Access to Mental Health Literacy for Rural Pennsylvania Older Adults

1. Access to Mental Health Literacy for Rural Pennsylvania Older Adults “Healthy ABCs” Train the Trainer Program

2. This project has been funded in whole or in part with Federal funds from the Department of Health and Human Services, National Institutes of Health, National Library of medicine, under Contract No. HHSN-276-2011-00003-C

3. PA Behavioral Health andAging Coalition (PBHAC) Who are we? • Formed in 1999 as a statewide coalition of individuals and organizations concerned about the mental health and substance use needs of older adults across the Commonwealth • Primary Role: Advocate for changes that will improve services for older adults with mental health or substance use disorders

4. PBHAC What we do: • Outreach/education • Medicare counseling specific to behavioral health prescription medications • Serve on statewide advisory committees

5. PBHAC • Contact information: • www.OlderPA.org • info@olderpa.org • 717-541-4219 • Do you receive our emails? • Go to www.OlderPA.org and click on “Join Now!” • You will receive our monthly newsletter and notification about upcoming training opportunities.

6. Access to Mental Health Literacy for Rural Pennsylvania Older Adults • Why??????? • In the United States, • One in four older adults has a significant mental disorder. • Older adults with mental illness, more than any other population, are at increased risk for receiving inadequate and inappropriate care.

7. Why????? • Mental disorders in older adults are associated with • Significant disability and impairment • Compromised quality of life • Cognitive impairment • Increased caregiver stress • Disability • Increased mortality • Poor health outcomes

8. Why??? • Traditionally, the responsibility for health literacy has fallen to the health care practitioner - the health care provider shared information, initiated testing, and determined care plans with little input from the patient. • This project proposed to shift this dynamic by providing older adults with the information that they need in order to share the responsibility of mental health literacy and to become active partners in decisions regarding their diagnosis, treatment, and care options.

9. A little bit of history… • In 2012 PBHAC received funding from NN/LM MAR to develop the curriculum for the mental health literacy training for older adults. • This curriculum was tested in Schuylkill County, a rural county in Northeastern PA. • In 2013, PBHAC received funding again from NN/LM MAR to develop a train-the-trainer program to offer the original curriculum by community members for community members.

10. Healthy ABCs • Health and Active Aging • Health for Bodies and for Brains • Health Care and Concerns

11. The Curriculum • The final curriculum developed in 2012-13 was created in PowerPoint format and included more than 70 slides covering the following topics: • Creating a Healthy Lifestyle • Behavioral Health and Older Adults • Treatment for Behavioral Health Issues • Medication and Older Adults • Be Wise, Know Where to Get Help

12. The Curriculum

13. Creating a Healthy Lifestyle • Lifelong Recipe for Good Health • Make friends, manage stress, maintain a sense of purpose • Our Bodies and Our Brains • What’s the Difference? (Between someone with normal age-related memory changes and someone with dementia) • Questions to Ask Your Doctor

14. Behavioral Health and Older Adults • Typical Mental Health Concerns in Older Adults • People at Any Age Can and Do Recover from a Mental Health Disorder! • Depression: Signs and Causes • Suicide: How to Help • Anxiety: Signs and Causes • When Should a Professional Be Contacted?

15. Treatment for Behavioral Health Issues • Why Don’t People Seek Treatment? • Overview of Mental Health Services • Who can provide them • Community Supports • What is available • Mental Health Treatment Options • Types of treatment available • Substance Abuse Treatment Options

16. Medication and Older Adults • Types of Medications Used in the Treatment of Mental Disorders • Facts About Older Adults and Prescription Medications • What Do You Need To Know To Take Your Medication Safely? • Risk Factors for Medication Misuse and Alcohol

17. Alcohol Use

18. Be Wise, Know Where to Get Help • Take An Active Role in Your Health Care! • Bring a List of All Medications (Over the Counter and Prescription, Including vitamins and Supplements) to All Doctors and Health Care Staff You See • If You Don’t Understand… Ask!

19. Resources • Types of Organizations That Can Help • Online Resources • NIH Senior Health • Medline Plus • PillBox

20. NIHSeniorHealth

21. Train-The-Trainer Manual • Overview of the Healthy ABCs Program • Understanding Adult Learning • Delving Into The Material • Scripts • Trainer “Teach Back” Sessions

22. Manual (cont.)

23. The Numbers… • 18 volunteer trainers were trained • 14 of the trainers provided presentations in their communities, for a total of 18 community presentations made • 207 older adults attended the community presentations • 100% of older adults who attended the community presentations “agreed” or “strongly agreed” that the presentation was interesting, 99% said it was easy to understand

24. The Numbers (cont.) • 89% of community participants agreed that there was enough time spent on each of the topic areas (12% disagreed generally stating that they wish more time was spent on certain topics). • Which leads us to…

25. Challenges • We focused the Train-the-Trainer sessions on three rural Pennsylvania counties. • Recruitment was challenging. We used newspapers, Internet and word of mouth. • Not everyone who was trained as a “trainer” actually followed through and gave a community presentation. • Initially we planned for the community presentations to be 1 hour in length. We modified this after feedback stating this was too short, and now recommend 2 hours for the program.

