BACKGROUND: Wellness program participation may reduce the risk of falling, emergency department-use, and hospitalization among older adults. "On the Move" (OTM), a community-based group exercise program focused on the timing and coordination of walking, improved mobility in older adults, but its impact on falls, emergency department-use, and hospitalizations remains unclear. The aim of this preliminary study was to investigate the potential long-term effects that OTM may have on downstream, tertiary outcomes. METHODS: We conducted a secondary analysis of a cluster-randomized, single-blind intervention trial, which compared two community-based, group exercise programs: OTM and a seated exercise program on strength, endurance, and flexibility (ie, 'usual-care'). Program classes met for 50 min/session, 2 sessions/week, for 12 weeks. Older adults (>= 65 years), with the ability to ambulate independently at >= 0.60 m/s were recruited. Self-reported incidence of falls, emergency department visitation, and hospitalization were assessed using automated monthly phone calls for the year following intervention completion. Participants with >= 1 completed phone call were included in the analyses. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated (reference = usual-care). RESULTS: Participants (n = 248) were similar on baseline characteristics and number of monthly phone calls completed. Participants in the seated exercise program attended an average of 2.9 more classes (p = 0.017). Of note, all results were not statistically significant (ie, 95% CI overlapped a null value of 1.0). However, point estimates suggest OTM participation resulted in a decreased incidence rate of hospitalization compared to usual-care (IRR 0.88; 95% CI 0.59 to 1.32), and the estimates strengthened when controlling for between-group differences in attendance (adjusted IRR 0.82; 95% CI 0.56 to 1.21). Falls and emergency department visit incidence rates were initially greater for OTM participants, but decreased after controlling for attendance (adjusted IRR 1.08; 95% CI 0.72 to 1.62 and adjusted IRR 0.96; 95%CI 0.55 to 1.66, respectively). CONCLUSION: Compared to a community-based seated group exercise program, participation in OTM may result in a reduced risk of hospitalization. When OTM is adhered to, the risk for falling and hospitalizations are attenuated. However, definitive conclusions cannot be made. Nevertheless, it appears that a larger randomized trial, designed to specifically evaluate the impact of OTM on these downstream health outcomes is warranted. TRIAL REGISTRATION: ClinicalTrials.gov (NCT01986647; prospectively registered on November 18, 2013).

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