1、Arthritis Education Partnership Reaching Rural Tennessee Audiences,Barbara (Bobbi) P. Clarke, PhD, RD Professor, Extension Health Specialist and Co-Director, UT Center for Community-Based Health Initiatives SERA 19 Rural Health Conference September 11, 2007,2,Purpose of Presentation,Share with you A
2、 unique state partnership addressing arthritis self-management education Strategies for success Program impact at the state and county levels,3,Did You Know,One out of every three adult Tennesseans has arthritis Tennessee ranks above the national average for arthritis prevalence Arthritis is the maj
3、or cause of chronic pain and disability, impacting medical expenses, lost wages and the ability to maintain independence,4,What Is Arthritis?,Not an old persons disease Half of seniors do not experience arthritis Three out of five Tennesseans are younger than age 65 Other causes besides aging Injury
4、 Joint abuse Overweight/obese Chronic condition without a cure Term covers over 100 diseases and conditions affecting the joints and connective tissue,5,Arthritis Control Challenges,Self-management disease No treatment is right for everyone Lack knowledge to self-manage disease to control the pain,
5、depression and minimize further joint damage Lacking access to arthritis intervention and treatment Healthcare providers lack the time to teach self-management skills,6,The Solution: Tennessee Arthritis Education Partnership Since 2003,Tennessee Department of Healths Arthritis Control ProgramTenness
6、ee Chapter of the Arthritis FoundationUT Extension statewide educational network of Family and Consumer Sciences educators,7,Three Evidence-based Educational Programs,Focus on self-care skills to reduce pain and discomfort of arthritis, decrease medications & decrease doctor visits: Arthritis Self-H
7、elp Program Arthritis Foundation Exercise Program Tai Chi,8,Arthritis Self-Help Program (6 2-hour Session),Teaches how to: Self-manage arthritis daily Exercise, medications, pain control, expressing feelings, weight control, relaxation techniques, pacing daily activities Communicate with healthcare
8、provider Benefits: decreased pain, medication use, depression, improved daily activities of living and doctor visits,9,Arthritis Foundation Exercise Program (8 Session),Low impact, joint safe exercises Standing or sitting exercises Benefits: decreased pain, joint stiffness, medication use, and incre
9、ased energy, muscle strength, flexibility,10,Tai Chi (8 Session),High stance Sun Style Tai Chi gentle on joints Range of motion exercises and agile steps Pain control through breathing and relaxation techniques Benefits: reduced pain, depression and stiffness, improved flexibility and balance, impro
10、ved cardiovascular function,11,County Demographics,Rural counties in Tennessee geographically isolated, especially in the Appalachian Mountain chain Services and educational resources are limited in this area,12,County Demographics (cont.),Arthritis cases increased 53% from 1990 to 2000 17 Rheumatol
11、ogist locations in the state, mostly urban areas While there are senior centers located within each county, there is a lack of educational providers for Arthritis education,13,TN Arthritis Education Partnership Goals,Establish and maintain a network of UT Extension educators who are certified to tea
12、ch AF programs. Improve the understanding about arthritis as a chronic disease among rural Tennesseans. Teach rural Tennesseans to be better self-managers of their disease by changing their behaviors that lead to better control of symptoms.,14,Building the UT Extension AF Certified Instructor Networ
13、k,Conducted series of AF certification programs across the state from 2004 2007Training 54 UT Extension educators in various programsConducted an Arthritis Update professional development conference in 2005 at three regional sites Rheumatologist, pharmacist, physical therapist and AF staff Requested
14、 by UT Extension educators 2008 Arthritis Update,Role of Partners,16,TN Chapter of the Arthritis Foundation,Tennessee Chapter of the AF Certification training Evidence-based programs Quality control of instructors and programs Record keeping for national reporting,17,Tennessee Department of Health,P
15、rovide funding for instructor training registrations ($100 ASHP & AFEP, $200 Tai Chitravel to and from the certification trainings, meals and hotel if necessaryAF educational resourcespartner meetings and national meetingdevelopment of low literacy educational and promotional materials,18,University
16、 of Tennessee Extension,Coordinate training sites Promoted training opportunities Develop low literacy educational and promotional materials Funded the Tai Chi instructor trainings Institutionalize the AF programs as part of the UT Extension Public Health Education Program. Must include in annual pl
17、ans of work. Provide web-based impact reporting system (SUPER) Develop indicators and collecting program impact data Develop and maintain individual Web sites for each program and the partnership,19,Partnership Impact,CDC Grant revenue ($60,000) Improving the quality of life for 5,737 Tennesseans in
18、 2006 Recipient of two national awards in 2006 CDC Partnership Award National Arthritis Foundation Public Health Innovation Award 2005 CDC Exemplary Program model for other states,20,Arthritis Self-Help Program,2,383 ASHP Graduates 86% women, 12% men, 2% youth End-of-Program Survey: 86% increased co
19、nfidence in arthritis management 3-Month Follow-Up (n=1,987): 100% improved ability in coping with arthritis 57% improved overall health,21,Demonstrating Results,Arthritis Self-HelpExercise ProgramTai Chi,3-Month Follow-Up,Self-Reporting through Pen and Paper Surveys,End-of-Course Evaluation,22,Arth
20、ritis Foundation Exercise Program,747 participant 54% women,46% men, 15% youth End-of-Program Survey: 81% reported exercises safe and enjoyable 74% improved performance of daily activities 74% decreased pain and stiffness 3-Month Follow-Up (n=350): 75% increased range-of-motion 63% decreased pain an
21、d stiffness 88% continued the exercise routines,23,Tai Chi,3,607 Tai Chi Graduates 77% women, 15% men, 8% youth End-of-Program Survey: 86% decreased stiffness 82% improved balance 71% improved in overall health 3-Month Follow-Up (n=1,200) 100% continued practicing Tai Chi 77% improved in overall hea
22、lth,24,Outreach Strategies,Extension educators collaborate, plan, promote, implement, evaluate/report Partner with newspapers, health care providers, senior centers, county health councils, health departments Offer program to community colleges and university,25,Outreach Strategies,Partner with news
23、papers, health care providers (physicians, pharmacists, physical therapist, worksites, senior centers, county health councils, health departmentsOffer program community colleges and universities, senior centers, fitness centers, rec centers, churches, worksitesWork with media and community events to
24、 promote AF programs and educate public about arthritis,26,User Fees,All fee-based programs ASHP - $35.00 AFEP - $32.00 Tai Chi - $48.00 Fees Enhance: Course Materials Agent Training Travel,27,Conclusions,Partnerships are vital Must have strong coordination, trust, respect, follow-through and cooper
25、ation among partners Outreach through Extension can expand the rural capacity of AF in creative and diverse ways Funding from CDC is vital Win-win partners at state and county levels Real winners are the Tennesseans who participated in the programs and now reduced their suffering from arthritis.,Tennessee Arthritis Education Partnership THANK YOU!,
