YMCA S BLOOD PRESSURE SELF- MONITORING PROGRAM AHA CHECK. CHANGE. CONTROL. LEADERSHIP SUMMIT

Transcription

1 YMCA S BLOOD PRESSURE SELF- MONITORING PROGRAM AHA CHECK. CHANGE. CONTROL. LEADERSHIP SUMMIT

2 Y STRUCTURE: ASSOCIATIONS & BRANCHES OUR REACH 2

3 THE Y s APPROACH TO HEALTHY LIVING Impacting INDIVIDUALS Impacting FAMILIES Impacting ORGANIZATIONS Impacting COMMUNITIES Impacting SOCIETY To PROMOTE WELLNESS (Primary) Group Exercise Youth Sports Swim Lessons Personal Training Wellness Centers Family Camp Adventure Guides Employee Wellness Benefits Policies Promoting Healthy Eating Policies Promoting Physical Activity Built Environment Access to Fresh Fruits & Veggies P.E. in Schools Economic Incentives and Disincentives (taxation or subsidies) Tobacco-free Environments To REDUCE RISK (Secondary) Diabetes Prevention Falls Prevention Tobacco Cessation To RECLAIM HEALTH (Tertiary) Blood Pressure Management Arthritis Management Childhood Obesity Diabetes Management Cancer Survivorship

4 KEY LEARNING: EVIDENCE-BASED PROGRAMS MATTER DISCOVERY Efficacy Validation DEVELOPMEN T Translation Scaling DISSEMINATION Dissemination YMCA s Diabetes Prevention Program Enhance Fitness (Arthritis Self-Management) LIVESTRONG at the YMCA (Cancer Survivorship) Moving for Better Balance (Falls Prevention) Blood Pressure Self-Monitoring Childhood Obesity Intervention Brain Health Parkinson s Tobacco Cessation

5 PROGRAM DEVELOPMENT AT THE YMCA High Blood Pressure 80 million adults in the US have this mostly preventable condition, and only half have it under control. Childhood Obesity 1 in 6 children in the US have obesity. Formation of Healthy Habits in Early Childhood 1 in 7 preschool children in the US have obesity. Brain Health & Cognitive Decline 16 million adults in the US are living with cognitive impairment. Tobacco Cessation 5 Cigarette smoking kills more than 480,000 Americans each year. Parkinson s Disease ~ 1 million adults in the US live with Parkinson's disease, costing nearly $25 billion per year.

6 About1 in 5 (20.4%) U.S. adults with high blood pressure don't know that they have it. In 2009, Americans visited their health care providers more than55 million times to treat their high blood pressure. About7 in 10 U.S. adults (69.9%) with high blood pressure use medications to treat the condition. Team-based care that includes the patient, primary care provider, and other health care providers is a recommended strategy to reduce and control blood pressure. 78 *Centers for Disease Control and Prevention 6

7 BLOOD PRESSURE SELF-MONITORING: THE BASICS Who? Adults with hypertension; has ever been diagnosed or currently taking antihypertensive medication Interested in a self-monitoring program model Must not have experienced a recent cardiac event, nor have atrial fibrillation or other arrhythmias, nor be at risk for lymphedema What? When? Where? How? 4 month program: regular contact and 10-minute consultations with Healthy Heart Ambassadors and monthly nutrition education seminars Participants self-monitoring and tracks blood pressure Anytime, anywhere (lobby, clinic, multipurpose space) Space for blood pressure stations and nutrition education seminars Support, Education, and Coaching by trained staff Self-Monitoring and tracking using a self-identified tool Trained on proper self-monitoring techniques 7 Blood Pressure Self-Monitoring 2015 YMCA of the USA

8 SAMPLE POPULATION Enrollments n=1,476 Participants with no BP readings n=357 (24%) Participants with at least 1 BP reading n=1,119 (76%) Starters No follow-up reading n=378 <2 months btwn. initial & final reading n=215 2 months btwn. initial & final reading n= YMCA of the USA Completers

9 THE PERCENTAGE OF AFRICAN AMERICANS SERVED IN THE BLOOD PRESSURE PROGRAM IS GREATER THAN IN THE COMMUNITY. White 55% 57% Black 26% 38% Commu nity Hispanic/La tino 8% 22% YMCA of the USA

10 THERE IS A STATISTICALLY SIGNIFICANT DIFFERENCE IN SYSTOLIC AND DIASTOLIC BP BETWEEN INITIAL AND FINAL READINGS (N=526). p< p< Initial Final Initial Final Systolic Diastolic YMCA of the USA

11 THERE IS A STATISTICALLY SIGNIFICANT DIFFERENCE IN SBP & DPB BETWEEN INITIAL AND FINAL READINGS AMONG THE 48% OF PARTICIPANTS BEGINNING THE PROGRAM WITH A HYPERTENSIVE READING (N=255). Hypertensive reading: Those with an a SBP of 140 mmhg OR a DBP 90 mmhg p< p< Initial Final Initial Final Systolic Diastolic YMCA of the USA

12 PARTICIPANTS WITH THE HIGHEST INITIAL BP READINGS DEMONSTRATE A SIGNIFICANTLY GREATER CHANGE IN SBP AND DBP. Change in systolic Overall avg. (-6.3) p< Overall avg. (-3.2) p< *Based on the AHA risk levels Change in diastolic

13 YMCA PILOTS PRODUCED SLIGHTLY MORE FAVORABLE FINDINGS THAN THOSE REPORTED IN THE CHECK IT, CHANGE IT STUDY. Check It, Change It (n=1,784) At baseline, 49.3% of participants had a BP <140/90 mmhg. By 6 months, 74% of participants either reached a BP <140/90 mmhg or had a 10 mmhg reduction in SBP. YMCA- Pilots 1&2 (n=526) At baseline, 51.7% of participants had a BP <140/90 mmhg. After an average of 4.3 months, 75.1% of participants either reached a BP <140/90 mmhg or had a 10mmHg reduction in SBP. Overall, mean SBP decreased by 4.8 mmhg. Overall, mean DBP decreased by 2.5 mmhg. Overall, mean SBP decreased by 6.3 mmhg. Overall, mean DBP decreased by 3.2 mmhg YMCA of the USA Check It, Change It enrolled patients from 8 clinics in Durham County, NC between 12/09/2010 and 11/11/2011.

14 PROJECTIONS FOR BLOOD PRESSURE SELF-MONITORING PROGRAM # of program sites cumulative) # of Participants (minimum cumulative) ,764 10,000 19, YMCA of the USA

15 PORTFOLIO OF THE YMCA S COMMUNITY INTEGRATED HEALTH APPROACH 15 YMCA s Diabetes Prevention Program: a lifestyle behavior change program based on 20 years of evidence showing the intervention can reduce the number of new cases of type 2 diabetes by 58% overall and 71% for individuals 60 years of age and up. Moving For Better Balance: an evidence-based falls prevention program designed to help improve strength, balance, flexibility and mobility through slow, therapeutic movements based on Tai Chi. LIVESTRONG at the YMCA: a group-based cancer survivor exercise intervention that has been proven to improve survivors fitness and quality of life. Enhance Fitness: a nationally recognized senior fitness and arthritis management program that has been proven to significantly decrease participants age-related functional decline and health care costs.

16 THANK YOU Valerie A. Lawson, MS, RD, LDN Program Development YMCA of the USA