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10/27/2014

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University of New Hampshire Institute on Disability/UCED

Joan B. Beasley, Ph.D.

Integrated Health and Wellness Approaches to Challenging Behavior in Persons with IDD

Joan B. Beasley, Ph.D. Jarrett Barnhill, MD Anne D. Hurley, Ph.D. Beth Marks, RN, Ph.D.



Public Health Model of Intervention

• Primary: Capacity building; promoting wellness, improved quality of life; better outcomes

• Secondary: Expertise, access to appropriate care, cross systems communication; crisis prevention; accountability

• Tertiary: Expertise, appropriate response, stabilization, intervention; accountability

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Joan B. Beasley, Ph.D. Numbers Benefitting from

Intervention

Effective Strategies ‘Changing the odds’

Accurate Response

‘Facing the

odds’

Improved Supports

‘Beating the odds’

Potential

impact of intervention

Required

intensity of intervention

Primary Intervention: Improved access to services, treatment planning, integration of health and wellness, and development

of service linkages

Secondary Intervention: Identification of individual/family stressors, crisis

planning/prevention, health and

medication monitoring and crisis intervention services

Tertiary Intervention: Emergency room services,

hospitalizations and law enforcement interventions

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Medical and Genetic Conditions : Key Players for IDD and Mental Health

Assessments

Anne Desnoyers Hurley, Ph.D.

Research Associate Professor

University of New Hampshire- Institute on Disability

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Initial Psychiatric Diagnostic Interview

General Population ID Population

Establish relationship Relationship with a Team

Conversation, detailed questions & answers

Verbal ability limited

3rd party information

Evaluate overall presentation Atypical presentation Behavioral phenotypes

Discuss diagnosis and treatment plan

“Team” treatment negotiation

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Chief Complaint N= 100 each Hurley et al. 2003 OPD

NIQ Mild M-P

• Aggression* 6 45 37 • Mood* 38 9 3 • Anxiety* 24 8 1 • Suicidality* 14 6 0 • Physical* 5 6 18 • SIB * 0 2 9 • Cognitive* 2 5 11 • Psychotic 2 5 12 • Other 9 14 19

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How Can We Improve Assessment?

• Send for all medical and educational records • Integrating instrumentation into our

assessment process • Assessment of adaptive skills and

neuropsychological testing and projective testing

• Specific tools to assess symptoms or areas, at initiation and regular follow-up

• Careful integration of psychosocial stressors and medical conditions

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START Formal Assessments

• ABC (Aberrant Behavior Checklist)

• RSQ (Recent Stressors Questionnaire)

• MEDS (Matson Evaluation of Medication Side Effects)

• Obtain all medical and educational records

• Case Conference Seminar for select individuals –CET Clinical Education Team

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What do we Mean by Medical?

• Any condition that causes pain, illness, or impairments

• Chronic illness

• Disability – extra burden

• Medical problems that are intermittent

• ALL OF THE ABOVE CAUSES PSYCHOLOGICAL DIFFICULITES

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What about Genetics

• Many people with intellectual disability have that condition because it is genetic in nature

• Genetic conditions cause physical characteristics to be different, usually several

• Many genetic conditions also are the cause of intellectual disability

• Behavioral phenotype is that part of a genetic condition that influences intellectual ability and/or behavior and psychological / psychiatric functioning

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Why are Genetics Important?

• Because if we are trying to help someone who has a specific known genetic condition, we must find out as much as possible about how it may cause medical problems, what types of medical services the person may need, and we will understand psychiatric difficulties and/or challenging behavior associated with the condition better.

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Case #1

Down Syndrome

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Oscar 17 yo Down syndrome

• Referred due to severe physical aggression

q 2-3 months, female staff or community

members, incontinent, fecal smearing

• 2006 psychiatric eval suggested he was

manipulative

• Axis I current: mental disorder due to

medical problems; r/o autism spectrum

disorder, r/o ODD

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Oscar 17 yo Down syndrome

• ADHD –age 5

• Surgical procedure, complications, psychological reactions?

