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Partners in Care Foundation Self-Management Technical Assistance Center
Supported by:
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Partners in CareWho We Are
Partners in Care is a transforming presence, an innovator and an advocate to shape the future of health care
We address social and environmental determinants of health to broaden the impact of medicine
We have a two-fold approach, creating and using evidence-based models for: health system practice change and enhanced patient self-management
Changing the shape of health care through new community partnerships and innovations
Partners in CareWho We Are
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Health Self-Management Services
Partners in Care FoundationTechnical Assistance Center
Licensing & Quality Assurance
Data Entry & Management Training Communication
Materials
Coalition Administration
Partnership Development
New System Partners
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HEALTHIER LIVING / CHRONIC DISEASE SELF-MANAGEMENT PROGRAM
Program Overview
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California Chronic Disease
Self Management Education
Workshops (2012-2015)
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What is Self-Management?The actions that individuals living
with chronic conditions must do in order to live a healthy life.
Physical Activity
Medications
Decision Making
Action Planning
Breathing Techniques
Understanding Emotions
Problem-Solving
Using Your Mind
Sleep
Communication
Healthy Eating
Weight ManagementWorking with Health Professionals
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Target Population
People with at least one chronic condition – OR –
A family member, friend or caregiver of someone with a chronic condition
Stamina to attend 2 ½ hour sessionCognitive function to participate
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Self-Management Programs• Chronic Disease
Self-Management*
• Arthritis
• Diabetes
• HIV/AIDS
• Chronic Pain
• Tomando Control de su Salud (Spanish)
• Arthritis (Spanish)
• Diabetes (Spanish)
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Healthier Living (CDSMP)• Award-winning evidence-based program
developed by Stanford University
• 12 -16 participants & 2 Trained Leaders
• People with different conditions or their caregivers
Six-week Program 2 ½ hours, one day a week Includes:
Group discussions Activities Short lectures
Workshop Materials: Healthier Living Book, Relaxation CD, & Charts
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CDSMP Leader Training
• 4 day training (6-8 hours per day)
• Facilitated by two certified Master Trainers for groups of 10-20 new leaders
• License from Stanford University is required to train or offer CDSMP
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PROGRAM ACTIVITIES & CONTENT
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Session Structure
• Welcome• Feedback & Problem Solving• Activities & Education
– Brainstorming– Discussion– Demonstration & Practice– Lecturette
• Making an Action Plan• Closing
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Week 1 Week 2 Week 3 Week 4 Week 5 Week 6
Intro to Workshop &
Group Introductions
Feedback & Problem Solving
Dealing with Difficult
Emotions
Making Decisions
Better Breathing
Making Health Food Choices
Working with Health Care
Providers & the Health Care
System
Pain & Fatigue Healthy Eating
Medication Usage
Mind-Body Connection
Weight ManagementMaking
Informed Treatment Decisions
Getting a Good Night’s
Sleep
Physical Activity Endurance Exercise
Commun-ication Looking Back &
Planning for the Future
Depression Management
Preventing FallsRelaxation Problem Solving Positive
Thinking
Making An Action Plan Making An Action Plan
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OUTCOMES & EVALUATIONParticipant Health & Healthcare Utilization Savings
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Participant Health Outcomes
CDC Meta-analysis of 20 studies show that CDSMP
contributes to improvements in:
Psychological statusPhysical health status
Self-efficacy andSelected health behaviors
Brady, Teresa J. Executive Summary of ASMP/CDSMP Meta-Analyses. CDC, May 2011. http://www.cdc. gov/arthritis/docs/ASMP-executive-summary.pdf
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Participant Health Outcomes
2013 National Study found IMPROVEMENTS in:
Ory, Jiang, Lorig, Laurent, Whitelaw, and Smith, 2013.
