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2004 Model Practice Application (Public)Application Name: 2004 Model Practice Application (Public) : Pasco County Health Department : Arthritis Self-Help Course Applicant Name: Mr. David C Johnson Practice Title Arthritis Self-Help Course Submitting LHD/Agency/Organization Pasco County Health Department The Arthritis Self-Help Course (ASHC) targets people of any age who are suffering from the pain of arthritis to improve their quality of life. Since January 2003, the Pasco County Health Department has empowered over 230 participants from the community who suffer from arthritis. The program’s objectives are that 100 participants will complete all six classes, each class will have between 10 and 15 participants, and participants will take less arthritis medication, exercise more, and move with ease.
Eighty-five percent of participants have completed the entire six-week course. One hundred percent of returned surveys indicated that participants learned the strategies, used the strategies after the class, and now take less pain medication. Attitude towards the class was favorable, and 100 percent of the class said they would refer the course to others. Participants reported using multiple skills learned during the course to reduce pain management including the three steps of exercise, distraction or relaxation techniques, and planning future goals. The basic requirements to replicate this program are: 1) volunteer leaders who have successfully completed the ASHC training and who are willing to follow program protocol; 2) materials provided by the Arthritis Foundation; 3) facilities to hold the course; and 4) ways to promote the course.
Responsiveness and Innovation The majority of Pasco County’s population is over the age of 55. One in two adults in Florida over the age of 65 has arthritis. There is currently no surgical, pharmaceutical, or other cure for arthritis. Arthritis Self-Help classes are held locally in the community in areas with the most demand. Classes are normally during the day. This is the most appropriate time for people in need. Even though medication helps reduce pain and increase activity levels, many participants want to reduce the amount of medications they take. This both a budgetary and a health concern, given the rising costs of prescription medication and known side effects due to long-term use of many pharmaceuticals. Arthritis and fibromyalgia are painful diseases. People who suffer from it are more willing and eager to learn techniques to help them improve their quality of life through self-management.
Agency Community Roles The coordinator of the program is a health educator in the health education office of the Pasco County Health Department. The coordinator finds a location within the community to hold classes, promotes the program, and teaches it as needed. The Arthritis Foundation helps promote the course, as do the local senior centers, hospitals, and libraries that allow the classes to be held in their facilities at no cost. The coordinator of the CDHPE within the Health Education office also helps to promote the classes to her clientele through a monthly newsletter. The coordinator of the ASHC attends community meetings and trainings and holds an annual volunteer luncheon for leaders. The better the relationship with other community stakeholders, the more they are willing to help promote and teach the classes. This community buy-in—rather than single-agency dependence—can help sustain the program.
Costs and Expenditures The Pasco County Health Department is one of three counties to receive a small grant to hold the classes. The costs of the program include 20 hours per week of coordinator time and $40.00 per person for class materials. In-kind contributions include classroom facilities. The CDC and the Arthritis Foundation supported the practice for the 2003-2004 fiscal year.
Implementation
- Decide when a class is to be held.
- Contact the list of trained volunteers in Pasco County to see if they are available to teach the course.
- Find a location by contacting local senior centers, hospitals, and libraries. Rotate the location by geography, community composition, and type of venue to make sure all participants will feel comfortable in a given location.
- After the date and location are set, a form must be faxed to the Arthritis Foundation in Tampa, FL so they can help promote the class.
- Arrange for local promotion, such as sending press releases to the local papers and handing out flyers at health fairs, county buildings, and local health departments.
- Once 15 participants are signed up, a waiting list is created for the next class. Smaller classes have proven to be more effective.
- Send post cards or make telephone calls within three days of the class as an extra reminder to improve attendance.
- Teachers review the educational material the day before the class, discuss division of activities, and prepare classroom materials. Since the class must be taught the same way each time to ensure it can be replicated, the teachers must familiarize themselves with the material each time. Also, the team teaching approach requires coordination for optimal enjoyment of the students.
Sustainability Significant stakeholder commitment is growing but unable to support the program without the grant at this time. The course could be supplemented with a participant fee. Community sponsorship is not possible, because there are a limited number of commercial establishments in the county and many other worthwhile causes are competing for attention. The county’s two largest employers are the school system and the county government. Plans for raising funds include: 1) continuing to apply for funding sources; 2) encouraging volunteer leaders; 3) asking class participants and leaders to organize fund raising activities; and 4) advocating for insurance coverage of the class.
Outcome Process Evaluation Promotion is measured by asking participants where they learned about the course. When the program first began, press releases were where the majority of participants learned about the course. Currently, most referrals come from past participants.
Pre- and post-tests are given during the first and last classes. A comparison is made on the participant’s pain level at the beginning and at the end of the class. Also noted is if less arthritis medication is needed because of the techniques taught to them in the class. Are they able to do more physical activity since joining the class? At least 75% of the participants are able to do more activity with less pain. Conclusions from the initial follow-up survey are that they have learned techniques to help them control pain and are taking less medication.
Program staff can be reasonably certain that changes are due to the classes. What they learn in the class is what they take home with them. By the end of the six weeks participants are talking about how the techniques taught in the class have helped them do the things they were not able to do before the class. There have been no other campaigns or classes available in this area for arthritis that the students took advantage of during the time of the class and survey follow-up.
The process objective of each class having at least 10 participants was met, as well as the number of classes offered. At the end of the course, participants have stated that they are taking less arthritis medications as well as shown on the surveys, and participants are exercising more with less pain.
Lessons Learned The waiting list has proved to be a successful resource for future scheduled classes. Make sure to send out reminder postcards or flyers or call the participants about three to five days prior to the course. Some participants may have forgotten that they registered for the course.
Key Elements Replication Keeping leaders from prior years has been effective. Recruiting leaders within the classes resulted in a few participants. More leaders are needed to teach the classes so as to reach all parts of the county. |
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