• Hearing impairment

• Vision severe nearsighted, legally blind

• Psychiatric medications with no evidence of response- adverse events documented previously

• Morbid obesity, hyperlipidemia, HTN, sleep apnea, hypothyroidism

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Oscar Age 17 Down syndrome

• Prevacid- 30 mg, 1x/day

• Perphenazine- 2 mg, 2 tabs 2x/day

• Levothyroxine- 150 mg 1x/day

• Clonidine- 0.1 mg in AM, 0.05 mg in PM, 0.1mg @ HS

• Abilify- 5 mg @ HS

• Clonazepam- 0.5 mg 1x/day @ HS

• Allegra - 90mg (1/2 tab) @ HS

• Melatonin 3 mg @ HS 16



Types of Down Syndrome

• 95% of people with Down syndrome have trisomy 21– 3 copies of chromosome #21

• 4% have Robertsonian translocation because part of #21 attached to another chromosome, e.g., #14

• 1% have mosaicism because only some cells have 3 copies of #21: they may have milder features

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Epidemiology

• >60% spontaneously aborted

• 20% stillborn

• 1983: 9.5 in 10,000 live births

• 2003: 11.8 in 10,000 live births

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Down Syndrome Phenotype

• Short stature

• Broad neck

• Small hands

• Epicanthal folds on eyes

• Upslanting palpebral fissures

• Flat nasal bridge

• Small mouth

• Brachicephaly

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Down Syndrome Behavioral Phenotype

• Intellectual Disability mild-moderate

• Extroverted, highly social

• Impulsive, insistent

• Ability in reading, math, daily living skills

outstrips predictions based on IQ testing

• More than 10% have Autism

• “Ambitious”

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• Scottish award-winning film & TV actress Paula Sage receives award with Brian Cox-- Wikipedia BAFTA Scotland

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Anxiety Disorders “Internalizers”

• Panic dx

• Agorophobia

• OCD

• Obsessional slowness

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Active/Inattentive-Extroverted “Externalizers”

• ADHD

• May be linked to problems in

expressive-receptive language

frustration and perception of

being “stubborn”

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Common Medical Problems

• Hearing impairment ✓

• Visual limitations ✓

• Fine & gross motor ✓

• Congenital heart disease ✓

• Depression

• Anxiety disorders

• Early aging

• Celiac disease

• Hypothyroidism ✓

• Osteoarthritis

• Eczema

• Seizures

• Obesity ✓

• Sleep apnea ✓

• Diabetes

• Alzheimer’s disease

• Constipation

• GERD✓

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normal vision

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severe nearsighted

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Changes

• Training and understanding of visual and hearing challenges

• Referral to visual specialists to consider adaptive equipment, ? Ipad and other devices which may help Oscar understand and communicate better

• Focus on serious health problems, some linked to obesity, that might be addressed with more activity and dietary consultation with family and school

• Address supports and ways to help him focus and be engaged rather than reinforcements and consequences

• Address psychiatric medications re: effectiveness vs. side effects

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Resources

Guide for Parents of Teens and Young Adults with Down Syndrome Association of West Michigan

616- 956-3488 • 866-665-7451 (toll-free)

http://www.kcdsg.org/files/content/Guide%20for%20Teens%20and%20Adults%20with%20Down%20Syndrome.pdf

European Down Syndrome Association

Health Care Guidelines for People with Down Syndrome

http://www.edsa.eu/files/essentials/edsa_essentials_2_healthcare.pdf

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Case #2

F-G syndrome

Opitz–Kaveggia syndrome

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George 30’s Mild ID

• Lives in 24-hr staffed apartment, gets upset easily, bangs on walls, pulls staff into debate with no end

• Speaks well, but often too quickly

• Can be “manipulative”

