Date Presented 04/22/2023

An efficacy trial for the Stroll Safe outdoor falls prevention program will be presented. Results reveal a significant improvement in knowledge of outdoor fall risks and an increase in safe strategy use for community mobility among participants.

Primary Author and Speaker: Tracy Chippendale

PURPOSE: Outdoor falls present a challenge to the well-being of community dwelling older adults. There are several existing programs that address fall risk. However, despite the differences in risk factors, none of the existing programs specifically targets outdoor falls. To fill this gap, the Stroll Safe program was developed. Stroll Safe is a manualized 7-week group-based program that teaches behavioral strategies to increase safety outdoors. The purpose of this study was to examine the efficacy of the Stroll Safe program.

DESIGN: A multisite RCT was used. Due to a strong risk of contamination within sites, randomization occurred at the site level. Participants: Inclusion criteria were: Age 60 and older, English speaking, community-dwelling, able to ambulate outdoors independently with or without a mobility aid, and must answer ‘yes’ to one of more of the following questions 1) Have you fallen outdoors and hurt yourself in the last year? 2) Have you fallen outdoors two or more times in the past year? 3) Have you had two or more stumbles or trips outdoors in the last month? 3) Are you afraid that you might fall outdoors?

METHOD: Eight Naturally Occurring Retirement Community program sites (N=86) were randomly assigned to the treatment or wait list control group. Outcome measures included the Outdoor Falls Questionnaire (OFQ) and the Falls Behavioural Scale for the older Person (FaB). An ANCOVA was used to compare change scores between groups.

RESULTS: Significant differences (ps <.001) were found between groups for knowledge of outdoor fall risks and safe strategy use. Effect sizes were large (Cohen’s d = 1.2 & 1.9). Results were retained at 6-week follow up.

CONCLUSION: The Stroll Safe program was shown to be effective in improving knowledge of outdoor falls risks and increasing safe strategy use for community mobility.

IMPACT STATEMENT: Stroll Safe fills a gap in outdoor falls prevention and addresses the AOTA priority area of promoting community safety.


Chippendale, T. (2015). Development and validity of the Outdoor Falls Questionnaire. International Journal of Rehabilitation Research, 38(3), 263–269.

Chippendale, T. (2019). Feasibility of the Stroll Safe outdoor falls prevention program. American Journal of Occupational Therapy, 73, 7304205060.

Clemson, L., Cumming, R. G., & Heard, R. (2003). The development of an assessment to evaluate behavioral factors associated with falling. American Journal of Occupational Therapy, 57, 380–388.