The Young at Heart Strength Training - A Fall Prevention Program (YAH) is a direct education intervention designed to increase physical activity and reduce sedentary behaviors in older adults age >60 and/or in persons with disabilities. YAH classes meet for 1 hour, 2-3 times per week with at least one day of rest between classes for adequate recovery. There is a minimum of 32 sessions but can be ongoing without an end date. To maintain fidelity, all instructors are certified through an 8-hour training and must complete 4 hours of continuing education provided by Healthy Aging Association through the instructor meetings, which can be viewed via the internet. YAH classes are offered free of charge to all attendees. Classes are progressive and always consist of a warm-up, a movement phase with stretching and balance activities, followed by a cool-down.
Delivery Methods: In-Person or Virtual
Intervention Target Behavior: Physical Activity and Reducing Screen Time
SNAP-Ed Strategies: Direct Education
YAH targets older adults in community settings such as churches, community centers, senior centers, senior housing, etc. In the last 17 years, YAH classes expanded from 4 community-based classes to over 30 in Stanislaus and southern San Joaquin, CA counties. In FY 2019, YAH programming reached 1,465 unduplicated older adults. HAA brings YAH classes and outreach into the county's rural areas to reach the most vulnerable, low-income and underserved older adults. Of older adults served, 83% are female and 17% male, 71% are white non-Hispanic and 17% Hispanic origin, and 38% live in the rural communities. As of 2020, virtual delivery is an option, if in-person deliver is not an option or safe for the public.
Settings: Community-wide
Age/Population Group: Older Adults
Race: All
Ethnicity: All
YAH includes 32 one-hour sessions taught by a trained instructor that involve a dynamic warm-up, strength building exercises, stretches, 4 balance activities, and a cool-down. These intervention components provide the participants ways to increase range of motion, improve balance, strength and reduce falls. The program consists of a minimum of 10 core strength building exercises followed by a stretch and a maximum of 20 strength building exercises depending on the progression level of the class. The 8-10-minute warm-up, 10 core exercises, 4 balance activities, and the 5-8 minute cool-down must be completed in every class. There are a total of 5 different routines for the instructor to choose. The 10 core exercises are done in every single class, the additional exercises 11-20 vary per routine. It takes 2 months to set up the class, coordinate with the sites, train the instructors, and promote the class. We encourage participants to pre-register or sign-up to ensure the class has at least 8 participants prior to starting.
All exercises can be done sitting or standing and utilize resistance bands for most of the exercises. Exercises can be modified to accommodate most levels of function and include instruction from the instructors on how to exercise safely and effectively. Activities are medically, geographically, culturally, and linguistically appropriate for the community's older adult population.
To deliver YAH classes, instructors must have been trained by individuals with Healthy Aging Association YAH certification. Certification allows that Lead Trainer to train others to teach the class (however they cannot train others to teach). To purchase the certification and to set up a training date, all interested organizations must email Healthy Aging Association at healthy.aging2000@gmail.com. A link to purchase the materials will then be sent.
The certification and intervention materials include:
- 12-hour training spread over two days (certification good for one year)
- Lead Trainer Binder
- Digital copy of implementation materials
- Digital Young at Heart Quarterly Instructor Newsletters (4 annually)
- Certified Instructor Manual
- Approved Routines
- Class Forms
- Participant Manual
- Resistance Tubes (3 levels of resistance)
- Poster and half sheet flyer
- Program Brochure
- On-going Materials and Support
- Quarterly Conference calls
- Agenda and materials for all three annual Instructor Meetings
- Timely updates to the manual and/or materials
Community dwelling older adults who participated in the YAH fitness program for one year had better confidence in their balance (p=.012), better functional balance performance (p=.039), and a lower number of falls (p=.004) in a year as compared to their age and sex matched, non-exercising, counterparts. This suggests that exercise alone had a positive effect on the reduction of the risk and number of falls in older adults.
- Comparing Fall Risk of Older Adults in a Community-Based Fitness Program to Non-Participants - Thesis and Abstract
Evidence Base: Practice-tested
Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.
| Readiness and Capacity - Short Term (ST) | Changes - Medium Term (MT) | Effectiveness and Maintenance - Long Term (LT) | Population Results (R) | |
| Individual | MT3 | |||
| Environmental Settings | ||||
| Sectors of Influence |
- MT3j: Aerobic or cardio fitness, muscular strength, muscular endurance and/or flexibility
YAH evaluation materials include:
- Tinetti Fall Efficacy Scale (TFES): Used for all participants during session one of the programs and then again after session 32.
- Participant "spotlight" form: Participants write down physical and mental improvements and how the program has made an impact on their life.
- Rapid Assessment of Physical Activity (RAPA) tool.
To order, email the Healthy Aging Association at healthy.aging2000@gmail.com.
Website: The YAH website includes information on the Healthy Aging Association, their programs, a calendar of YAH classes, and more.
Contact Persons:
Jessica Enes
Program Manager, Healthy Aging Association
Phone: (209) 525-4670
Email: healthy.aging2000@gmail.com
Dianna Olsen
Executive Director, Healthy Aging Association
Phone: (209) 525-4670
Email: healthy.aging2000@gmail.com
*Updated as of August 4, 2023