When Westbrook’s three-year public health prevention services block grant was renewed for a fourth year beginning on Oct. 1, 2018, one of the first things the town’s health director, Sonia Marino, did was embrace the opportunity to extend the reach of her falls prevention program. The town’s annual Election Day flu clinic at the senior center seemed like the perfect occasion to communicate with those heading in to vote but who aren’t senior center regulars, Marino said. So she set up a booth focusing on falls prevention. In addition to information, those who stopped by were rewarded with freebies like non-slip socks, medication containers, and stress balls, all paid for with some of the $1,700-per-year grant funds. A raffle offered prizes of canes, grab bars, and pick-up tools known as “grabbers.” “People were here to vote and to get a flu shot,” she said. “This was a population that we don’t normally get to see that we want to get information out to.” Noreen Saunders, physical therapy supervisor at Westbrook Visiting Nurses (VNA), provided assessments then and there to seniors who had fallen or felt they were at risk for falling. She conducted a series of tests, such as monitoring how many times a person could move from sitting to standing within a timed period, and how long they could walk at a comfortable pace before needing to rest. The testing enabled her to ascertain whether the person was at risk for falling as well as to recommend a program of exercise. She and Courtney Burks, the senior center’s director, demonstrated on a mat the proper way to get up from a fall. “Some of the clients didn’t feel comfortable getting on the floor, but some of them did,” Saunders said. “That’s something they try to incorporate into exercise classes is how to safely get up off the floor.” The senior center offers an hour-long strength and balance training class on Tuesday and Thursday mornings and many of the people in that class turned up on Election Day for the falls prevention information and assessments. Saunders says she will re-evaluate them in a week or two to ascertain how much participation in the class has improved their physical condition and reduced their risk of falling. Also in attendance on Election Day were masters of public health (MPH) students from Southern Connecticut State University (SCSU), who had composed a survey they encouraged seniors to fill out that day. “Falls prevention is very studied,” Marino said. “We have access to a lot of free information. It’s getting that information out to the public and seeing what’s needed for Westbrook. The SCSU students were tasked with going out and finding out what seniors were doing for physical activity.” SCSU’s MPH program is a natural partner for Marino; she holds a master’s degree in public health from SCSU herself. Westbrook has a high percentage of seniors in its population: According to U.S. Census Bureau 2018 estimates, 21.4 percent of the population is 65 years of age and older. The Census Bureau’s 2017 figures indicate that 14.9 percent of the U.S. population is 65 and older. In a small town, Marino said, working with other departments is key, and the goals of the town’s Heath Department closely align with those of the VNA and the senior center. Information gathered via the MPH students’ survey was shared with those departments and made clear that many local seniors were interested in more activities to improve strength and balance. Discussions of those findings between Marino, Saunders, and Burks led to a plan to offer a class designed to prevent falls, Tai Ji Quan: Moving for Better Balance, created by Fuzhong Li at the Oregon Research Institute. The program is adapted from the martial art Tai Ji Quan to focus on balance, mobility, and improving the gait of participants. Saunders and Burks enrolled in a program to train as Tai Ji Quan instructors through Dartmouth-Hitchcock Medical Center in New Hampshire. The training was free, provided they planned to implement the class within a year. They intend to offer the class twice a week at the senior center in the fall. The Tai Ji Quan program is evidence based, Saunders and Burks explained, and has been shown to decrease falls by 55 percent for seniors and 67 percent for those with Parkinson’s disease. Those who sign up for the class will be required to make a six-month commitment to ensure they fully benefit. Some of the funds from the block grant will be used to purchase equipment for the class. The grant will also pay for a presentation on falls prevention to be offered in the spring, Marino said. Past presentations made possible by the grant, including one by a pharmacist who talked about medications that might affect balance, were scheduled for the fall. Marino is hoping with the next one to reach some of the snowbirds who leave Westbrook for the winter. The grant was awarded by the Connecticut Department of Public Health. It’s been renewed, Marino said, because the town demonstrates to the state each year that the funds are put to effective use in improving the health of members of the community.