• Had 3 psychiatric hospitalizations, talks about spirits that calm him

• Short attention span, obsessive compulsive behaviors that must be repeated

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Strengths - Challenges

• Can speak well verbally

• Has interests such as sports, fishing, shopping, wrestling

• Likes to dress as a “gangster”

• Trouble with constipation, bedwetting, complains of heartburn

• Still upset about girlfriend who died 4 years ago

• Has 2 part time jobs

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ABC Area Scores Total possible Service Team

Irritability 45 18

Lethargy 48 0

Stereotypy 21 9

Hyperactivity 48 26

Inappropriate Speech 12 2

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Current Psychiatric Diagnoses

• Current diagnosis in file

• Axis I: Bipolar Disorder, Dysthymia, Attention Deficit Hyperactivity Disorder, Posttraumatic Stress Disorder

• Axis II:ID Mild

• Axis III: FG Syndrome – Agensis of Corpus Collosum ,constipation, bedwetting, heartburn

• Axis IV: Problems related to the social environment – Problem with support group

• Axis V: deferred

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• Ranitidine HCL 1 50mg BID, GERD

• Colace/Doc-Q-Lace 100mg Daily constipation

• Ditropan XL/ 10mg QHS incontinence

• Levothyroxine sodium 50mcg Daily hypothyroid

• Lamictal/Lamotrigine 300mg QHS

• Risperdal/risperidone 1mg BID

• Risperdal/risperidone 1 mg Q 24 PRN agitation

• Risperdal 3mg HS

• Propanolol HCL 10mg TID

• Tenex/Guanfacine 1mg TID ry

• Simethicone 125mg Q 8 hr PRN bloating

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Genetics Home Reference page Rare Diseases Information NIH

• 5 regions of the X chromosome are involved

• The condition is called FGS1 when it is caused by a change (mutation) in a gene MED12

• FGS2 is caused by mutations in the FLNA gene. The genes responsible for FGS3, FGS4, and FGS5 remain unknown. FGS is inherited in an X-linked recessive pattern

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autosomal recessive inheritance wikipedia

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FG Syndrome- Physical Problems

• Feature of facial configuration

• Macrocephaly

• Undescended testicles

• Broad thumbs and large great toes

• Cardiac defects

• Low muscle tone or hypotonia

• Intestinal and anal abnormalities and severe constipation

• Often die in infancy

• Inguinal hernia

• Reflux

• Limb defects

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FG Syndrome - Behavioral Phenotype-Neurological Problems

Intellectual disability, mild to severe

Outgoing personality

Extreme hyperactivity

Abnormalities in corpus collosom

Seizure disorder

Low muscle tone – hypotonia

Self-absorption and fascinations with mechanical toys and objects, Autism Spectrum Disorder

Demanding of attention

Becomes “unglued” by little changes 38



• Kim Peek (1951-2009) was a “savant” of exceptional ability

• Exceptional memory (could memorize an entire book at an early age) and social difficulties

• He had agenesis of the corpus collosom and FG syndrome

• Screen writer for Rain Man met him

• http://www.youtube.com/watch?v=k2T45r5G3kA Kim Peek video

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http://www.youtube.com/watch?v=k2T45r5G3kA

http://www.youtube.com/watch?v=k2T45r5G3kA

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Kim Peek basis of Rain Man wikipedia

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Changes

• GI specialist re: underlying conditions contributing to his problems in this area + other medical recommendations

• Discuss reducing d/c risperidone

• Provide more consistency in choices & activities

• Staff to be coached in dealing with “arguments” and rigid thinking

• Alter expectations re: his independence

• Counseling re: loss and past difficulties

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Final Points

• All people that we help are not able to speak for/ or advocate for themselves as well as typical people

• Not only are their wishes and dreams often inaccessible, they are unable to relate information and symptoms in psychiatric settings and also in medical settings

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Final Points

• Often medical problems are a source of “challenging behavior” and/or “psychiatric problems”

• Behavioral phenotypes explain many difficulties and must be considered

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Final Points

• A thorough medical evaluation must be initiated for people with ID and challenging behavior and/or psychiatric symptoms

• We must help everyone to see the individuals we help through a personal understanding of their lives… how would it be if I were born legally blind? How do we help someone who is neurologically different in a way that causes him to be just as he is and accept his inability to be as we wish?

