Shiraz E-Med J. 2021 December; 22(12):e109363. Published online 2021 September 12. doi: 10.5812/semj.109363. Research Article The Effectiveness of the Stepping-On Fall Prevention Program on the Quality of Life, Fear of Fall, and Fall-Preventive Behaviors Among Community-Dwelling Older Adults: A Randomized Clinical Trial Sakineh Gholamzadeh 1, * , Maryam Ebrahimi 2 , Nasrin Sharifi 3 and Masoume Rambod 1 1 Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2 Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran 3 School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran * Corresponding author: Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Email: sakinghsir@yahoo.com Received 2020 December 13; Revised 2021 May 02; Accepted 2021 June 05. Abstract Background: Along with increasing population of the elderly in various countries, the incidence of falls and respective damages has also increased. Objectives: Given the numerous disagreements regarding the effectiveness of different interventions mentioned in various sources, the present study aimed to examine the effectiveness of the Stepping-On fall preventive program on the quality of life, fear of fall, and fall-preventive behaviors among community-dwelling older adults in Shiraz, Iran. Methods: This study is a single-blinded randomized interventional or clinical trial study conducted on 90 elderly people under the coverage of two large health centers during 2019 - 2020 in Shiraz, Iran. Multi-stage randomized sampling was used to select the participants who were randomly allocated to either of the intervention (n = 45) or control groups (n = 45). Data collection tools were the Fall Efficiency Scale, fall prevention behaviors, and Lipad quality of life questionnaires. The intervention group participated in a 7-session Stepping-On program, while the control group received the same routine care. Collected data were analyzed with SPSS software version 22. Results: The findings indicated that the Stepping-On program was effective on the fear of falling scores (P = 0.008) and the quality of life of the elderly under study (P = 0.019) at follow-up time. However, there was no significant difference immediately after the intervention (P > 0.05). However, the mean score of fall-preventing behaviors increased during the course of the study and reached a significant level immediately after the study was conducted (P = 0.046) and the other two months later (P = 0.028). Conclusions: The Stepping-On program may apparently affect the study variables. Therefore, further research is suggested to con- firm the effectiveness of this program so that it can be used across all healthcare centers for the elderly. Keywords: Falls, Fall Prevention, Quality of Life, Fear of Fall, Fall Preventive Behavior, Stepping-On Program 1. Background According to the official reports, the world population was around 7.63 billion people in 2018, and it is still grow- ing in number (1). Iran is no exception to this rule. Ac- cording to the latest report of the Statistical Center of Iran, around 7,300,000 Iranians are of old age, which makes up 9.3% of the national population (2). As the aging popula- tion grows, the health-related issues of older people be- come more prominent and urgent. Falls have been one of the most common of such problems that, depending on the severity of the injury, usually need medical attention (3). Falls are considered the second biggest cause of death by injury (accidental or unintentional) around the world. An estimated number of 646,000 deaths caused by falls are reported each year worldwide, of which a large major- ity (almost 80%) occurs in countries with low or middle in- come (4). In a six-month cohort study in Iran, 7.8% of el- derly people aged 60 years and above reported a history of falls, almost half of them experienced falls once, a quarter had them twice, and the rest had three or more incidents (5). Of all the people who experience falls, 20% to 30% are injured moderately to severely and suffer fractures, lacera- tions, or even traumatic brain injuries (4). Fall is also the cause of 10% - 15% of emergency depart- ment referrals and 50% of hospitalizations due to injuries among people 65 years and older (6). The fall is the result of the interference of several factors. Internal factors (such as Copyright © 2021, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.