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Unique Partnership Leads Expansion of Successful Chronic Disease Self-Management Program

Chronic diseases are the leading cause of death in this country and account for 75% of total health care costs. According to the Centers for Disease Control and Prevention, 80% of older adults have one chronic condition and 50% have two or more. Nearly 50% are debilitating. Yet the surprising dynamic is that chronic diseases could be largely prevented by changing four factors in a person's lifestyle.

These four factors – lack of physical activity, poor nutrition, tobacco use, and excessive alcohol consumption – are responsible for many of the problems caused by chronic diseases. Additionally, the physical limitations can cause loneliness, depression, fear, and self-doubt that only intensify the effects of illness over time.

But the Better Choices, Better Health (BCBH) program, developed at Stanford University, has achieved significant outcomes in reversing the problems of chronic diseases during a six-year local pilot implemented by Vintage, Inc. The program has made considerable strides in helping to reverse the unhealthy choices people make by addressing, for example, why doctors' advice often does not translate into life-saving changes in habits and behaviors.

The program helps counteract these tendencies in a six-week series of 2-1/2 hour workshops that cover topics including exercise, appropriate use of medications, effective communication with health professionals and social networks, pain and emotional self-regulation techniques, and how to make informed treatment decisions. The information gets results because it is delivered in a supportive group setting facilitated by two peer leaders who have been through the program themselves.

Participants say that the program's accountability and positive feedback make the difference. Each participant develops an individualized action plan of incremental steps toward a healthy lifestyle, and reports back on progress and challenges each week. The net effect puts participants back in control of their lives and reinforces the idea that the consequences of chronic disease are not inevitable.

A University of Pittsburgh study conducted on Vintage's BCBH workshops identified significant results in participants, among them increased healthy behavior; less frustration and discouragement; more confidence in their ability to keep their illness from interfering with their lives; better communication with health care professionals; and significantly less pain and fatigue. Benefits included some participants being able to reduce or discontinue prescription medications or insulin levels; or becoming BCBH peer leaders and trainers to show other chronic disease sufferers how to improve their lives.

The United Way of Allegheny County, Highmark, and the Allegheny County Medical Society are co-sponsoring the expansion of BCBH, and the Community College of Allegheny County joined Vintage last year as a community partner. The expansion will enable Vintage to work with CCAC on recruiting and training more peer leaders and organizing more workshops across the county; offer online workshops through the National Council on Aging that will make the program more accessible; identify more community partners as host sites; and replicate its successful workshop model at additional sites in the region.

The NCOA believes that programs like BCBH can achieve potential savings of $6.6 billion if just 10% of Americans with chronic conditions participate. With the involvement and support of the five entities above for this national model, the focus and influence of the health care community may make such an impact on one of Allegheny County's most pressing health concerns: chronic disease.

For more information about BCBH, contact Heather Sedlacko, Director, Programs for Seniors and People with Disabilities, at heather.sedlacko@uwac.org, or visit the website www.alleghenybetterhealth.org.

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