Evidence-based Health Program Overview. yourjuniper.org. Today

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1 Evidence-based Health Program Overview Paula Woischke Healthy Aging Coordinator Central MN Council on Aging yourjuniper.org Today What are Evidence based Health Programs (EBHP)? Which EBHP s relate to Fall Prevention Statewide Initiative of Juniper Network How to find workshops and make referrals through Juniper Possibilities of being trained in the EBHP s 1

2 Evidence based Programs Has a specific target population Has specific, measurable goal(s) Has a stated reasoning behind it and proven benefits Has an organized, well defined program structure and timeframe Specifies staffing needs/skills and tools and resources Builds in program evaluation to measure program quality and health outcomes Chronic diseases and injury are among the most common and prevalent health problems facing Minnesotans today. Source: Minnesota Center for Health Statistics 2

3 Chronic diseases are costly. 75% of the $2.6 trillion spent for health care goes for chronic disease treatment $5 billion annually being Minnesota s share For every dollar spent on health care only four cents are spent on prevention. Levi J, Segal LM, Juliano C. Prevention for a Healthier America: Investments in Disease Prevention Yield Significant Savings, Trust for America s Health, 2008 Chronic Diseases Account for 7 of Every 10 Deaths 4 out of 5 who are 50+ live with Chronic Illnesses 10% Heart Disease 15% Diabetes 40% High Blood Pressure 25% High Cholesterol 20% Mental Illness 3

4 What EBHP s are available? To Help with Chronic Conditions: Stanford Self Management Programs Living Well with Chronic Conditions Living Well with Chronic Pain Healthier Living with Diabetes ICAN Diabetic Prevention Program Stanford University Self Management Programs 6 week series of workshops 2 ½ Hour each week Increase self confidence in the ability to control symptoms and manage the affect of multiple chronic health issues Participative instruction with peer support 4

5 CDSMP Workshop Overview Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Overview of self management and chronic health conditions Using your mind to manage symptoms Getting a good night s sleep Making an action plan Feedback and problem solving Dealing with difficult emotions Physical activity and exercise Preventing falls Making decisions Pain and fatigue management Better breathing Healthy eating Communication skills Medication usage Making Informed treatment decisions Dealing with depression Working with your health care professional and system Weight management Future plans Stanford University Self Management Programs Study results show that participants demonstrated significant improvement in health status and quality of life Also spent fewer days in the hospital Many of these results persisted for as long as three years Includes constant modeling, active problem solving, formal brainstorming, action planning 5

6 ICAN Prevent Diabetes Year Long Program meet weekly 16 weeks and once a month thereafter for one year CDC approved curriculum with lessons, handouts, and other resources to help you make healthy changes. A lifestyle coach, specially trained to lead the program, to help you learn new skills, encourage you to set and meet goals, and keep you motivated. The coach will also facilitate discussions and help make the program fun and engaging. A support group of people with similar goals and challenges. Together, you can share ideas, celebrate successes, and work to overcome obstacles. In some programs, the participants stay in touch with each other during the week. It may be easier to make changes when you re working as a group than doing it on your own. Let s talk about Fall Prevention Where do you think Minnesota ranks for falls and fall related deaths? What is the most common room for falls to happen? What modifiable factors can we promote with others to prevent falls? 6

7 Fall Prevention Let's keep Minnesotans right side up. Falls are the leading cause of injury for children and for adults 35 years and older. Falls and fall related injuries among adults over age 65 are on the rise. Currently Minnesota ranks fifth among states in the number of fall related deaths. Having a fall can change one s life forever. Fall Prevention Minnesota had the 5th highest fall death rate in the US in 2009.Minnesota s fall death rate continues to rise. Adults age 65 and older accounted for more than 86% of MN fall deaths Older adults in Minnesota experienced over 29,900 falls in 2009, causing 639 fatalities and an estimated medical cost of $255,435,200. MN falls have no apparent seasonal pattern. 7

8 CDC Statistics CDC s Injury Center monitors falls, fall related injuries, and associated costs, reporting: One fourth of Americans aged 65+ falls each year. Every 11 seconds, an older adult is treated in the emergency room for a fall; every 19 minutes, an older adult dies from a fall. Falls result in more than 2.8 million injuries treated in emergency departments annually, including over 800,000 hospitalizations and more than 27,700 deaths. Adjusted for inflation, the annual direct medical costs for fall injuries are $31 billion. Hospital costs account for two thirds of the total. By 2020, the annual direct and indirect cost of fall injuries is expected to reach $67.7 billion. Fall Prevention 8

9 Factors That Increase Risk of Falling History of falls: two falls or one fall with injury in the past 12 months. Fear of falling Mobility Complications of chronic health conditions Poor nutritional status Medication side effects and/or interactions Alcohol use Home and environmental hazards Incorrect size, type, or use of assistive devices (walkers, canes, crutches, etc.) Quick Screening These three questions have been found to have strong value in predicting falls. Have you fallen in the past year? How many times have you fallen in the past year? Are you afraid of falling? 9

