Healthy Living (CDSMP) & Arizona Living Well Institute

1. Healthy Living (CDSMP) & Arizona Living Well Institute www.azlwi.org

2. Agenda • Background, structure and purpose of Healthy Living • Arizona Living Well Institute • Opportunities • Q & A Arizona Living Well Institute Arizona Living Well Institute

3. 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 University’s 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 Arizona Living Well Institute

4. Evidence-Based Programs 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 Promising Practice Best Practice Evidence-Based Model 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. Arizona Living Well Institute

5. Healthy LivingStanford University’s CDSMP http://med.stanford.edu/patienteducation/ Healthy Living Arizona Living Well Institute Arizona Living Well Institute

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

7. 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-yourself-better/ Arizona Living Well Institute

8. Topics Covered • Action Plans • Feedback/Problem Solving  • Getting a Good Night’s 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 Arizona Living Well Institute

9. Healthy Living Facilitators

10. 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. Arizona Living Well Institute

11. 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.stanford.edu/research/Review_Findings_CDSMP_Outcomes1%208%2008.pdf Arizona Living Well Institute Arizona Living Well Institute

12. 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.stanford.edu/research/Review_Findings_CDSMP_Outcomes1%208%2008.pdf Arizona Living Well Institute

13. 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 (n=1,170) • 12 month (n=825) • 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. Arizona Living Well Institute

14. 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! Arizona Living Well Institute

15. 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 Arizona Living Well Institute

16. 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

17. Arizona Living Well Institute The mission: to advance evidence-based programs for Arizona communities through structured communication, multi-level coordination and systematic coaching. Arizona Living Well Institute

18. Arizona Living Well Institute Funds to launch the Arizona Living Well Institute were made available by grant funds from St. Luke’s Health Initiatives and the Arizona Department of Health Services through a grant from the Administration on Aging. www.azlwi.org Arizona Living Well Institute

19. 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 Arizona Living Well Institute

20. 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. Arizona Living Well Institute

21. Community-Based Referral Network

22. 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 Arizona Living Well Institute

23. Opportunities Arizona Living Well Institute

24. 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. Arizona Living Well Institute

25. 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. Arizona Living Well Institute

26. 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 Arizona Living Well Institute

27. Questions? AZ Living Well Institute info@azlwi.org (480) 982-3118 www.azlwi.org Arizona Living Well Institute