good life club project a national sharing health care project (chronic disease self-management)...

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)