3/30/2017 Oklahoma’s Suc Oklah ’s Success in ss in Delive Delivering CDSM CDSME Program Pro rams in Co in Correctio rrectional F al Facilities cilities Introduction Zach Root Grant Developer Aging S ervices Oklahoma Depart ment of Human S ervices Obj ectives Chronic Disease S elf-Management Program (CDS MP) CDS MP in Oklahoma Partnerships Program Reach and Participants CDS MP in the Prison S ystem Zach Root Zohre Salehezadeh, PhD Trainers and Participants 2015 AS A Conference Expected Benefits Chicago, IL Chronic Disease Self-Management Objectives of this Presentation Program (CDSMP) Lay-led participant education program offered in communities in the Gain insight into: United States and several other countries 1) How Oklahoma has successfully implemented CDS MP into Participants are adults experiencing chronic health conditions such the prison system; as hypertension, arthritis, heart disease, stroke, lung disease, and diabetes (family members, friends and caregivers can also 2) How the inmates at the Oklahoma Department of participate) Corrections (ODOC) facilities across the S tate have Provides information and teaches practical skills on managing benefitted from this program; chronic health problems 3) The challenges and obstacles faced along the way; and Gives people the confidence and motivation they need to manage the challenges of living with a chronic health condition 4) What lessons we have learned from this process. CDSMP in Oklahoma CDSMP in Oklahoma Target populations and their settings Our partners 60+ or living with chronic conditions Funder: U.S. Administration on Aging S tarted with rural areas located in the Northern, Central, S outh Oklahoma Department of Human Services (OKDHS) and S outheast regions, then extended the programs to urban and Oklahoma State Department of Health (OSDH) other areas Local County Health Departments Low-income and high poverty rate: Oklahoma Department of Corrections (ODOC) Median income (65+ householders): $35,005 Oklahoma Health Care Authority (OHCA) Area Agencies on Aging, local community-based and faith-based • (Median in OK 2013-general population: $43,777) organizations (grant-funded and non-grant-funded) Poverty rate for 65+: 9.5% • (Rate in Oklahoma 2013- general population: 16.9% ) 1
3/30/2017 CDSMP in Oklahoma CDSMP Reach in Oklahoma Our numbers so far Living Longer, Living Strong with Chronic Conditions: Participants and Workshops To Date: Workshop Sites, Participants, and Population Over 65 ODOC CDSMP: • Workshops: 391 • Participants: 4,594 • S ites: 18 Non-ODOC CDSMP: • Workshops: 222 • Participants: 2,504 Grand Total S erved: 7,098 CDS MP participants in 613 workshops since 2006 Notes: There have been 391 ODOC workshops and 222 community workshops. Only community participants who listed Additionally, 17 DS MP workshops (207 participants) and 2 a zip code are included. Data presented as of 3/18/2015. The number of LLLS participants (n = 4,594 for ODOC; n = 2,504 Tomando Control de su Salud workshops (21 participants) for community) by county are provided when appropriate. CDSMP Workshop CDSMP in the Prison System Participants’ Race (Differences from regular CDSMP) 1,754 Incarceration is like a chronic condition with its own set of (52.5%) Community ODOC 1800 stressors 1430 1600 (65.9%) 1,250 "Inmates don't come to us in good health to start with” , Director 1400 (27.2%) Justin Jones said. "After years of substance abuse, when they get 1200 886 into their mid-50s, they have an array of chronic illnesses." (26.5%) 1000 Different approaches needed with leaders 800 464 448 “ Prison Culture” and earning the respect and trust of the 600 (13.9%) (20.8%) 346 228 (13.5%) 400 127 participants 122 (6.8%) 27 8 4 4 (5.9%) (5.8%) 200 (1.4%) (0.2%) (0.2%) (0.1%) S ecurity procedures 0 Native Asian Black Pacific White Multi ‐ Racial Unknown American Islander Community Workshop Participants: 2,504 NOTE: 349 of the respondents indicated ODOC Workshop Participants: 4,594 they are of Hispanic or Latino descent CDSMP in the Prison System CDSMP in the Prison System (Workshop trainers and target population) (Participants and leader considerations) ODOC obtained a S tanford CDS MP license How are inmates recruited to the program? Offenders and community volunteers were trained Referrals by Medical Staff LLLS Master Trainer oversees workshops and provides fidelity Automatic selection due to certain illnesses monitoring and program updates Age (60+) ODOC Annual Report S tatistics: “ Request of Staff” initiated by inmate (for all of the above) In 1980, the system had 85 inmates who were age 50 and older, Waiting list a figure that has grown to 5,120 in 2014 (2014 Annual ODOC Orientation for new prisoners Report) S election of inmate leaders ODOC reports that older offenders have contributed to increases Workshop size is limited to 16 participants with facilities in health care expenditures conducting as many as 6 workshops/ week For instance, ODOC spent $60.8 million on medical care in • 2005 versus $84.0 million in 2014 2
3/30/2017 Expected Benefits to Family Expected Benefits to Relationships Department of Corrections Participants are encouraged to practice self efficacy Offenders who are aware of healthcare role Apply positive life style principals to relationships with family Offenders who are solution-oriented members and loved ones, Offenders aware their actions create +/ - outcomes Focus phone calls on positive achievements • Reduction in write-ups and misconducts Include healthy life lessons when writing letters • Discuss concerns over loved ones’ health and wellness during An offender with an positive action plan for his/ her life • visits Reduced staff stress and anxiety Take the focus off self and utilize materials from the • Increased offender releases, reduced staff turn-over workshops to encourage loved ones to seek wellness Problems that develop as a result of a chronic condition tend to dwindle as the workshop progresses Expected Benefits to Offenders Are Talking the State of Oklahoma Individuals who promote the need for self-awareness through “ Living Longer Living S tronger taught me a better way of self-efficacy and self-advocacy handling my chronic pain and ways to help deal with A possible reduction in the cost of ODOC Medical care for long every day life while having Lupus. My teachers gave me a term offenders better understanding than most doctors ever have.” Offenders who have been certified and conducted workshops will be available to serve their communities after release “ Living Longer Living S tronger taught me a lot about my health and the importance of my medication. I learned how to set goals and stick to them. S ince the class I have lost 21 pounds. This was a great class.” Offenders Are Talking Evaluation of the Chronic Disease Self-Management Program Offered to the ODOC Inmates Zohre S alehezadeh, PhD “ Living Longer Living S tronger has had a tremendous Research Manager impact on my life. I learned exercises that I never would have thought to do and learned to set goals and was given Oklahoma Depart ment of Human S ervices the tools to be able to achieve those goals each week. I Office of Planning, Research and S t at ist ics would like to thank the people that offered this class to Research Questions me.” Intervention Data Collections’ Tools, Methods and Timeframe “ When I call home I feel like I am giving back. I ask about S tudy Participants my families health and tell them I am eating better and Pre/ Post S urvey exercising.” S cale construction Findings Conclusions and next steps 3
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