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Resilience: A Complex Neurodevelopmental Phenomenon

Jarrett Barnhill MD, DLFAPA, FAACAP, NADD-CC University of North Carolina

Chapel Hill, NC Medical Director, National Center fore START Services

UNH/IOD

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Goals

• Basic differences between risk/vulnerability/predisposed and resilience

• Concept of developmental windows for vulnerability, resilience and emerging cognitive, emotional and practical skills

• Complex traits have complex genetics, understanding of gene-environment interactions - an ecological model

• What can we do about building resilience - treat v. state

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What is Resilience?

• A dynamic process that contributes to a positive adaptation to significant adversity

• Why don’t monozygotic twins have a 100% concordance for psychiatric disorders - shared/non-shared environments, long-term v. short-term differences; probabilistic not deterministic

• A fluid-dynamic process, nodal points in the risk/predisposing- protective/perpetuating processes

• Begins in infancy - synchrony, attunement, attachment, movement towards autonomy

• How does ID affect to this developmental trajectory

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Many Faces of Resilience

• Immunity to many disease states - HIV/AIDS resistant noted with Chemokine-5 receptor prevents the virus from entering the cell

• Dementia - APOE e2/4 ratio; cognitive reserve; exercise, dietary health - relationship to aging (Trisomy 21)

• Trauma and Stress Related disorders - early parenting/attachment/temperament; relationship to gene X environment interaction; capacity to elicit protective responses from others; early intervention - 10-15% develop PTSD

• Individuals with genetic risks for severe mental disorders but who never develop the syndrome

• Intellectual Disabilities - cognitive, emotional, practical skills v. deficits

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Complex Developmental Trajectory of Resilience

• Trajectory of vulnerability/mastery development - phase specific stressors challenged and help organize adaptive skills

• The evolution of parent-infant attachment, synchrony, reciprocity and temperament play key roles in the organization of CNS, stress response systems and development of late emerging executive and fluid intelligence

• Relationship to neuroplasticity, critical periods, turning points

• Events that disrupt this trajectory can be biological, psychological, and social but need to be specified - if we do not adapt our thinking to integrate new information the bio-psycho-social model can become a cliché

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Resilience as a Complex Behavioral Trait

• Brain development - top down regulation of perception, emotion, language, memory and executive function

• Polygenic/ pleiotropic - complex gene environment interactions

• Brain as an organ of social adaptability developing in a social context - stress response system, neuroendocrine regulation

• Temperament: beh. inhibition, extroversion/introversion, novelty

• Attachment - secure, ambivalent, disorganized/avoidant

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Social-Cultural Issues

• Ecological model - developmental changes in levels of socialization, expectations, expansion of basic attachment to social and cultural factors

• Synchrony, oxytocin/vasopressin and belonging

• Access to material resources; relationships, identity, cohesion, power and control, cultural adherence, social justice

• Level of environmental “enrichment”

• Impact of changing demands, culture change and loss of effective rituals

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What Can We Do - Enhancing Resilience?

• Design program in ecological and developmental contexts

• Identify most at risk children and intervene early, safety needs

• Adapt programs to developmental age, temperamental matching the changing trajectory of attachment needs

• Adapt therapy to pulsed interventions that concentrate of maximizing critical periods

• Shift from a pathology focus to an adaptive one - flexibility of programs

• Modification of the developmental process, alter gene effects

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Reference:

Carrey N Ungar M (Eds). Resilience. Child and Adolescent Psychiatric Clinics of North America, 2007, Philadelphia: Elsevier Saunders. 16(2).

