculum to coaches and providing them with guidance and support as they lead the Matter of Balance classes. 

MOB seated exercises Iowa

Who should attend?

The program is designed to benefit older adults who:

  • Are concerned about falls
  • Have sustained falls in the past
  • Restrict activities because of concerns about falling
  • Are interested in improving flexibility, balance and strength
  • Are age 60 or older, community-dwelling and able to problem solve

What do participants learn?

The program enables participants to achieve significant goals. They gain confidence by learning to:

  • View falls as controllable
  • Set goals for increasing activity
  • Make changes to reduce fall risk at home
  • Exercise to increase strength and balance

A Matter of Balance Video

See how the Matter of Balance program helps older adults overcome the fear of falling and increase activity.

Learn about the Matter of Balance Lay Leader Model

The original program, A Matter of Balance: Managing Concerns About Falls, requires a health care professional to lead the classes. The Matter of Balance Lay Leader model uses lay leaders, called Coaches, instead of health care professionals to lead the class. MaineHealth trains Master Trainers who in turn train Coaches to lead the class.

The original program, A Matter of Balance: Managing Concerns About Falls, was developed and evaluated by the Roybal Center for Enhancement of Late-Life Function at Boston University, with a grant from the National Institute on Aging. Under the original model, a health care professional - frequently a nurse or physical therapist - delivered the program.

In October 2003, MaineHealth's Partnership for Healthy Aging, Southern Maine Agency on Aging, Maine Medical Center's Geriatric Center and the University of Southern Maine received grant funding from the Administration on Aging to translate A Matter of Balance into a program that uses volunteer lay leaders instead of health care professionals to deliver the Matter of Balance class. Because the Matter of Balance Lay Leader Model uses volunteer lay leaders instead of health care professionals, it reduces the cost to deliver the program. Therefore, it can be offered more frequently, reaching a significantly higher number of older adults.  

MaineHealth provides master trainer training sessions that prepare organizations to offer A Matter of Balance in their communities. Master trainers are responsible for teaching the Matter of Balance curriculum to coaches and providing them with guidance and support as they lead the Matter of Balance classes.

The Matter of Balance Volunteer Lay Leader Model has proven to be as effective as the original program. Significant improvements for participants were found regarding their levels of falls efficacy, falls management, falls control, exercise and social limitations with regard to concerns about falling.

This model was distributed and evaluated throughout the state of Maine. The collaborative developed a structured tool kit and curriculum as part of a master trainer program. Organizations can be licensed as master trainer sites to train coaches and implement the program in their communities. A Matter of Balance is now offered in 41 states, the District of Columbia, and British Columbia, Canada.

A Matter of Balance Lay Leader Model
Master Trainer Flow Chart

A Master Trainer is responsible for teaching the Matter of Balance curriculum to coaches and providing them with guidance and support as they lead the Matter of Balance classes.

What qualities and experience are necessary to become a Master Trainer?

  • Experience and interest in working with older adults
  • Knowledge about the special needs of older adults
  • Good communication and interpersonal skills
  • Experience with group process and facilitation
  • Comfort with teaching, leading group discussion and role play
  • Willingness to learn about and support the principles and protocols of evidence-based programs
  • Enthusiasm about being a member of a team
  • Dependability
  • Ability to use technology to provide either:
    • Matter of Balance in-person Coach Trainings and/or facilitate community classes including: audiovisual equipment (TV/DVD, overhead projector), and/or
    • Matter of Balance Virtual Coach Training to facilitate virtual community classes including: computer hardware, platform software, cameras, and audio equipment.
  • Ability to perform range-of-motion and low-level endurance exercises and to demonstrate A Matter of Balance exercises
  • Ability to carry up to 20 pounds
  • Life experience valued with an education or healthcare background a plus
You must attend a 20 hour Master Trainer Training session offered by MaineHealth's Partnership for Healthy Aging to earn A Matter of Balance Master Trainer Certification. We recommend that two staff members from an organization be trained to assume responsibility for the program. All materials necessary to implement the Matter of Balance program in your community are provided during the training session. Learn more.

We have trained Master Trainers from 1120 organizations in 46 states, Puerto Rico and the U.S. Virgin Islands. Download a list of organizations in your state that offer the A Matter of Balance Program (excel file).

MOB Map of training sites across the US

Sandy's Story

Sandy shares how the Matter of Balance program helped her regain her ability to participate in the activities she enjoys.

Evidence-Based Programs

A Matter of Balance is among 19 nationally recognized evidence-based programs represented by the Evidence Based Leadership Collaborative (EBLC). The mission of the EBLC is to increase delivery of evidence-based programs that improve the health and well-being of diverse populations.

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