evidence-based health promotion programs for recreational therapists to facilitate productive aging...
TRANSCRIPT
Evidence-based Health Promotion Programs for Recreational Therapists to Facilitate Productive Aging Among
Community-Dwelling Older Adults
Diane Skalko, MS, LRT/CTRS
Objectives of Presentation
1. Describe the rationale for providing evidence-based health promotion programs for Recreational Therapists to implement with community-dwelling older adults.
2. Identify at least 3 evidence-based programs and the evidence supporting each program’s benefits for Recreational Therapists to utilize.
Objectives Continued
3. Develop awareness of available resources for Recreational Therapists implementing health promotion programs.
Administration on Aging, U.S. Dept. HHS, 2011
Administration on Aging, U.S. Dept. HHS, 2011
Incidence of Chronic Illness
Medicare beneficiaries:
~ 68.4% of Medicare beneficiaries have 2+ chronic conditions
Over 1/3 have 4+ chronic conditions (Lochner & Cox, 2013)
Chronic Illness-Health Care Spending
“84% of all health care spending in 2006 was for the 50% of the population who have one or more chronic medical conditions”
(Robert Wood Johnson Foundation, 2010)
Improving Chronic Disease & Reducing Medical Costs
Active people –Less healthcare costs (CDC as cited in Center for Advancement & Health, 2006)
Older adults can improve their health through regular physical activity (CDC, 2013)
Improving Chronic Illness & Reducing Medical Costs
CDC study related to healthcare costs and chronic illness
(CDC as cited in the Center for Advancement & Health, 2006, p 1)
Center for Advancement & Health, 2006
Group Evidence-Based Health
Promotion Programs
Rationale for Providing Evidence-Based Programs
Proven research
Assists with obtaining funding
Helps with evaluating program effectiveness
Helps with identification/choosing effective programs
NCOA, n.d. b.
CMS Report to Congress: Community Based Wellness & Prevention
Programs
Phase III: Prospective Study
Phase II: Retrospective Analysis
Phase I: Environmental scan, evidence review, pilot evaluation of CDSMP
CMS, 2013
Link to CMS Report
http://innovation.cms.gov/Files/reports/CommunityWellnessRTC.pdf;
CMS, 2013
Findings from CMS Report
Enhance® Fitness
Matter of Balance
Arthritis Foundation
Exercise Program
Arthritis Foundation
Tai Chi Program
4 community based wellness programs were identified as saving money for Medicare beneficiaries
CMS, 2013
Enhance®Fitness (EF)
Formerly known as Lifetime Fitness Program. Pilot initiated
in 1993
Managed by Senior Services (Seattle, WA) and the Univer. of WA Research Center
ACL, 2011; Senior Services, 2013
Enhance®Fitness (EF)
Approved by AoA, NCoA, and CDC Arthritis program
Disseminated in over 550 sites
ACL, 2011; Senior Services, 2013
EF Program Description
Physical activity program for older adults
(‘near frail’ to very active)Primary program goal:
“Improve the overall functional fitness and well-being of older adults” (NCOA, 2011a., p. 1)
Program website: www.project enhance.org/NCOA, 2011a; Senior Services, Project Enhance, 2012
EF Program Description
Minimal equipment
Seated (Level 1) and/or standing (Level 2)
Low cost
Class size: 10 to 25
New participants:NCOA, 2011a
Strength training (20 min)
Balance training interspersed
Cool-down (3-5 min)
Cardiovascular exercises (20 min)
Warm up (5-8 min)
Flexibility (8-10 min)
EF Class Description
ACL, 2011; NCOA 2011a
Simple movements to warm up muscles
Balance movements
Increase intensity level
Warm up (5-8 min)
Senior Services, Project Enhance, 2012
Cardiovascular exercises (20 min)
Walking
Use of choreographed
aerobic exercises
Senior Services, Project Enhance, 2012
Cool-down (3-5 min)
Lower heart rate
Decrease metabolism
Examples: Step touches, slow marching in place, fist & fling, balance exercises
Strength training (20 min)
Required Exercises:Upper body
Anterior/posterior deltoidsBiceps/triceps
Lower BodyHip abductorsHip extensorsKnee extensors/flexorsPlantar/dorsiflexorsSit to standSenior Services, Project Enhance, 2012
Flexibility/Stretching (8-10 min)
Required UB Exercises
Neck stretch
Shoulder shrug
Deltoid stretch
Biceps/triceps stretch
Finger stretches
Senior Services, Project Enhance, 2012
Required LB Exercises Quadriceps stretch Inner thigh stretch Calf stretch Hamstring stretch Soleus stretch Ankle pointing/flexing
Balance training interspersed
Static
Sit to stand
Ankle sways
Side twists
Stretching up tall
Sideways leans
Dynamic Marching in place
Tandem walking, walking on tip-toes
Stepping over objects
Walking with head turns and quick stops
Heel walk
Senior Services, Project Enhance, 2012
EF Outcome Measures
Fitness Checks: first week and at 4 months testing
Part of Fullerton Functional Fitness Test (Center for Successful Aging, 2010)
Optional testsNCOA, 2011a
Biceps Curl Test
Chair Stand Test
8 Foot Up and Go
EF Leader Training
One instructor per class; CPR certification
Certified Instructor
Group leading experience or background in related health field preferred
ACL, 2011; NCOA, 2011a
EF Other Costs & Equipment
Training fee
Site fee
Site renewal fee
NCOA, 2011a
Example of EF Class
http://www.cdc.gov/prc/program-material/enhance.htm