good life club project a national sharing health care project (chronic disease self-management)...
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Good Life Club Good Life Club ProjectProject
A National A National
Sharing Health Care Sharing Health Care ProjectProject
(Chronic Disease Self-(Chronic Disease Self-
Management)Management)
Project Manager - Jill KellyProject Manager - Jill Kelly
Today….Today….
Describe project model Describe project model
Describe evaluation frameworkDescribe evaluation framework
Overview outcomesOverview outcomes
Good Life Club ConsortiumGood Life Club Consortium
Inner East Community Health Service Inner East Community Health Service
Manningham Community Health Service Manningham Community Health Service
MonashLink Community Health Service MonashLink Community Health Service
Whitehorse Community Health Service Whitehorse Community Health Service
Chinese Health Foundation of AustraliaChinese Health Foundation of Australia
Whitehorse City CouncilWhitehorse City Council
Eastern HealthEastern Health
Whitehorse Division of General Practice Whitehorse Division of General Practice (auspice)(auspice)
Objective of projectObjective of project
Improved self-management capacity of people over 50 years of age with diabetes living in eastern suburbs of Melbourne
Sub target of older men and Chinese community
Major Strategies:Major Strategies: Telephone coaching by Allied Health Telephone coaching by Allied Health
Practitioners & general practice nursesPractitioners & general practice nurses
Promotion of Multi-disciplinary care Promotion of Multi-disciplinary care planningplanning
Client Website Client Website www.goodlifeclub.infowww.goodlifeclub.info
Club activitiesClub activities
Client newsletter Client newsletter
& email newsletter& email newsletter
National Evaluation National Evaluation FrameworkFramework
CLIENTCLIENT
PROCESSPROCESS Marketing/Reach/RecruitmentMarketing/Reach/Recruitment Care PlanningCare Planning
IMPACTIMPACT Behaviour – self-efficacyBehaviour – self-efficacy Satisfaction with programSatisfaction with program
OUTCOMEOUTCOMEBaseline, 6 m, 12 m & 18 mBaseline, 6 m, 12 m & 18 m
Health statusHealth status Health related QOLHealth related QOL Functional statusFunctional status Social functioningSocial functioning Psychological distressPsychological distress Satisfaction with life (overall well-being)Satisfaction with life (overall well-being) Health Service usage (self-reported)Health Service usage (self-reported)
HEALTH SERVICE PROVIDERHEALTH SERVICE PROVIDER
PROCESSPROCESSMarketing/reachMarketing/reach
IMPACTIMPACT Perceptions – key informant Perceptions – key informant interviews & focus groups of interviews & focus groups of HSP & GPsHSP & GPs
HEALTH SERVICE SYSTEMHEALTH SERVICE SYSTEM
PROCESS PROCESS Infrastructure developmentInfrastructure development IntegrationIntegration
IMPACTIMPACT SustainabilitySustainability
Project EnrolmentProject Enrolment
353 clients353 clients
10% enrolments were Chinese-speaking10% enrolments were Chinese-speaking
43% enrolments were men43% enrolments were men
One thirdOne third of enrolled clients of enrolled clients
referred by GPsreferred by GPs
High level of patient, GP satisfactionHigh level of patient, GP satisfaction
Interim 6 Month Client Interim 6 Month Client Outcomes (n=85)Outcomes (n=85)
Increased confidence in managing Increased confidence in managing conditioncondition
Increased physical activityIncreased physical activity
Less time being fearful/worried about Less time being fearful/worried about healthhealth
Able to turn taps (results of strength Able to turn taps (results of strength training) training)
Fall in mean number of GP visitsFall in mean number of GP visits
Interim 12 month dataInterim 12 month data(n = 49)(n = 49)
Decreased hospital Emergency Decreased hospital Emergency Department presentationDepartment presentation
Increased use of allied health Increased use of allied health practitionerspractitioners
18 month / End of project 18 month / End of project datadata
CLIENTSCLIENTS Mixed bag of evidenceMixed bag of evidence Health service usage patterns trending in Health service usage patterns trending in
desired directionsdesired directions Sustained involvement in walking exerciseSustained involvement in walking exercise Clients had a wide range of benefits Clients had a wide range of benefits
including including
↑↑ motivation, motivation, ↑↑ability to cope with ability to cope with diabetes, better knowledge and strong diabetes, better knowledge and strong social supportssocial supports
CLIENT GAINS THAT HAVE BEEN CLIENT GAINS THAT HAVE BEEN SUSTAINEDSUSTAINED
Self-reported symptoms of Self-reported symptoms of Pain, shortness of breathPain, shortness of breath Levels of discouragement attributed to health Levels of discouragement attributed to health
problemsproblems Fear of health problemsFear of health problems Associated worries and frustrationsAssociated worries and frustrations
Changes in confidence not sustainedChanges in confidence not sustained
HEALTH SERVICE PROVIDERSHEALTH SERVICE PROVIDERS
Implementation difficulties e.g.Implementation difficulties e.g.
