Data Collection Process for Wisconsin Stepping On Leaders


Fall 2018 Data Collection ~ Less materials to distribute and a streamlined process!

We will send (12) copies of everything you need. This will include instructions, informational sheets, a script, copies of the Baseline Questionnaire and separate Questionnaires to administer at the 7th session, the Attendance Log, and a pre-labeled return envelope.

The packet will be sent to the individual you list on the Workshop Notification Form for your Stepping On workshop.  



In the meantime, here’s a short summary:

  1. At the first session, you will distribute the shorter 5 page "Baseline" Questionnaires.  Please refer to the "Tips & Talking Points" and "Why Data Collection is so important" with information about the study and when participants have questions regarding the information they are filling out.
  2. At the end of the last (7th) session, you will ask participants to complete the 2 page “Post Program Survey”.
  3. You will make copies of the first four pages of each Baseline questionnaire and Attendance Log and give to your county aging unit/ADRC to enter into the “SAMS” system.
  4. You will send all of the original completed questionnaires ("Baseline" and “Post Program Survey”) and the Attendance Log to WIHA in the envelope provided.


The biggest things to note with this updated process is the elimination of the "Falls Behavioral Scale"  (which was previously disseminated 3 times throughout the 7 week workshop) and the Booser-Session Materials.  Also, our Walgreen's gift card supply is runing down to the end and we will no longer be distributing these once the supply runs out.

As always, we will keep participants’ names and contact information confidential and filling out the questionnaires is completely voluntary and participants are not required to do so to participate in the program.  

We will send the the person designated on your Workshop Notification Form the data collection packet about a week before the start of your workshop with additional information.  

Please let us know if you have any questions after reading through the materials. Thanks for all you do help prevent falls among older adults in Wisconsin!


Morgan Walsh, Adminstrative Assistant,



Forms and Instructions to print if you are short on time or need more than 12 sets:


Stepping On Data Collection Protocol (PDF) October 2018

Tips & Talking Points & Why Data Collection is so Important (PDF) October 2018

Attendance Log  (PDF) October 2018

Stepping On Baseline Questionnaire for Session 1   (PDF) October 2018

Post Program Survey for Session 7 (PDF) October 2018






Fidelity Coaches will use this Fidelity Monitoring Tool for your fidelity coaching session at Session 3, 4, 5, or 6, as appropriatey scheduled.



Workshop Evaluation - ALL WISCONSIN COUNTIES:

Make a copy for each participant and distribute at Session 7. Invite participants to complete and then collect and review for your own purposes. You do not need to send them to WIHA.

Workshop Participant Evaluation