[email protected]

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HealthMatters Program: Turning Evidence into Sustainable Practice for People with

Developmental Disabilities

Beth Marks, PhD, RN

NADD Pre-conference Integrated Health and Wellness Approaches to Challenging Behavior in Persons with IDD

San Antonio, Texas November 12, 2014 54

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Getting the Memo

Real People – Health

promotion for people with intellectual and

developmental disabilities (I/DD) and psychiatric disabilities

Practical Solutions – Evidence based practice for community services

Real Changes – Support for long-term

lifestyle changes

Copyright ©2014 HealthMattersProgram.org

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Real People

• People with I/DD are more overweight and obese compared to the general population.

• Paid caregivers experience stress and burnout

• poor health

• emotional problems

• unhealthy lifestyles

• poor quality of life


Did you know that 36% of all

American adults are obese?

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Mental Health, Morbidity & Mortality

CVD, acute & chronic pulmonary disease, accidents, suicide, cancer,

diabetes, liver disease, and septicemia

Smoking, obesity, & sedentary lifestyles

Die on average between 13.5 and 32.2 years earlier than general population

Biological pathways & chronic stress with mental illness

increased pituitary activity, cortisone levels, & proinflammatory factors

strokes and heart attacks, and abnormalities of the autonomic nervous system that might lead to more heart disease and sudden death issues.

1. Medical evaluation of psychiatric patients. Results in a state mental health system.Arch Gen Psychiatry1989; 46:733–740. 2. Wayne Katon, MD, Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine

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Main Causes of Obesity

• Medications that cause weight gain

• Less physical activity

• Genetics – lower muscle tone

• Environment – having the opportunity to eat and move

o Controlling food choices

o Choosing activity or exercise

Handout 2: Genetics, Lifestyle and Obesity 58

Primary Care is Reactive

Difficult for people who are reluctant, or unable, to seek help

Short consultation times

Physical exams are difficult for people who may be vague or suspicious

Emphasis often on psychological and social issues if mental health providers are present

Preventive and promotive health services often absent

1. Medical evaluation of psychiatric patients. Results in a state mental health system.Arch Gen Psychiatry1989; 46:733–740. 2. Wayne Katon, MD, Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine

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It’s Everyone’s Job

Lifelong culture of interdependency

Expectations and the tyranny of none

Power to impact health status and determine health practices

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Community Engagement Matters

• Developing and implementing evidence-based community-based health promotion programs.

• Sustaining evidence- based programs across community sectors.

• Parity in health status and equity in health care services for people with I/DD.

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Where People Live Matters

American Heart Association and American Stroke Association. (2009). Cardiovascular Diseases in the United States: 2009, retrieved from www.americanheart.org/downloadable/heart/1238516653013CVD_Stats_09_final%20single%20pages%20%282%29.pdf


Total Cardiovascular Disease Deaths, 2005/100,000 population

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Health Promotion

• Enable people to take control over and to improve their health.

• Build capacity within CBOs and communities:

Access to affordable and available health care.

Acceptable culturally relevant and satisfactory health care.

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Disability and Health Status

While a large proportion of persons

who are in bad health end up with a disability,

a large number

of people with

disabilities end up with bad health.

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Knowledge Lost in Translation

• Information gap

oSlow or no reach to people receiving services

oGood questions are asked – but not reaching academia.

• Gaps for groups:

owomen oracial/ethnic minorities oother high-risk groups in the

US healthcare system – people with disabilities

Lenfant C. Clinical Research to Clinical Practice - Lost in Translation? N Engl J Med 2003;349:868-74.

Dispelling Myths…

Myths

People with I/DD are sick.

Chronic conditions (e.g., obesity, hypertension, diabetes) are disability related.

Lifestyle habits are impossible to change.

Facts

People with I/DD see themselves as healthy.

Chronic conditions are lifestyle related (e.g., sedentary, poor diets, lack of opportunity).

Health promotion strategies work!