21% Depression
16% Managing Sleep Problems
13% Physical Activity
10% Fatigue Management
11% Pain Management
12% Medication Compliance
9% Communication with Physicians
Reduction in ER and Hospital Stays, resulting in $714 of savings per person
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EvaluationAttendance Log
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EvaluationCover Sheet
DRAFT
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EvaluationParticipant
Questionnaires
Session 1 and Final Session
DRAFT
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Fidelity Monitoringhttp://patienteducation.stanford.edu/licensing/FidelityManual2012.pdf
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MATERIALS & COSTS
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Program Licensing CostsSub-license from Partners in Care *prices subject to change
Up to 8 workshops per year (Multiple Programs) $150
Up to 16 workshops per year (Multiple Programs) $300
Single-Program License Fees from Stanford *prices subject to change
30 or fewer workshops, 6 Leader trainings $500
90 or fewer workshops,12 Leader trainings $1000
Multiple-Program License Fees from Stanford *prices subject to change
Up to 75 total workshops and 6 Leaders trainings $1000
Up to 120 total workshops and 12 Leaders trainings $1500
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Training Requirements and Costs
• Attend a 4-day training taught by two Master Trainers• Facilitate a 6-week workshop within six months of training• Facilitate two or more 6-week workshops per year to maintain fidelity
Leader Training
Local Training – 4 full days $800 - $1600/person
Stanford Training – 4 to 5 days $900 - $1600/person + Travel Costs
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Workshop Materials and Fees
Workshop MaterialsPrice for one
Number Needed for Workshop
Total Price Ongoing Price
Pencils $0.10 20 $2.00
Kleenex $1.49 1 $1.49
Dry Erase & Flip Chart Markers $18.58 1 $18.58
Workshop Charts Printing $97.00 1 $97.00
Dry Erase Easel Pads (or White Board)
$40.00 1 $40.00 $40.00 or $0.00
Blank Easel Pads (paper) $23.00 1 $23.00 $23.00
Easels $74.99 2 $149.98
Folding File Cart with wheels $24.99 1 $24.99
CD Player $40.00 1 $40.00
Book & CD $24.00 20 $480.00
TOTAL $877.04 $63.00
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Other Potential Program Costs• Volunteer Leader Stipends (optional)• Food & Refreshments (optional)• Mileage (as needed)
• Staffing Program Coordinator
─ Schedule and coordinate workshops─ Coordinate & Manage Fidelity Monitoring─ Outreach and registration─ Identify and support implementation sites─ Collect data and reporting
Volunteer Coordinator─ Recruit and orient volunteers─ Provide volunteer appreciation─ Monitor volunteers, provide fidelity checks
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TITLE III-DPotential Models & Additional Considerations
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Potential Ways to Move Forward
• Provide & Coordinate EB Programs• Use IIID Funding to provide all or a portion of
EBP Implementation in your Service Area– Contribute towards materials, licensing, leader
stipes, etc. – Contract with Agency to serve as ‘Central Hub’
that administrates program & maintains a cadre of trained Leaders that travel throughout service area
– Other Network Models
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Additional Evidence-Based Programs
PHYSICAL ACTIVITY• Arthritis Exercise Program• Walk With Ease
MEDICATION MANAGEMENT• HomeMeds
FALL RISK REDUCTION• A Matter of Balance
DEPRESSION MANAGEMENT• Healthy Ideas• PEARLS
CAREGIVER PROGRAMS• Powerful Tools for Caregivers• Savvy Caregiver
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Creating Pathways to Health
Develop referrals among/between evidence-based programs
CDSME
MOB
MOB Tai Chi
Cartoon Images developed by Preston Blair. Source: https://cdn.tutsplus.com/vector/uploads/2013/12/cartoonmovements-18a.gif
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*Program can be facilitated in Chinese, Portuguese, Vietnamese, and Russian.
Research by the Roybal Center for Enhancement of Late-Life Function at Boston University
Designed to benefit community-dwelling older adults who:• Are concerned about falls• Have sustained a fall in the past• Restrict activities because of concerns about
falling• Are interested in improving flexibility, balance
and strength• Are age 60 or older, ambulatory ( able to get to a
class) and able to problem-solve• Class size 8-12 participants
During 8 two-hour classes, participants learn:• To view falls and fear of falling as controllable• To set realistic goals for increasing activity• To change their environment to reduce fall risk
factors• To promote exercise to increase strength and
balance
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WHAT PARTICIPANTS ARE SAYING
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Testimonials• “Because I have been afflicted with Parkinson’s for over 20 years, I have suffered a
great deal of depression. The skills you've taught me in maintaining positive thinking and combating depression have really helped to improve my condition.” - John, age 69
• “I found the interaction with the other students in the class to be most enlightening. I realized that although I have a chronic illness I am not alone. Thank you for all the lessons in helping me to deal with this.” - Suzanne, age 57
• “The workshop put me back in charge of my life, and I feel great. I only wish I had done this sooner.” - Robert, age 68
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Thank you!
Dianne Davis, MPH, Senior DirectorHealth Self-Management Services
Partners in Care Foundation818.837.3775 116
WWW.CAHEALTHIERLIVING.ORG