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Chronic Disease Interventions. Taffy Fulton, MPH. Aging in Style. Living Well. Stanford Chronic Disease Self-Management Program. Taffy Fulton, MPH Program Coordinator. CDSMP in the Brazos Valley. Area Agency on Aging (AAA) Partner with SRPH
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Chronic Disease Interventions Taffy Fulton, MPH
Living Well Stanford Chronic Disease Self-Management Program Taffy Fulton, MPH Program Coordinator
CDSMP in the Brazos Valley • Area Agency on Aging (AAA) • Partner with SRPH • Want to reach everyone, including people in rural areas
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.
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
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
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
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
Living Well is Evidence-Based What does evidence-based mean? It means IT WORKS!!
Workshop Overview • 1 session weekly for 6 weeks • 2 ½ hour each session • Taught by lay leaders (everyday people) or health care professionals
Workshop Overview • Dealing with: • Fatigue, • Frustration, and • Pain
Workshop Overview Managing medicines
Workshop Overview How to talk to your doctor, family, and friends
Workshop Overview How to evaluate new treatments
Workshop Overview Daily living activities
Set a Goal • Set one goal at a time • Be realistic • Start off slowly with any change
Audience • People with diabetes • People living with HIV/AIDS (PLWHA) • People with cancer • People with connective tissue disorders, including lupus • People with neurological disorders
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
Recruitment • Community settings • Senior centers • Retirement centers • Churches • Libraries • Hospitals & Clinics • Resource centers • Pharmacies • Allied healthcare facilities • Service Organizations
Program Goals • Have classes in each county • Recruit volunteers to teach • Sustainability • Host sites • Class leaders
Evaluation and Follow-Up • Responsibilities of AAA • Group to develop evaluation • In progress http://patienteducation.stanford.edu/programs/cdsmp.html
Computer Kiosk • Touch screen computer • Self-guided • Diabetes information • Diabetes control goal setting Grant from Dell computer
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
Goals • Information dissemination • Behavior change • Determine whether or not people will use a kiosk like this
Audience • Low literate/education • Low socioeconomic status • Rural areas • People wanting information • Curiosity • Resource centers • Healthcare facilities
Development • Basic outline • Power Point • Narrative script and revision and revision and revision…. • Computer programming • Filming • Evaluation
Evaluation • Basic demographics • Diabetes information • Surveys • Focus groups • Page hits and amount of time spent on each page
A Message from your doctor What is diabetes? Diabetes Care Diabetes Prevention Videos Things to Do Everyday
Risk Factor for Diabetes Hispanic/Latino, African American, American Indian, or Asian American.
Working Keep a snack handy Adjust your activity, eating, testing and medicine times if you need to
Traveling • Take extra medicine • “I have diabetes” ID • Carry snacks • Don’t forget to be active.
1st Steps to a Healthier Life Change one thing at a time Set reasonable goals