26. Replicability • We attempted to include everything in the Train-the-Trainer Manual so that others could implement the program in their own communities. • We are finalizing the workbook (darn 508 compliance!!!) and will have it available very soon.

27. Contact Information • Rebecca May-Cole • PA Behavioral Health and Aging Coalition • rebecca@olderpa.org • 717-541-4219 ext. 106

28. Central NY Library Resources Council Consumer Health for Central NY: An Outreach Project for CLRC

29. CLRC is ... a regional, nonprofit, cooperative, multi-typelibrary network, serving Herkimer, Madison, Oneida, and Onondaga Counties.

30. CLRC Membership • Membership includes 5 hospital libraries and 3 circuit hospitals • Circuit Librarian visits 3 hospitals bi-weekly

31. Consumer Health Outreach Award • Applied Spring 2012 • Award period May 2012 – April 2013 • Project directed by Medical Circuit Librarian • Project Assistant hired to handle logistics • Project Assistant was student in 2nd year at Syracuse University iSchool

32. The Plan • Work with area YMCAs and other community organizations • Respond to stated need for consumer health information • Medical circuit librarian would teach classes in “Healthy Searching” • Project Assistant would make appointments, manage schedule, assist with preparation

33. The Method • Letters and emails sent to contact list • Community organizations • Libraries • Brochure developed for Healthy Searching program • Announced program at CLRC events • Distributed brochure widely

34. The Reality • Little response from community organizations • Much better response from public libraries • Requests to present at health fairs

35. Our Response • Project Assistant followed up with non-responders • They were not familiar with CLRC • Suspicious of anything offered for free • In case of YMCA, we were seen as competition • Increased focus on what worked (libraries) • Classes for staff worked better than classes for users

36. Our Successes • 3 health fair exhibits • Large class for school library media specialists • Multiple classes for public library staff • 3-part series for one public library • Town recreation department • We’re still getting requests from libraries!

37. Lessons learned • We had an “in” with libraries, but other types of organizations didn’t recognize us • Require specific support commitment up front • People are really unaware of these resources

38. More successes • Healthy Searching curriculum in place • Project Assistant is now a Health Sciences Librarian Fellow at NYU’s Langone Medical Center

39. Thank you! Questions? Contact Angela Thor clrcmcl@verizon.net This project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No. HHS-N-276-2011-00003-Cwith the University of Pittsburgh, Health Sciences Library System.

40. Parkinson’s Disease Consumer Health Learning Service Jeanne Strausman, MLS; Gerri Flanzraich, DLS; MahnazTehrani, MLS,MSIT This project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No. HHS-N-276-2011-00003-C with the University of Pittsburgh-Health Sciences Library System.

41. Parkinson’s Disease Consumer Health Learning Service • Primary goal for this project was to improve the ability of Parkinson’s patients and their caregivers in finding reliable health information on the internet related to Parkinson’s disease and the issues of living with a neurological disorder. • Give patients/caregivers the skills to become better educated patients and improve their health information literacy

42. Parkinson’s Disease Consumer Health Learning Service Target Audience: • Patients/caregivers from Adele Smithers Parkinson’s Disease Treatment Center of the NYIT/College of Osteopathic Medicine Methods: • Office created within Academic Health Care Center to serve as Parkinson’s Disease Consumer Health Service • 3 laptops • 3 mice • 3 large type keyboards • Laptop storage cabinet • Desk and 2 chairs

43. Parkinson’s Disease Consumer Health Learning Service Methods • Develop a LibGuide listing websites and links on Parkinson’s Disease, Treatments, Drugs, Support, Life Style and Assistance for Caregivers • Recruit patients/caregivers by creating promotional materials (flyers and a brochure) to advertise this service. • Staff and health professionals who worked with these patients handed out brochures to them. Advertising was also listed on the American Parkinson Disease Association support group website.

44. Parkinson’s Disease Consumer Health Learning Service Methods • If a patient/caregiver was interested in a training session, a staff member from the Adele Smithers Parkinson’s Disease Center would schedule an appointment with the librarian for a one-on-one training session • Librarians also spoke with various small groups that met at the Adele Smithers Center and explained the purpose of the one-on-one training sessions and demonstrated the Parkinson’s Disease LibGuide