Living Well with Chronic Conditions

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Transcription:

Living Well with Chronic Conditions Data Report OREGON DEPARTMENT OF HUMAN SERVICES JANUARY 2009

2 I. Introduction Living Well with Chronic Conditions Living Well is Oregon s name for the Stanford Chronic Disease Self-Management Program (CDSMP). Living Well encompasses three different evidence-based programs. Living Well is the English language version of CDSMP. It is a 6-week, peer-led workshop for people with one or more chronic conditions and their caregivers. Tomando Control de su Salud is the culturally adapted, Spanish language version of CDSMP. It is also a 6- week, peer-led workshop for people living with one or more chronic conditions and their caregivers. Positive Self-Management Program is a 7-week peer-led workshop designed specifically for people living with HIV/AIDS. All three programs cover topics such as healthy eating, depression management, communication, managing fatigue, working with health care professionals, problem solving, and action planning. All three programs have been shown to help people living with chronic conditions better manage their health, resulting in fewer hospital stays, reduced health care expenditures, and improved overall health and energy levels. Oregon DHS asks organizations who offer Stanford self-management programs (Chronic Disease Self- Management Programs (CDSMP) or Living Well with Chronic Conditions, Tomando Control de Su Salud, and Positive Self-Management for People with HIV/AIDS) to collect core demographic information on participants in programs they offer, and to share this anonymous data with DHS in order to track use and expansion of the program in Oregon. This report includes cumulative data since August 2005, when data collection began. Since that time, DHS has attempted to collect data from all programs, but the numbers reflected in this report are only inclusive of those workshops that have submitted data. There may be several workshops and participants that are not represented in this report. DHS works with counties and regions to provide specific reports as needed. For more information on the following data, or to make a specific data request, contact the DHS Living Well program at (888) 576-7414 or living.well@state.or.us.

3 II. Program Data: August 2005 December 2008 Since August 2005, a total of 247 Living Well programs have been offered through various organizations, including hospital systems, clinics, local health departments, community-based organizations, and health plans across Oregon. Programs since 2005 250 200 206 150 100 50 0 18 23 Living Well Tomando PSMP The average number of participants who registered for programs was 13, ranging from 1 to 27. The average number of participants who completed at least 4 of the 6 sessions was 8, ranging from 1 to 21. Research indicates that positive health outcomes are achieved when at least 4 sessions have been attended. 17% of programs reported that they charged a fee for the program. The fee ranged from $5 to $120, with a mean of $30.

4 All Programs (Living Well, Tomando, PSMP) by Year 120 111 100 80 71 Living Well 60 Tomando 40 37 PSMP 20 0 6 1 13 4 1 1 2 2005 2006 2007 2008 Total Programs by County (2005-2008) CLATSOP TILLAMOOK COLUMBIA WASHINGTON MULTNOMAH HOOD RIVER SHERMAN UMATILLA WALLOWA YAMHILL CLACKAMAS GILLIAM MORROW UNION LINCOLN BENTON POLK MARION LINN WASCO JEFFERSON WHEELER CROOK GRANT BAKER No programs 1 program 2-4 programs COOS DOUGLAS LANE DESCHUTES LAKE HARNEY MALHEUR 5-10 programs 11-20 programs 20+ programs JOSEPHINE CURRY JACKSON KLAMATH

5 Recruitment Approaches Programs use various recruitment approaches to encourage participation. Recruitment Approaches Programs Using This Approach (n=247) Fliers / brochures 171 (69%) Referrals from partner agencies 101 (41%) Newspaper / radio / TV promotion 90 (36%) Presentations to community groups 87 (35%) Other 85 (34%) Data not collected 29 (12%) Other recruitment methods included: Newsletter and calendar listings, information distributed at health fairs, personal recruitment letters, email distribution lists, and Web site listings.

6 III. Participant Data: August 2005 December 2008 Since August 2005, when DHS began collecting data, 2,606 participants have filled out all or part of a short anonymous demographic form at the initial session of the programs. DHS began to collect data on Positive Self-Management Programs in November 2008. Data on chronic conditions and how people heard of workshops are based on a set number of check-off options that each participant completes, plus the option of writing in additional health conditions. Total Participants by Year The number of participants has increased each year since DHS began collecting data. 1600 1400 1371 1200 1000 800 816 600 400 200 0 53 366 2005 2006 2007 2008 Average Number of Chronic Conditions Since August 2005, participants reported an average of 3.1 chronic conditions with a range from 0 to 12 (n=2,606). 600 Number of Participants 500 400 300 200 100 0 0 1 2 3 4 5 6 7 8 9 10 11 12 Number of Chronic Conditions per Participant

7 Participants by Condition Self-Reported Chronic Condition(s): (check-off options on participant forms) Total (n = 2,606) Arthritis 43% (1108) High Blood Pressure 37% (973) Chronic Pain 33% (857) Depression 29% (752) High Cholesterol 29% (749) Diabetes 28% (723) Heart Disease 17% (449) Asthma 14% (372) Fibromyalgia 14% (355) COPD 8% (206) Cancer 7% (186) Stroke 4% (110) Multiple Sclerosis 2% (51) None of above, here to accompany family or friends 8% (220)

