1. Feel Better. Take Charge. Living Healthy (i.e. The Chronic Disease Self-Management Program, CDSMP)

2. Feel Better. Take Charge. Self-management positive self-manager There is no way [a patient] can avoid managing a chronic condition. If he/she does nothing but suffer, this is a management style. If the patient chooses to be a “positive self-manager” and undergo all the best treatments that health care professionals have to offer, along with being proactive in his/her day-to-day management, this will lead to the healthiest life possible. Kate Lorig, RN, DPH, et al. Living A Healthy Life with Chronic Conditions

3. Feel Better. Take Charge. Chronic Disease Self-Management Program (CDSMP) Evidence-based program developed by Stanford Univ. Format: Train the Trainer –Lay Leader Led – teams of 2 –2 ½ hours session; 1x/wk; 6 weeks –10 – 15 participants Stanford Univ. / T Trainers Master Trainers Lay Leaders Workshop Participants

4. Feel Better. Take Charge. CDSMP – Program Goal To enable participants to build self-confidence to assume a major role maintaining their health and managing their chronic health conditions.

5. Feel Better. Take Charge. Illustration of self-management problems for a sample of chronic conditions Chronic Condition Pain Fatigue Shortness of Breath Physical Function Emotions Arthritis XXXX Asthma/Lung Disease XXXX Diabetes XXXX Heart Disease XXXXX Lorig, et al., 2006

6. Feel Better. Take Charge. Reasoning behind the program’s design and elements People with chronic conditions have similar concerns and problems. People with chronic conditions must deal not only with their disease(s), but also with the impact on their lives and emotions. Lay people with chronic conditions, when given a detailed leader's manual, can lead the CDSMP as effectively, if not more effectively, than health professionals. The process or the way the CDSMP is taught is as important, if not more important, than the subject matter that is taught.

7. Feel Better. Take Charge. Essential program components and activities Coping strategies incorporated include: –goal setting and feedback –behavior modeling –problem-solving techniques –decision making Individuals are taught to control their symptoms through: –Relaxation techniques –Changing their diets –Managing sleep and fatigue –Using medications correctly –Physical activity –Communication with health providers

8. Feel Better. Take Charge. Workshop Session Content Session 1Session 2Session 3 1.Introduction 2.Workshop Overview & Responsibilities 3.Differences Between Acute & Chronic Conditions 4.Using Your Mind to Manage Symptoms & Distraction 5.Introduction to Action Plans 6.Closing 1.Feedback / Problem-Solving 2.Dealing with Difficult Emotions 3.Introduction to Physical Activity & Exercise 4.Making an Action Plan 5.Closing 1.Feedback Problem-Solving 2.Better Breathing 3.Muscle Relaxation 4.Pain & Fatigue Management 5.Endurance Activities 6.Making an Action Plan 7.Closing

9. Feel Better. Take Charge. Workshop Content, Continued Session 4Session 5Session 6 1.Feedback / Problem-Solving 2.Future Plans for Health Care 3.Healthy Eating 4.Communication Skills 5.Problem-Solving 6.Making an Action Plans 7.Closing 1.Feedback / Problem-Solving 2.Medication Usage 3.Making Informed Treatment Decisions 4.Depression Management 5.Positive Thinking 6.Guided Imagery 7.Making an Action Plan 8.Closing 1.Feedback Problem-Solving 2.Working With Your Health Care Professional and the Health Care System 3.Looking Back and Planning for the Future 4.Closing

10. Feel Better. Take Charge. Research Shows That CDSMP Participants… Increased their levels of physical activity. Developed better coping strategies and symptom management. Showed better communication with their physicians. Improved their self-rated health and social/role activities, Experienced less health distress. Had less fatigue. Experienced decreased disability. Had lower numbers of physician visits and hospitalizations.

11. Feel Better. Take Charge. Tremendous National Support US Administration on Aging (AoA) –Over $50 million in grants awarded Other federal agencies: –CDC –AHRQ –CMS Dozens of private funders, including: –Atlantic Philanthropies –John A. Hartford Foundation –Health Foundation of South Florida –Robert Wood Johnson Foundation –Archstone Foundation

12. Feel Better. Take Charge. Living Healthy (i.e. CDSMP) 3-year demonstration grant from AoA in 2007 –7 Area Agencies on Aging (AAAs) covering 46 counties Have expanded to 7 more AAAs  now covering 80 counties Will be state wide by the end of 2012 Working to target hard-to-reach, underserved adults 60+ and offer the program in a wide variety of settings.

13. Feel Better. Take Charge. {State wide by the end of 2012} Current Reach {State wide by the end of 2012}

14. Feel Better. Take Charge. you How can you get involved in Living Healthy? Participate in a Living Healthy workshop! Becoming a Lay Leader or help identify people who would be interested in becoming Lay Leaders Locate new sites for workshops and/or trainings Help us get the word out  Refer clients, and mention the program to colleagues, family members, and friends Help us connect with people, groups, organizations, etc. that may be interested.

15. Feel Better. Take Charge. Contact Information Serena Weisner, MS CDSMP Project Director NC Division of Aging & Adult Services serena.weisner@dhhs.nc.gov (919) 733-0440