...…Changing Attitudes

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Determining Health Needs and Interests

• Biological factors – syndrome and gender- related conditions

• Behavioral practices

• Access to health care services and programs

– Physical, attitudinal, programmatic, and communication/literacy

• Socio-economic and environmental issues

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Beyond Personal Health Practices

• Sustainable health promotion programs

o “Point of View” for Health

o Behaviors most often influenced by broader socio-environmental and economic factors

o “Where the people are…”

• Community Coalitions

o Social capital – sense of trust and long-term reciprocity

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Health and Equity

Translating Evidence-Based Health Promotion Practice to Policy

There has been a lack of bi-directionality (sort of) because your research is yours (rightly so) and our comments may be helpful to you or not, but may not have significant influence on your process in the end.

~ Leslie Hoelzel, Grant Manager, ARCA

Translating Evidence-Based Health Promotion Research to Practice

There has been a lack of bi-directionality (sort of) because your research is yours (rightly so) and our comments may be helpful to you or not, but may not have significant influence on your process in the end.

~ Leslie Hoelzel, ARCA

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1.Community ignored

2.Community placed

3.Community informed

4.Community as partners

Community Partnerships: “Won’t-Take-Failure-for-an-answer”

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Aging, Disability, and Aging with a Disability

Currently 641,000 adults age 60 and older.

Projected increase of 90% to 1.2 million age 60+ by 2030.

Individuals with I/DD who have lived 30-50 years with a disability are experiencing new health concerns.


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Adults living in community settings have the

highest CVD risk of all

adults with I/DD.

CVD is strongly associated

with health behaviors –

specifically poor nutrition

and lack of physical activity.

CVD and People with I/DD

Cardiovascular disease (CVD) is one of the most common causes of death.


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National Core Indicators (NCI) What is it?

• The National Core Indicators (NCI)

o Started in 1997

o Collaborative effort between the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI).

• The goal: Standard set of performance measures

States to manage quality and

Across States for making comparisons and setting benchmarks.

• Today 41 states are participating


www.nationalcoreindicators.org/states/

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NCI Wellness Indicators

www.nationalcoreindicators.org/states/


NCI State Report: Kentucky 2012-2013

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Practical Solutions-Research to Practice


Handout: HealthMatters Program Research to Practice

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HealthMatters Program: Research Trials

University-Based Program

Professional Led

Community-Based

Program Train-the-Trainer

Adults with I/DD

exercise attitudes

exercise self-efficacy

exercise outcome expectations

life satisfaction

cardiovascular fitness, strength and

endurance

cognitive–emotional barriers

Heller, et al., (2004); Rimmer, et al., (2004)

Adults with I/DD

perceived health behaviors

exercise self-efficacy

nutrition/activity knowledge

cholesterol & glucose

fitness (flexibility)

exercise & nutrition socio-

environmental supports

Marks, Sisirak, Chang (2013)


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Health and Exercise – What can HealthMatters Do?

Example Goal

Increase the overall

percentage of recipients who

engage in moderate

physical activity for

30 minutes a day at

least three times per week by at least 5%.

Strategies to Meet Goal

* Structured activities within day services (12-week

HealthMatters Program) * Partnership with community recreation centers

* Targeted health education programs


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HealthMatters Train the Trainer Workshop: Becoming a Certified Instructor

• Theoretically-driven Workshop

• Strategies to teach exercise and nutrition classes and motivate people to achieve wellness goals

• Tools to evaluate changes in health

Handout: Workshop Brochure


CEUs are provided for Advance Practice Nurses,

Registered Nurses, Licensed Practical Nurses, Social

Workers (LCSW, LSW, LPC, LCPC), Nursing Home

Administrators, Speech Language Pathologists, Physical

Therapists, Occupational Therapists, Recreational

Therapists, and Qualified ID Professionals (QIDP).

