2. Chronic Disease Interventions Taffy Fulton, MPH

3. Aging in Style

4. Stanford Chronic Disease Self-Management Program Taffy Fulton, MPH Program Coordinator Living Well

5. CDSMP in the Brazos Valley Area Agency on Aging (AAA) Partner with SRPH Want to reach everyone, including people in rural areas

6. Brazos Valley Populations 265,000 people in 2000. 37,500 people are 60+ years of age or 15 % of total population. Nearly 30% of Brazos Valley’s older adults live with incomes at or below 200% of the poverty level; approximately 17% have incomes below the poverty level.

7. Brazos Valley Seniors with On-going Health Concerns 59% of older adults have high blood pressure 55 % have high cholesterol 56 % have arthritis 16 % have diabetes 66.5 % are overweight 29.5 % are obese

8. Ongoing Health Concerns in the Brazos Valley

9. Chronic Disease Self-Management Program More chronic diseases now than in past Physicians claimed they did not have enough time to work with their patients Fits well with the chronic care model

10. CDSMP Assumptions People with chronic conditions have similar concerns and problems People with chronic conditions must deal not only with their disease(s), but also with the impact these have on their lives and emotions Lay people with chronic conditions, when given a detailed leaders manual, can teach the CDSMP as effectively, if not more effectively, than health professionals The process or way the CDSMP is taught is as important, if not more important, than the subject matter that is taught

11. Who developed Living Well? Dr. Kate Lorig –Professor at Stanford School of Medicine –Arthritis nurse –Wanted some type of treatment plan for her patients –Developed Arthritis Self-Help Program –Adapted program to any chronic illness

12. Living Well is Evidence-Based What does evidence- based mean? It means IT WORKS!!

13. Workshop Overview 1 session weekly for 6 weeks 2 ½ hour each session Taught by lay leaders (everyday people) or health care professionals

14. Workshop Overview Dealing with: –Fatigue, –Frustration, and –Pain

15. Workshop Overview Managing medicines

16. Workshop Overview How to talk to your doctor, family, and friends

17. Workshop Overview How to evaluate new treatments

18. Workshop Overview Daily living activities

19. Set a Goal Set one goal at a time Be realistic Start off slowly with any change

20. For what audience is this appropriate?

21. Audience People with diabetes People living with HIV/AIDS (PLWHA) People with cancer People with connective tissue disorders, including lupus People with neurological disorders

22. Audience People with High Blood Pressure People with heart disease including high cholesterol People with arthritis People with hepatitis Care givers for people with chronic diseases

23. Recruitment

24. Community settings Senior centers Retirement centers Churches Libraries Hospitals & Clinics Resource centers Pharmacies Allied healthcare facilities Service Organizations

25. Program Goals Have classes in each county Recruit volunteers to teach Sustainability –Host sites –Class leaders

26. Evaluation and Follow-Up Responsibilities of AAA Group to develop evaluation In progress http://patienteducation.stanford.edu/programs/cdsmp.html

27. Living Well: Navasota, Texas

28. Living Well in Navasota, Texas

29. Living Well: Navasota, Texas

30. The Chronic Care Model

32. Computer Kiosk Touch screen computer Self-guided Diabetes information Diabetes control goal setting Grant from Dell computer

33. Diabetes and You A Computer Self-management Project Center for Community Health Development Texas A&M Health Science Center With support from the Center for Disease Control and Prevention, the Prevention Resource Center and the Dell Foundation

34. Goals

35. Information dissemination Behavior change Determine whether or not people will use a kiosk like this

36. Audience

37. Low literate/education Low socioeconomic status Rural areas People wanting information Curiosity Resource centers Healthcare facilities

38. Development Basic outline Power Point Narrative script and revision and revision and revision…. Computer programming Filming Evaluation

39. Basic demographics Diabetes information Surveys Focus groups Page hits and amount of time spent on each page

40. Evaluation

41. A Message from your doctor What is diabetes? Diabetes Care Diabetes Prevention Videos Things to Do Everyday

42. Risk Factor for Diabetes Hispanic/Latino, African American, American Indian, or Asian American.

43. Activity

44. Find someone to talk to. This could even be your pet

45. Working Keep a snack handy Adjust your activity, eating, testing and medicine times if you need to

46. Traveling Take extra medicine “I have diabetes” ID Carry snacks Don’t forget to be active.

47. 1 st Steps to a Healthier Life Change one thing at a time Set reasonable goals

48. How much activity should I get?

49. Healthy Eating