Falls are a serious health risk for older adults. But for those living in rural and frontier areas of the USA, the risks are higher because of limited access to health care providers and resources. This study employed a community-based participatory research approach to develop a fall prevention toolkit to be used by residents of rural and frontier areas without the assistance of health care providers. Qualitative data were gathered from both key informant interviews and focus groups with a broad range of participants. Data analysis revealed that to be effective and accepted, the toolkit should be not only evidence based but also practical, low-cost, self-explanatory, and usable without the assistance of a health care provider. Materials must be engaging, visually interesting, empowering, sensitive to reading level, and appropriate for low-vision users. These findings should be useful to other researchers developing education and awareness materials for older adults in rural areas. 1. Introduction Falls by older adults are a significant public health issue. One-third of adults aged 65 and older fall each year [1]. For older adults, the most frequent cause of admission to a hospital for injury or trauma is a fall, and falls are the leading cause of injury-related death for adults in this age group [1]. Older adults located in rural and frontier areas of the US have increased risk because of limited access to health care providers and resources. Falling Less in Kansas used a three-step community-based participatory research approach to develop a fall awareness and risk reduction toolkit to be used by older residents of rural and frontier areas without the assistance of health care providers. 2. Background Falls can lead to a loss of independence, a decline in physical function and activity, higher rates of nursing home placement, and major economic consequences for individuals and families [2, 3]. The Centers for Disease Control and Prevention (CDC) report, “The state of aging and health in America 2007,” lists fall reduction as one of the top three areas that can significantly improve the quality of life for older adults [1]. In Kansas, fall trends are similar to national trends. Falls are the most common cause of trauma in Kansas and the second-leading cause of unintentional injury-related death, accounting for nearly 20% of such deaths. Of patients admitted to the hospital with a trauma-related fall, more than 40% were discharged to some type of institutional care. Between 2003 and 2007, the fall-related death rate for Kansans aged 85 or older was 158
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