8 Other Reported Chronic Conditions In addition to the check-off options of chronic conditions listed on the short demographic forms that each participant completes, participants can also write in additional chronic conditions. Other frequently added conditions are listed below. For a complete list of other frequently reported chronic conditions, see Appendix A: Additional Chronic Conditions Reported by Participants. Total (n = 2,606) Other conditions: 24% (635) Muscle, bone, or joint issues 6% (164) Digestive system issues 2% (59) Sleep apnea or sleep 2% (57) disturbances Anxiety disorder or panic 2% (45) disorder Osteoporosis 2% (41) Hearing or vision problems 2% (40) Headaches or migraines 1% (37) Chronic fatigue 1% (35) Endocrine disease 1% (31) Parkinson s disease 1% (27) Bipolar disorder 1% (25) Lupus 1% (22) Overweight or obesity 1% (20) Post-traumatic stress disorder 1% (20) Vertigo, Meniere s disease, or <1% (12) dizziness Participant Demographics Gender Race/Ethnicity African American American Indian/Alaskan Native Asian/Pacific Islander Hispanic/Latino White Age Age < 65 (n = 1,527) Age 65 (n = 1,079) Total (n = 2,606) Male 18% 30% 23% (593) Female 82% 70% 77% (1,996) 1% 5% 1% 16% 70% 1% 1% 3% 3% 84% 1% (34) 4% (93) 2% (48) 10% (267) 76% (1,974) Range Mean 11-64 years old 50 years old 65-96 years old 74 years old 11-96 years old 61 years old First time attendee 90% 93% 92% (2,389) Have medical insurance 62% 76% 68% (1,760)

9 Ways Participants Heard About the W orkshops Participants reported hearing about these workshops in a variety of ways, including provider referrals, local media, and advertisements at community and faith-based organizations. Total (n = 2,606) Heard about this workshop: Through a doctor or nurse s office 20% (527) Newspaper 18% (475) From a friend 15% (379) Other 14% (364) Other health or social service 9% (225) provider From a poster 5% (132) Word of mouth 4% (117) Senior Center 4% (100) From an announcement at work 3% (81) Church or faith group 3% (77) Family 3% (77) Senior or retirement housing 1% (33) Additional Ways Participants Heard About the Workshops In addition to check-off options, additional ways that participants reported hearing about workshops included the following: Catalog, class listing or newsletter Letter, postcard or other mailing Internet, email or listserv Health fair, conference or community event School, health class or extension services Senior companion, RSVP or senior volunteers Radio or TV ad Attended last session Other 2 7 9 14 18 18 20 24 42 0 5 10 15 20 25 30 35 40 45 Number of Participants

10 Appendix A: Additional Chronic Conditions Reported by Participants Behavioral/Mental Health Alcoholism Attention deficit disorder Chronic stress disorder Gulf War syndrome Hyperactivity disorder Obsessive-compulsive disorder Tourette s syndrome Multiple personality disorder Social phobia Cardiovascular Aneurism Aortic valve problem Bleeding disorder Blood clots Dissected aorta Heart palpitations Mitral valve prolapse Phlebitis Pulmonary hypertension Rapid heart rate Pacemaker Peripheral artery disease Vascular leg surgeries Skin Conditions Abcess Dermatitis Morgellon s disease Psoriasis Shingles Genetic Disorders Charcot Marie Tooth syndrome Haemochromatosis Neurofibromatosis Immune/Autoimmune Allergies Antiphospholipid antibody syndrome Behcet s disease Chemical sensitivity HIV Immune deficiency syndrome Immune globulin antibody deficiency Scleroderma Sjogren s syndrome Nervous System Alzheimer s, Brain injury Carpal tunnel syndrome Chiari malformation Chronic Lyme disease Dementia, Lewy body dementia Epilepsy Erythromelalgia Essential tremor Fainting spells Memory loss Neuropathy/peripheral neuropathy Paresthesia Pinched nerves Polymyalgie rheumatica Post-polio syndrome Post-herpetic neuralgia Sciatica Seizures Spinal stenosis Sympathetic dystrophy syndrome Spina bifida Spinal demyelinenation Polycythemia vera Myeloproliferative disease Internal Conditions Abdominal adhesions Bladder nerve weakening Costochondritis Enlarged prostate Gout Hepatitis C Hernia Incontinence Interstitial cystitis Kidney condition Liver condition Pancreatitis Ulcer Urostomy Sarcoidosis Tumor Other Reasons Anemia Bronchitis Chronic cough Chronic sinusitis Constant sinus drainage Cyclic vomiting syndrome Endometriosis Hot flashes, menopause Hypoglycemia Fluid build-up in legs Lymphedema Overeating Scoliosis Valley fever 10