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Health Matters: The Exercise and Nutrition Health Education Curriculum

Evidenced-Based Curriculum for adults with I/DD

36 interactive modules with 23 additional lifelong

learning modules

Understand attitudes toward health, exercise & nutrition.

Identify current behaviors.

Develop clear exercise and nutrition goals and stick to them.

Gain skills and knowledge about exercising & eating nutritious foods.

Support each other during class

Marks, Sisirak, & Heller (2010). Health Matters: The Exercise, Nutrition, and Health Education Curriculum for

People With Developmental Disabilities , Brooks Publishing., p. xii


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40 Year Gap

Great progress with health promotion and disease prevention in the general population.

Implement health promotion programs on a larger scale for people with disabilities.

Provide sustainable evidence-based health promotion programs as a standard of care.


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Real Changes - Matters of Support

Individuals with I/DD (Intrapersonal)

Social Support (Interpersonal)

Caregiver support

Peer support

Supportive Environments (Organization, Community, Policy)

Socio-Ecological Theory Source: Golden, S. and Earp, J. (2012), Social ecological approaches to individuals and their contexts: twenty years of health education and behavior health promotion interventions.


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Organizational Culture…

Supports health & well-being of people with I/DD and caregivers

Links employee wellness programs to organizational outcomes

absenteeism turnover health care costs workers compensation claims

Healthier workforce linked to higher job satisfaction and performance.

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Strategically Balanced Approach

Culture

Confidence

Knowledge

Resources

Organizational Capacity – HealthMatters Assessments


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1. Resources: Employees have resources to

promote health among adults with I/DD 2. Culture: Leaders, managers and staff

enable and support health promotion practice and values are practiced.

Commitment – Employees believe in and advocate for health promotion

Policy – Vision, mission, and policies align to support health promotion

3. Confidence: Employees are able to

implement health promotion activities 4. Knowledge: Employees understand

fundamental principals and strategies of health promotion

Strategic Planning for Health Promotion


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Signs&Symptoms Program: Early Recognition of Health Problems

Increase continuity of care within day/residential CBOs.

Instruct caregivers to observe early signs and symptoms of new or changing health concerns among people with I/DD.

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HealthAdvocacy for Providers, Families, and People with I/DD

Increase understanding of health care experiences and needs among adolescents and adults with I/DD

Improve culturally relevant care

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Peer to Peer HealthMessages Program

Teach people with I/DD to become Healthy Lifestyle Coaches (HLCs)

Mentors support HLCs to implement a 12-week HealthMessages Program for peers.

12 week program

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HealthMatters 4Kids: Today Counts

Diabetes Prevention Workshop

Introduces health promotion and health advocacy for children and adolescents with I/DD

Developed by Northpointe Resources in collaboration with HealthMatters Program at UIC.

Audience

Parents/Caregivers, Educators, and Healthcare Providers who support children with I/DD.

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Scaling-Up Evidence-Based Programs

• Facilitate buy-in, fiscal accountability, and policy support from stakeholders

• Understand facilitators and barriers for scale-up

• Achieve widespread translation in CBOs for reach, effectiveness, adoption, implementation and maintenance of program

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HealthMatters: Scale-Up Research Project

A 5year research study evaluating the usefulness of an interactive webinar (Health Matters Program: Train the Trainer online course).

Aimed at staff working in community-based organizations providing services to people I/DD.

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Study Objectives

This study will help us learn how we can best deliver webinar training

to give staff in community-based organizations the necessary skills to:

Assist individuals with I/DD to develop their health promotion goal.

Develop and teach a physical activity, nutrition, and health education program for individuals with I/DD to reach their health promotion goal.

Support individuals with I/DD to make long-term lifestyle changes


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Contact

Beth Marks

312-413-4097

[email protected]

www.HealthMattersProgram.org

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Download - PowerPoint Presentationthenadd.org/wp-content/uploads/2014/11/31st-precon2-1.pdf · •MEDS (Matson Evaluation ... • Address supports and ways to help him focus and be engaged

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