Competing demandsCompeting demands After-hours workAfter-hours work Difficulty contactingDifficulty contacting clientsclients Av. Number of coachingAv. Number of coaching sessions per client= 6sessions per client= 6
0
1
2
3
4
KnowledgeStages
KnowledgeProcesses
Use Stages UseProcesses
Rat
ing
Pre
Post
Figure 1.Figure 1. Mean scores for the pre- Mean scores for the pre-training and post-training assessments training and post-training assessments for 35 coachesfor 35 coaches
FIVE SUSTAINABILITY FIVE SUSTAINABILITY “PROJECTS”“PROJECTS”
Trialled different modelsTrialled different models Barriers and facilitators identifiedBarriers and facilitators identified
FacilitatorsFacilitators Supportive and proactive managementSupportive and proactive management Organisational and health professional Organisational and health professional
behaviour change supportedbehaviour change supported
Transition Phase – 2 yearsTransition Phase – 2 years
Action Plans to embed CDSMAction Plans to embed CDSM Organisational supportOrganisational support Train the Trainers Flinders Uni modelTrain the Trainers Flinders Uni model Regional Practitioners networkRegional Practitioners network Stanford course leaderStanford course leader
trainingtraining
National themes….National themes….
CLIENTSCLIENTS ↓ ↓ Hospital readmissions, ↓ specialist Hospital readmissions, ↓ specialist
visitsvisits ↑ ↑ Quality of lifeQuality of life Difficult to engage people from CALD Difficult to engage people from CALD
backgroundsbackgrounds Lack of male participationLack of male participation Those with worse health, made Those with worse health, made
greatest changegreatest change
National themesNational themes
HEALTH SERVICE PROVIDERSHEALTH SERVICE PROVIDERS Difficulty engaging GPsDifficulty engaging GPs CDSM not a priority in acute health CDSM not a priority in acute health
sectorsector HSP’s had most difficulty (competing HSP’s had most difficulty (competing
demands, resources)demands, resources) Projects are clear about benefits & Projects are clear about benefits &
challenges for SM for clients, challenges for SM for clients, practitioners and organisationspractitioners and organisations
More InformationMore Information www.goodlifeclub.infowww.goodlifeclub.info
(see Health Professionals/Resources)(see Health Professionals/Resources)
Australian Journal of Primary Health Australian Journal of Primary Health
Vol. 9 2&3 2003Vol. 9 2&3 2003
www.chronicdisease.health.gov.auwww.chronicdisease.health.gov.au
http://sharinghealthcare.pwcglobal.com.au./Sharinghttp://sharinghealthcare.pwcglobal.com.au./SharingHealthCare/healthcare.nsfHealthCare/healthcare.nsf
(PriceWaterHouse Coopers)(PriceWaterHouse Coopers)