Evidence-Based Disease Prevention Grants Program
The Purpose of the Program and How it Works
Chronic diseases and conditions, as well as disabilities resulting from injuries sustained in mishaps such as falls, disproportionately affect older Americans. The situation is becoming ever more critical as the huge Boomer generation moves into later ages. Fortunately, there exists a large body of scientific evidence on the efficacy of low-cost self-care programs that can reduce older adults’ risk of disease, disability, and injury. These “evidence-based” programs empower older people to take more control of their own health through lifestyle and behavior changes.
For most of this decade, the Administration on Aging (AoA) and other federal agencies— the Agency for Healthcare Quality and Research (AHRQ), the Centers for Disease Control and Prevention (CDC), the Centers for Medicare and Medicaid Services (CMS) among others —have joined with The Atlantic Philanthropies, the John A Hartford Foundation, the Robert Wood Johnson Foundation, and other national organizations, to bring these effective programs to older adults.
This innovative public-private partnership is making evidence-based programs available in 27 states and hundreds of communities around the country. These organizations are working with state and local leaders to build the knowledge, experience, and systems for nationwide access to self-care programs that will improve the health of older Americans. States must put in place the Stanford University Chronic Disease Self-Management Program (CDSMP) and may also implement other evidence-based programs targeting physical activity, fall prevention, nutrition and diet, depression, and/or substance abuse. Among the other programs being adopted are Enhance Fitness, Matter of Balance, Active Living Every Day, and Healthy IDEAS. The State-level initiative represents a dynamic $30 million public/private partnership, which in turn supports the states in powerful (and sometimes new) collaborations between their offices on aging and health departments. Together, these state teams provide important policy leadership and management oversight to evidence-based programming. They also support the local partnerships (including nonprofit aging services providers, area agencies on aging, health organizations, the business sector, and other potential collaborators from both the private and public sectors) that lead to successful implementation of these evidence-based programs.
At-risk populations are an important target of the program. Participant demographics collected by grantees indicate that this target is being reached:
- 70% of participants are 70 years old or older; 37% are 80 or older
- 48% of participants live alone
- 30% are members of various racial or ethnic minority groups
Grants
In September 2006, AoA awarded $13 million to sixteen states to improve the health and quality of life of older Americans. In June 2007, AoA awarded an additional $5.7 million to eight additional states for the same purpose. These awards support the delivery of evidence-based prevention programs for service providers of older adults, such as senior centers, nutrition programs, senior housing, projects and faith-based organizations.
The grantees can implement evidence-based disease prevention programs in one or more of the following subject areas:
Chronic Disease Self-Management: Chronic disease self-management—providing patients the education, motivation and tools to make behavior changes—leads to improvement in health status, increased patient satisfaction, and in some cases, reductions in health care use and costs.
Fall Prevention: Among older adults, falls are the leading cause of injuries, hospital admissions for trauma and related deaths. The frequency, harm and costs associated with falls make a fall prevention program a cost-effective strategy for reducing functional decline and health care costs among high-risk seniors.
Physical Activity: Regular physical activity can help prevent or control many of the health problems that often reduce the quality and length of life for older adults. These health problems include obesity, arthritis, high blood pressure, diabetes, depression, and colon cancer.
Nutrition: Two-thirds of older Americans are not eating the daily recommended five servings of fruits and vegetables. Many older adults, including those with chronic diseases, can substantially benefit from programs that assist them in making healthy food choices.
Medication Management: Older adults are particularly vulnerable to medication errors because of the number of medications they take and the biological changes of aging and disease.
Depression: Nearly 20% of U.S. adults, 65 years and older, experience depressive symptoms. The core components of depression self-management programs include screening and assessment, education for clients and family caregivers, referrals to appropriate health professionals and behavioral activation.
To learn more about a state’s evidence-based grant program please click on the desired state.
State Awards 2007 (All in Doc Format)
Arkansas
Arizona
California
Colorado
Connecticut
Florida
Hawaii
Idaho
Illinois
Iowa
Maine
Maryland
Massachusetts
Michigan
Minnesota
New Jersey
New York
North Carolina
Ohio
Oklahoma
Oregon
South Carolina
Texas
Wisconsin
Back to top
Data Highlight Extensive Services Provided to Seniors
Although several states are just getting started, there are strong indications that the awards are already making a difference. Some early successes occur in three key areas:
Impact: Quantitative data that show who has been reached through these proven programs and the breadth of local capacity building
Influence: Descriptive results that indicate the ability of grantees to establish new partnerships or affect change with other statewide stakeholders
Leverage: Evidence that documents how these awards have led to additional funding of evidence-based programs through public or private sources
Impact
Reaching older people with rigorously studied interventions is the ultimate goal of the state-level program. As of August, 2008 more than 15,000 older adults have participated in at least one evidence-based program. The following three programs have had the largest enrollment:
More than 7,500 individuals participated in the Chronic Disease Self-Management Program (CDSMP)
More than 1,900 individuals participated in Matter of Balance, a fall prevention program
More than 1,900 individuals participated in Enhance Fitness, a physical activity program
A key aspect of this evidence-based prevention initiative is to build sustained capacity for continued impact in the years ahead. To this end, more than 580 settings have provided evidence-based programs during 2007 and 2008, including senior centers, area agencies on aging, housing sites, churches, meal sites, community centers, libraries, clinics and many more.
Current peer-reviewed articles based upon AoA’s 2003 demonstration grants to 12 community projects document the positive impact of CDSMP, Matter of Balance, and other evidence-based programs on older adult health.
Influence
During the first project year, state leadership demonstrated exceptional skill in establishing new partnerships and engaging diverse organizations around evidence-based prevention for older adults. A genuine collaboration between the state offices on aging and the state health departments has emerged in the participating states. In many places, this kind of partnership had not existed before and represents a significant step forward in ensuring quality outcomes for older adults.
All states are working to engage health plans and health care providers in evidence-based prevention programming. These efforts are being advanced by a learning network sponsored by AoA, the Agency for Healthcare Research and Quality (AHRQ), and Centers for Disease Control and Prevention (CDC). Relationships with the health care sector are taking a variety of forms:
In Illinois, Maine, Maryland, Ohio, Oregon, and many other states, providers are promoting evidence-based programs to their patients and making direct referrals to CDSMP and a Matter of Balance.
In California, Colorado, and other states, Kaiser is contributing the time of its own CDSMP master trainers to train workshop leaders for local aging service organizations.
Leverage
Based on the benefits of evidence-based prevention programming, states have been able to acquire additional funds from a variety of sources:
In Wisconsin, evidence-based programming is fully integrated into the State’s $3 million investment in Aging and Disability Resource Centers. In South Carolina, advocacy organizations have mounted an impressive campaign to push the legislature to fund evidence-based prevention programs.
In Florida, a foundation has launched a five-year, $7.5 million initiative on healthy aging, incorporating evidence-based programming and other strategies. Oregon, California, Colorado, and other states are also receiving substantial philanthropic support.
Back to top
Resources and Useful Links
National Resource Center
The AoA funds a National Resource Center that provides technical assistance to the grantees. The Center’s Web site includes reports and other resources related to this program and healthy aging. To find out more information on the Center for Healthy Aging (the Center) please visit the Web site at www.healthyagingprograms.org
Back to top
| Last Modified: 2/24/2009 1:38:29 PM |
|