Monday, October 24, 3:00 p.m.-4:30
p.m.
The Administration on Aging's Evidence-Based Prevention
Initiative: Early Results From 13 Demonstrations
Authors
N. Whitelaw1; L. Beattie1.
1The National Council on the Aging, Center for Health
Aging, Washington, DC
Background
In the Fall 2003, AoA launched The Evidence-Based Prevention
Initiative with the specific intent of demonstrating how the
results of rigorous research (from NIA and other Institutes,
CDC, AHRQ and others) can be effectively translated into
practice through community organizations serving older adults.
Specific interventions target disease self-management, physical
activity, nutrition, medication management, and/or falls
prevention. AoA has committed $6 million and other funders have
added a similar amount to support 13 local demonstration
projects and a National Resource Center at NCOA.
Methods
The progress and outcomes of this initiative are been
tracked by NCOA and researchers at PRCs and each demonstration
site. The RE-AIM framework guides the evaluation through 5
dimensions: Reach into diverse, at-risk populations;
Effectiveness in replicating improvements in health reported in
the original trials; Adoption by a variety of settings;
Implementation that maintains fidelity to original intervention;
Maintenance of effects over the long term.
Results
Halfway through the grant period, it is clear that the
community programs are working. Key in the early months was the
willingness and capability of aging service organizations to
understand the interventions and the importance of fidelity.
While engaging diverse settings and staff (e.g., senior centers,
nutrition programs, community action agencies, low-income
housing, case management programs), each project has developed
and implemented practices to ensure fidelity. Each project is
gathering longitudinal data on participants. Retention rates are
high (over 80%) and preliminary analyses indicate that
improvements in health outcomes are matching the original
trials.
Discussion
To date, this Initiative has successfully addressed
two pressing problems – inattention to behavioral risk factors
among the older adults and the shortage of effective
community-based programs to address these risks. The systematic
strategies and tools used for this Initiative can assist other
agencies to implement programs that can make a difference in
population health.
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The Delta HOPE Tri-State Initiative
Author
M. Lombardo, Wellness Incorporated, Duluth, GA.
Background
The goal of this initiative is to replicate a
successful school-based nutrition and physical activity
intervention with the objective of coalescing organizations to
combat the epidemic of children who are overweight and at risk
for overweight and obesity.
Methods
The ability to affect the largest number of children
at risk for overweight/obesity requires that you reach them
where they are ready to learn in school. These materials are
linked to core curriculum objectives which makes them
appealing to teachers, principles and administrators in that
they keep students on task with math, science and language
arts studies while simultaneously instructing on nutrition
education and/or incorporating physical activity into their
seat work. To effectively deliver a comprehensive, replicable
program using these materials, we created a public/private
partnership with the Cooperative Extension Services of three
land grant universities: Mississippi, Louisiana and Arkansas
as well as other public agencies.
Results
A sample of results include:
Participating students
experienced an increase in the total number of minutes engaged
in physical activity by an average of 3.42 hours over the
length of the intervention. Students participating in the
intervention expanded their knowledge base in the areas of
general health and safety, physical activity and nutrition
with no grade levels achieving below at least 61% of students
mastering (at 70% or better) at least on of the student
knowledge assessments. 68% of teachers report they would
recommend the program to other teachers. The HOPE project
has been selected for presentation at nearly a dozen national
conferences.
Discussion
The three components that make this project unique
and worthy of discussion are: 1. It's model, school-based,
curriculum-linked approach; 2. The partnerships created; 3.
The original, easy-to-use, child-friendly materials.
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Tutu's House—A Hawaiian Style Community Health Resource
Author
D.L. Moody, Friends of the Future, Kamuela, HI.
Background
Tutu's House on Hawaii Island is a non-profit
community health resource center, with a service area of 1,000
square miles; of the area's five US Census-reported ethnic
groups, none comprises even a third of the total population.
Our rural region has the most HPSA areas in the state, coupled
with high obesity, diabetes and asthma rates, and an
unacceptably high stroke-related death rate. Residents must
travel to the island of Oahu, more than 200 miles away, for
many treatment options.
Methods
In Hawaiian tutu means grandparent/elder, a source of
unconditional acceptance ~ and Tutu's House is, first and
foremost, a safe nurturing place where each person can find
preventative and proactive health and wellness information to
assist them in making positive choices for themselves and
their families. Neither a clinic or a social service, Tutu's
House offers, at no charge, a lending library, assisted
Internet health research, video teleconferencing capability,
rooms for educational presentations designed to inspire
community health literacy, and a non-judgmental, encouraging
staff.
Results
Over the past decade, supported primarily by local
contributions, staff and volunteers have created a culturally
appropriate, integrative and holistic approach to improve the
quality of life based on the Hawaiian concept of Aloha – a
mutual love and respect. Tutu's House has offered more than
8,000 presentations with more than 64,000 attendees, and 3,950
volunteers have provided 10,990 hours of time.
Discussion
In Tutu's House, there is no distinction of
ethnicity, economic, education or health status; all welcome
and encouraged to share their concerns health-related in a
compassionate, confidential environment. Health and wellness
of individuals, and ultimately communities, is based on
positive relationships, access to broad information sources,
and empowerment to make personal health choices. We propose a
poster session to share our evolved processes so other remote,
diverse and underserved populations may benefit from our
experience.
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Activate Chester County Health Initiative
Author
S.A. Herr, YMCA of the Brandywine Valley, Coatesville, PA.
Background
In 2004, the YMCA of the USA launched a 10-year
national health initiative called Activate America to focus on
the obesity crisis and associated chronic diseases. Activate
Chester County, a county-wide health initiative, is the YMCA of
the Brandywine Valley's local response to the national
initiative.
Methods
A youth health curriculum was implemented into our
existing YMCA summer day camps and after-school child care
programs in which they receive planned physical activity,
nutrition education, and smoking and drug prevention education.
A Healthy Communities Challenge was implemented in collaboration
with county and community organizations. A dedicated web site
allows individuals to track their health profiles, log physical
activity time, view calendar of events, read current fitness and
nutrition information, and compete in specific challenges. H.I.P.
Kids, a 12-week intervention program, delivered by degreed
professionals, was developed for children identified in or above
the 85th percentile of their BMI.
Results
Activate Chester County was launched in April 2005 and
gaining support, funding, and community attention. The YMCA of
the USA recognized our efforts by awarding the partnering
Associations an opportunity to participate in the Pioneering
Healthier Communities Conference. The H.I.P Kids program is
currently being offered to YMCA Associations in NJ, Phila., and
surrounding counties. Independence Blue Cross is interested in
the program for insurance re-imbursement.
Discussion
The Activate Chester County Health Initiative
promotes physical activity and the development of healthier
lifestyles to adults, children and families. Although a
county-wide initiative, the focus is on individual communities
and creating inclusion and opportunities for developing
healthier lifestyles, especially in our lower poverty areas. The
initiative has deeped the YMCA's ability to develop
collaborations with community organizations and leaders and
established the YMCA as the leader in addressing the needs of
our community.
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