10 What is your role? Assess Clients for Risk for falls Find and Refer to community EBHP workshops and resources Become a trained Leader and offer in your community? Collaborate with local efforts on Fall Prevention Falls Task Groups St. Cloud, Brainerd, Cass Lake STEADI Assessment Find training materials on CDC website Videos and tutorials Tool kits Can be offered in variety of settings clinic, home, church with faith community nurses, health fairs, etc. 10

11 Evidence Based Health Programs What s available in this community and throughout Minnesota? Matter of Balance Stepping On Tai Ji Quan: Moving for Better Balance EnhanceFitness S.A.I.L. Stay Active and Independent for Life Breaking the cycle: A Matter of Balance 8 week class at a community site Discussion group to share concerns and begin to view falls as controllable Set goals for increasing activity Make changes to reduce fall risk at home Exercise to increase strength and balance aging/matter of balance 11

12 Stepping On What is Stepping On? Stepping On is a program that has been researched and proven to reduce falls in older people. It consists of a workshop that meets for two hours a week for seven weeks. Workshops are led by a health professional and a peer leader someone who, just like you, is concerned about falls. In addition, local guest experts provide information on exercise, vision, safety, and medications. Topics include: Simple and fun balance and strength training The role vision plays in keeping your balance How medications can contribute to falls Ways to keep from falling when out in your community What to look for in safe footwear How to eliminate falls hazards from your home on EnhanceFitness/ S.A.I.L. Ongoing 3 times per week Balance, Strength, Endurance, and Flexibility One hour class Perfect for everyone! Can be done seated and/or standing Gives you strength to perform your Daily Activities such as getting out of a chair

13 Tai Ji Quan: Moving for Better Balance The program consists of an 8 form core routine with built in exercise variations and a subroutine of Mini Therapeutic Movements, which, collectively, comprise a set of simple yet functional Tai Ji Quan based moves. This approach represents an enhancement of traditional Tai Ji Quan by transforming the movements into therapeutic training for postural control, daily functioning and clinical rehabilitation for older adults and individuals with physical limitations. One Hour Class Twice a week for 12 Weeks 24 sessions What EBHP program is appropriate? If someone is having difficulty with either Pain, Diabetes, or a Chronic Condition in managing their symptoms and need a support of a group and leaders then Consider referring to the Stanford Self Management Workshops 13

14 Overall Nutrition and Coaching ICAN Prevent Diabetes Lifestyle coaching workshop Helps you make healthier eating choices Work in that small group to encourage each other Weigh in each week and track food/activity Lifestyle coach works with you For Falls and new to Activity Stepping On Matter of Balance Both have an educational piece and exercise component to help get individuals get started Tai Ji Quan: Moving for Better Balance 14

15 Ongoing classes EnhanceFitness and S.A.I.L. Again is great for everyone to take and can join a class anytime. The social piece is as important as the exercises. Covered by most insurance companies through Silver & Fit and SilverSneakers How can you find the workshops? 15

16 What is Juniper? Strategic Alignment The six Minnesota AAA s have been working independently to expand evidence based programs in their region. Aligning the programs statewide and supporting them with a common technology infrastructure through a management services organization led by the MAAA will improve each agency s ability to Grow Revenue and Reach a Broader Population 16

17 Future State Minnesota Well-care Network -state-level oversight -regional hubs -institutionalized framework -standardized way of operating -policy and payer support What does the community system do? Coordinates the promotion and delivery of evidence based health promotion programs Organizes the recruitment, training, certifying, and monitoring of community program leaders Coordinates the collection, sharing, evaluation, and reporting of program and participant data 17

18 What does it mean for you? Opportunity to locate, register, and participate in a variety of Evidence based programs statewide through the ease of the Juniper Network/ To be able to have insurance possibly reimburse for these programs and keep affordable for participants Remain independent longer at home Features and timeline - MIS Current Features and Timeline Launch Timeline Soft Opening: November 9 for training; data entry begins by system admin, AAA developers, service delivery organizations, and class leaders Hard Opening: January 3, 2018 with press conference and statewide announcement Classes Listed: Starting 1/1/2018 going forward Key Functionalities Find A Class Become a Service Delivery Organization Become a Leader Leader Login Area Including Credentials Make an Online Referral Survey Entry and Reporting Data Capture and Export for Business Intelligence Informational PDFs about Ten Currently Supported Programs Interface with Mailchimp Social Media Web-Page Structure Home About Make A Referral For Healthcare Providers For Program Leaders Regional Pages (each AAA PSA) 18

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20 If you have interest in offering EBHP? If you want to offer any of the programs and workshops mentioned in your community there are opportunities to be trained. Contact myself Paula Woischke For more information Questions? 20

21 Resources Minnesota Falls Fact Sheet NAging/Docs/Admin/HealthyAging/FallsFactSheet_2012.ashx To learn more about Evidence based Health Programs through the National Council on Aging (NCOA) To learn more about What is an Evidence based Program? CDC Steadi Assessment Materials and Tutorials Updated with new features December 22 nd! Registration and Referrals will be available December 22 nd! You will be able to find : Upcoming workshops (by zip code, city, county) Upcoming Leader Trainings throughout the State Have the ability to refer and/or register online yourjuniper.org 21

22 First Let s move a little and do some balance exercises Combination of exercises from the EBHP workshops that I will review with you today 22