The National Council on Aging (NCOA) has released an issue brief entitled "Evidence-Based Health Promotion Programs for Older Adults: Key Factors and Strategies Contributing to Program Sustainability". This document is aimed at all community-based organizations, especially state units on aging and health. Information contained within the document can help organizations determine how to best work to sustain their programs. The link for this issue brief can be found in the left-hand column of the Partner Resources page under "National Publications", or can be accessed here: http://www.ncoa.org/improve-health/NCOA-Health-Promo-Issue-Brief.pdf. Missouri's Sustainability Toolkit: Self-Management Education Programs for People with Chronic Conditions was utilized as a reference in the creation of this document. To access Missouri's Sustainability Toolkit, please visit our website here: http://moarthritis.typepad.com/Final%20-%20Missouri%20Sustainability%20Toolkit.pdf.
Consultants – Advises and assists the Missouri Department of Health and Senior Services (DHSS), Missouri Arthritis and Osteoporosis Program in developing and implementing programs, to partner and to provide education and community-based services for people with arthritis and related conditions, and to reduce the disability of rheumatic disease and improve quality of life.
Delivery System - A sustainable, state-wide network that is connected contractually and strategically with MAOP that enables coordinated deployment of evidence-based interventions through out multiple delivery points with access to existing groups of people.
Support Partners - Organizations that provide technical assistance, training and project enhancement to MAOP.
Community Networks – A network of regional and local level organizations, community programs, special populations and volunteers connected with MAOP through the RACs that provide program delivery, donated space, referrals, etc.
Referral Network - A network of state-wide organizations that are connected with MAOP through a memorandum of understanding to promote and provide referrals to delivery system partners for physical activity and self-management interventions.
State program collaboration increases awareness and improves access to proven programs
Public Health Problem
Many Missouri adults with chronic diseases such as heart disease and diabetes also have arthritis.
Rural Missouri counties have had limited access to vital evidence-based programs for chronic disease self-management and the programs in urban areas have had low attendance.
State chronic disease programs maximize program dollars when they collaborate to ensure mutually-beneficial goals such as widespread referral to the proven interventions that help prevent and control chronic disease.
The Missouri Arthritis & Osteoporosis Program has an established delivery system for four evidence-based self-management interventions including the Chronic Disease Self Management Program, Arthritis Foundation Self Help Program, Arthritis Foundation Exercise Program, and EnhanceFitness.
They collaborated with three key chronic disease programs within the state health department – Heart Disease and Stroke, Diabetes Prevention and Control, and WISEWOMAN – to increase access to the four evidence-based interventions for residents who would benefit.
A memorandum of agreement between the Arthritis & Osteoporosis Program and the three state chronic disease programs led to contractual agreements with local public health agencies and federally qualified health centers to increase referrals to the proven intervention programs.
The Heart Disease and Stroke Program funds local public health agency contractors to provide one of the four evidence-based programs and actively refer clients to other available interventions. WISEWOMAN adds funding to existing contracts between the Arthritis & Osteoporosis Program and Regional Arthritis Centers to support referral of its clientele.
Four state chronic disease programs are maximizing program dollars by collaborating to reach a mutual goal of increasing access to chronic disease self-management programs.
Chronic Disease Self Management Program courses have tripled and attendance is up – providing greater opportunities for improved quality of life for those with chronic disease.
Awareness of the value of self-management and physical activity for people with chronic disease is increased among members of the Missouri health care delivery system.
Improvements reduce costly leader turnover and increase access for people with chronic disease
Public Health Problem
Over thirty percent of Missouri adults have arthritis.
Evidence-based interventions are important for controlling symptoms, disability and medical costs related to chronic diseases such as arthritis.
Missouri’s delivery of evidence-based interventions was hampered by turnover among volunteer course leaders resulting in the need for frequent leader training that was costly and inefficient. Rural Missouri counties also have been underserved by these interventions.
The Missouri Arthritis & Osteoporosis Program established a statewide partnership with three key groups to ensure delivery of evidence-based intervention courses - local public health agencies, the University of Missouri and the Bureau of Senior Programs Area Agencies on Aging. A memorandum of agreement between the Arthritis & Osteoporosis Program and the latter two organizations included provision of seed money.
Existing Regional Arthritis Centers took on a new management role in place of course delivery in order to oversee provision of services by members of the partnership. The Centers also provide support to partners and course leaders, course advertisement, general information about arthritis and public presentations to connect individuals to programs.
Members of the partnership have access to program data through an improved data collection and reporting system.
Missouri Arthritis & Osteoporosis Program funding is supplied by the Centers for Disease Control and Prevention and state general revenue.
Evidence-based course offerings have tripled over one year, greatly increasing access to needed services for people with arthritis and other chronic diseases.
Missouri now has an established system in place to ensure continued delivery of vital evidence-based interventions with the support of a broad base of partners.
Volunteer course leader turnover is no longer a problem because there is a dependable supply of paid leaders from partner organizations.
Streamlined data collection enables effective monitoring of access to and delivery of needed courses.