www.azlwi.org

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Healthy Living (CDSMP) Arizona Living Well
Institute

• www.azlwi.org

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Agenda

• Background, structure and purpose of Healthy
  Living
• Arizona Living Well Institute
• Opportunities
• Q A

Arizona Living Well Institute
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Nationwide Evidence-Based Initiative

• U.S. Administration on Aging funded Initiative
  2006
• To transform Aging Services Network to health
  impacting sites
• Brings evidence-based programming to
  community-based organizations
• Stanford Universitys CDSMP is the core program
• 2010 American Recovery and Reinvestment Act
  (ARRA)
• Communities Putting Prevention to Work Chronic
  Disease Self-Management Program initiative - 27
  million (45 states, District of Columbia and
  Puerto Rico)
• 2011 NASMHPD Peer Support Specialist Workforce
  Development Grant
• 2012 ACL-AoA 3rd Round of Self-Management Funding
• 22 States to continue to increase reach of EBP to
  ethnic minority groups and expand programs
  available

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Evidence-Based Programs
Promising Practice
Best Practice
Evidence-Based Model

• A process of planning, implementing, and
  evaluating programs adapted from tested models or
  interventions in order to address health issues
  at an individual level and at a community level

Source Altpeter, M., Schneider, E., Bryant, L.
Beattie, B., Whitelaw, N. (2004). Using the
evidence base to promote healthy aging. National
Council on the Aging Evidence-based Health
Promotion Series, Vol. 1. Washington, DC
National Council on the Aging.
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Healthy Living

• Healthy LivingStanford Universitys CDSMP
• http//med.stanford.edu/patienteducation/

Arizona Living Well Institute
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Disease
Tense Muscles
Fatigue
Symptom Cycle
Shortness of Breath
Pain
Stress/ Anxiety
Depression
Difficult Emotions
Stanford Chronic Disease Self Management, 2006
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Workshop Design

• 6 weekly sessions that meet 1 day per week for
  2.5 hours each
• Introduces tools needed in day-by-day life with
  chronic conditions
• Practices using self-management skills
• Focuses on goal setting
• Shared experiences, emphasizes mutual support
• Workshops Available
• English Spanish
• Diabetes Chronic Pain

www.wittysparks.com/2007/05/26/15-tips-to-manage-y
ourself-better/
Arizona Living Well Institute
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Topics Covered

• Action Plans
• Feedback/Problem Solving 
• Getting a Good Nights Sleep
• Managing difficult emotions
• Falls Prevention
• Physical Activity/Exercise
• Nutrition Food Labels
• Weight Management
• Mind-Body Connection
• Informed Treatment Decisions
• Working with Health Care

Arizona Living Well Institute
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Healthy Living Facilitators
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Ideal Abilities of a Leader

• Possesses good listening skills, is
  non-judgmental
• Understands the importance and purpose of
  fidelity (following the curriculum)
• Possesses good communication and
• interpersonal skills
• Exhibits enthusiasm
• Is dependable and consistent
• Comfortable in front of a small group
• Possesses life experience resulting in empathy
• to the needs and abilities of older adults.

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What are the Outcomes?
Self-Management NOT Health Education
Purpose of self-management is to help people gain
self confidence in their ability to - control
their symptoms - control how their health
problems affect their lives
5 year randomized study, 1000 people
Outcomes?
For more information on CDSMP outcomes, Review of
Findings on Chronic Disease Self-Management
Program (CDSMP) Outcomes Physical, Emotional
Health-Related Quality of Life, Healthcare
Utilization and Costs, http//patienteducation.sta
nford.edu/research/Review_Findings_CDSMP_Outcomes1
2082008.pdf
Arizona Living Well Institute
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Outcomes

• Increased physical activity
• Improved health-status
• Improved social/role activities
• Better psychological well-being
• Decreased days in hospital
• Improved self-reported general health
• Enhanced partnerships with physicians
• Increased energy/reduced fatigue
• Reduced health care expenditures
• For more information on CDSMP outcomes, Review of
  Findings on Chronic Disease Self-Management
  Program (CDSMP) Outcomes Physical, Emotional
  Health-Related Quality of Life, Healthcare
  Utilization and Costs, http//patienteducation.sta
  nford.edu/research/Review_Findings_CDSMP_Outcomes1
  2082008.pdf

Arizona Living Well Institute
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National Study of CDSMP (2010-2012)

• How does CDSMP affect the lives of participants
  and society as a whole?
• What are the impacts on
• Symptom management and lifestyle behaviors?
• Better care?
• Improved health?
• Reduced health care costs?

