1. WELCOME FROM BINGO to EBP’s: Cynthia Rockey, L.C.S.W., M.Ed. Health Promotion & Resource Manager East Tennessee Area Agency on Aging and Disability A Division of the East Tennessee Human Resource Agency

2. Objectives Discuss the definition and criteria of Evidenced Based Programming (EBP) Identify Evidenced Based Programming (EBP) instrumental in contributing to the health and wellness of older adults. Describe partnerships beneficial to the success and sustainability of Evidenced Based Programming.

3. The National Council on Aging Evidenced Based Programs (EBP) The primary purpose of the Title IIID Evidenced Based Programs is to provide services and activities, which have been demonstrated through rigorous evaluation to be effective evidence-based programs to assist older adults in maintaining a healthy lifestyle. As set forth by the Administration on Aging (AoA), the program shall target elders aged 60 and older for education and implementation activities that support healthy lifestyles and promote healthy behaviors. According to the AoA, health education reduces the need for more costly medical interventions. Source Older Americans Act of 1965

4. Criteria for and Importance of Evidenced Based Programs (EBP) Minimal Criteria: Demonstrated through evaluation to be effective for improving the health and wellbeing or reducing disease, disability and/or injury among older adults; and Ready for translation, implementation and/or broad dissemination by community-based organizations using appropriately credentialed practitioners. Intermediate Criteria: Published in a peer-review journal; and Proven effective with older adult populations using experimental or quasi-experimental design; and Some basis in translation for implementation by community level organization.

5. Criteria for and Importance of Evidenced Based Programs (EBP) cont’d Highest-Level Criteria: Undergone Experimental or Quasi-Experimental Design; and Level at which full translation has occurred in a community site; and Level at which dissemination products have been developed and are available to the public.

6. Criteria for and Importance of Evidenced Based Programs (EBP) Update Effective January 2015 Highest Tier Evidenced Based Title IIID Services: Demonstrated through evaluation to be effective for improving the health and wellbeing or reducing disease, disability and/or injury among older adults; and Proven effective with older adult population using experimental or quasi-experimental design; and Research results published in a peer-review journal; and Fully translated in one or more community site(s); and Includes developed dissemination products that are available to the public. http://www.ncoa.org/improve-health/center-for-health- aging/content-library/Title-IIID-Highest-Tier-Evidence-FINAL.pdf

7. Why Evidenced Based Programs (EBP)? 88% of over 65 population has at least one chronic health condition 21% of over 65 populations have chronic disabilities One-third of over 65 population fall each year, which is a leading cause of fatal injuries Impaired mobility is an independent risk factor for mortality

8. Why Evidenced Based Programs now cont’d? Sedentary lifestyles count as a major risk factor for chronic illnesses (heart disease, diabetes, osteoporosis, etc.) The aging population is expected to double to 70 million in the next 25 yrs. Incidence of stroke across the nation is 30-40% higher in the South and Southeast states.

9. State of Aging in Tennessee Tennessee’s over 65 population is higher than the national average Tennessee ranks in the bottom 10 states on almost all health and well- being measures Tennessee in particular have high incidences of chronic conditions ranking well above the national norm Source Governor’s Task Force on Aging 2014

10. State of Aging in TN cont’d 45 th in Cancer deaths 44 th in Cardiovascular deaths 49 th in Heart Attacks 49 th in Heart Disease 48 th in High Blood Pressure 44 th in Strokes 46 th in Diabetes Source United Health Foundation 2014

11. State of Aging in TN cont’d Health care for older Americans drives 66% of the country’s health care budget, but results in even higher personal costs in terms of diminished quality of life, loss of independence, and the ability to engage in and contribute to community life. It’s important to note most chronic conditions older Americans experience are preventable or can be delayed by the practice of healthy behaviors, the earlier... the better.

12. HEALTH & WELLNESS MOVING AT THE SPEED OF LIFE

13. Physical Activity & Aging Because of the low functioning status and high incidence of chronic disease, there is no segment of the population that can benefit more from regular exercise than the elderly. Source American College of Sports Medicine

14. Physical Activity the Rx for Health & Wellness

15. The one and only statistically significant intervention found to improve overall health outcomes and quality of life in the aging population is regular physical activity. Source Healthy Aging Briefing Series 2011

16. Increasing Physical Activity is the FIRST and most important prescription for virtually ALL chronic diseases… Diabetes COPD OA Heart disease Mood disorders Fibromyalgia Chronic Fatigue Chronic Pain Cancer Worried well…

17. Motivators to Initiate Physical Activity Improve health Decrease pain Improved mental acuity Never too old (or too young) to improve function Improved cognition Decrease risks of falls

18. Motivators cont’d…. Addresses several health domains (social, mental, spiritual, etc.) Improved Mood Prevention or slowing of disease process Medication decrease Nerve regeneration

19. It is your health... Self-Management

20. Self Management Beliefs Perceived ability to achieve a certain level of independence Expected success and benefits behavior changes will provide 4 major ways to determine: performance experience, observing the experience of others, verbal persuasion, and emotional states experienced.

21. Important considerations when Initiating Physical Activities Changes Self management beliefs are critical Pleasure, self-regulation skills and satisfaction are most important for sustaining physically active behaviors (i.e. goal setting, monitoring, accountability and celebrating successes)

22. Best Practices EBP Programs available thru ETAAAD Arthritis Foundation Aquatics Arthritis Foundation Exercise Arthritis Foundation Walk with Ease Tai Chi for Arthritis & Diabetes Chronic Disease Self Management Program Diabetes Self-Management Program Powerful Tools for Caregivers Silver Sneakers Stay Active and Independent for Life (SAIL)

23. Let’s Begin Practicing what we teach!

24. Educate, Advocate & Demonstrate Community Leadership Data Driven Partnership of public, private and non-profit and faith-based organizations

25. Partnerships for Growing and Sustaining Evidenced Based Programs (EBP) Senior Centers Worship Centers Worksites Parks & Recreation Ctrs. Schools Community Ctrs. Professional Organizations State Government

26. Challenges Affordability Self-Assessment Self-Management Community Sustainability Volunteers Training Change takes TIME...

27. References and Links... http://www.ncoa.org/improve-health/center-for-health- aging/content-library/Title-IIID-Highest-Tier-Evidence-FINAL.pdf http://www.ncoa.org/improve-health/center-for-health- aging/content-library/Title-IIID-Highest-Tier-Evidence-FINAL.pdf Administration for Community Living - www.acl.govwww.acl.gov American Journal of Health Behavior, Hughes et al., Nov/Dec2010 http://patienteducation.stanford.edu www.cdc.gov/diabetes/prevention www.arthritis.org www.powerfultoolsforcaregivers.org www.everydayhealth.com/stroke-risk-higher-in-southeast Washington State Department of Health (2009). Stay Active and Independent for Life (SAIL). tn.gov/sites/default/files/Aging-Task-Force-Final.pdf

28. Questions ??

29. THANK YOU BE You must BE the change you wish to see in the world! Gandhi