• Study Participants
• Baseline (n1,170)
• 12 month (n825)
• Measures
• Symptom management and lifestyle behaviors
• Better Care
• Experience of care
• Better Health
• Population health
• Lower Health Care Cost

Whitelaw, N., Lorig, K., Smith, M. L., Ory, M.
G. (March 19, 2013). National Study of Chronic
Disease Self-Management Programs (CDSMP).
Retrieved April 2, 2013, from www.ncoa.org/cha
Berwick et al. (2008). The Triple Aim Care,
Health, And Cost. Health Affairs.
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Estimated Cost Savings Related to Reduced ER
Visits Hospitalization

• Preliminary Results
• 740 per person savings in ER and hospital
  utilization
• 390 per person net savings after considering
  program costs at 350 per participant
• Reaching even 10 of Americans with one or more
  chronic conditions would save 4.2 billion!

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Workshop Types in Arizona

• English

• Spanish

• Healthy Living
• CDSMP
• Healthy Living with Diabetes
• DSMP
• Healthy Living with Chronic Pain
• CPSMP

• Tomando Control de su Salud
• Spanish CDSMP
• Programa de Manejo Personal de la Diabetes
• Spanish DSMP

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What Else Do I Need to Know?

• Healthy Living will NOT interfere with other
  programs - it will complement other
  programs!
• Healthy Living is not a support group.
• Even though participants share experiences and
  support each other, it is a workshop where you
  learn and try new skills, and increase your
  ability to manage your health.
• To be most effective, it is important for
  participants to be present and contribute in all
  sessions.

Arizona Living Well Institute
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Arizona Living Well Institute

• The mission
• to advance evidence-based programs for Arizona
  communities through structured communication,
  multi-level coordination and systematic coaching.

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Arizona Living Well Institute
Funds to launch the Arizona Living Well Institute
were made available by grant funds from St.
Lukes Health Initiatives and the Arizona
Department of Health Services through a grant
from the Administration on Aging.
www.azlwi.org
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How AZLWI Provides Support

• Coordination and leveraging of resources to
  create greater impact
• A systematic approach to data collection and
  management
• Coordination of training opportunities throughout
  the state, including coordination of
  self-management workshops
• Educate employers, health care providers and
  community services organizations about the
  benefits of self-management programs and
  evidence-based health promotion programs

Arizona Living Well Institute
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Community-Based Referral Network

• A comprehensive membership system of
  evidence-based wellness programs
• Promoted and integrated with primary and
  behavioral health outpatient providers of service
  for those living with or at risk of developing
  chronic conditions.
• In order to sustain and expand the impact of
  self-management programs, AZLWI is further
  developing, supporting and promoting a structured
  provider membership system to ensure quality
  evidence-based wellness services are provided at
  affordable prices.

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Community-Based Referral Network
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Benefits of Connecting Through AZLWI

• Strategic Growth
• Technical Assistance
• Regional Collaboratives
• County Coalitions
• Improved Retention
• Facilitators
• Participants
• Stay up to Date
• CDSMP Updates
• Meet Retreats
• Refresher Trainings

• Improved Problem Solving
• Local Mentors
• Statewide Webinars
• Leverage Funding Opportunities
• Partners supporting Partners
• System Infrastructure
• Rather than person centered

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Opportunities
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Partnership Opportunities

• Partnering with CBOs to broaden the array of
  non-clinical services
• New models of care delivery provide flexibility
  for service design and payment to include
  self-management programs
• Greater focus on patient motivation and
  engagement
• Growing awareness of effectiveness of
  self-management programs and value of partnering
  with community resources

Lachenmayr, S. National Council on Aging Patient
Self-Management As a Strategy to Reduce Hospital
Readmissions, September 2012. Slides 19-22.
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ACL CDSME Completer Payments

• Limited funding associated with the ADHS
  Administration for Community Living CDSME grant
• Primary goal to increase CDSMP/DSMP workshops to
  populations disproportionately impacted by
  chronic disease, specifically Spanish speaking,
  rural and minority populations.
• 125 per completer payment.
• September 1, 2013 and August 31, 2014
• A completer is defined as a participant that
  has attended 4 or more of the 6 sessions per
  workshop.

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Participant Comments

• I feel that this class has been of great benefit
  to me which will stay with me in times of
  difficulty or when I feel myself slipping back
  toward depression or isolation from people. I
  will put forth an extra positive effort to
  continue the breathing techniques and especially
  the exercises learned or reinforced in a
  continued plan to control my painful condition in
  the best possible way without being dependent
  upon prescription drugs. Rebecca Arizona City
• We had experienced, or learned different parts of
  this program before, but no part alone was life
  changing. But with this program structure, I am
  a different person than I was just six-weeks ago
  and hope to stay motivated! MDC - Goodyear

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Questions?
AZ Living Well Institute info_at_azlwi.org (480)
982-3118 www.azlwi.org