Implementing the Chronic Disease Self- Management Program (CDSMP) for Employees of a State Health Unit: Lessons Learned Nancy Patton, RN, MS Ohio Department of Health Director, Arthritis Program 8th Annual Arthritis Grantee Meeting Atlanta, Georgia September 18, 2007 Why Implement at the State Health Unit? • CDSMP is one of the evidence-based programs approved for funding by the CDC Arthritis Program • Bureau of Health Promotion and Risk Reduction (BHPRR) seeking opportunities for categorical program integration • Need for Master Trainer candidates to become fully certified by teaching two participant courses (close to home=less time/cost for BHPRR) • Increase buy-in from upper management by familiarizing them with the program and the need to implement and embed across the State Ohio’s 23 New Master Trainer Candidates February, 2007 Approval Process • Arthritis Program Supervisor • Deputy Director, Human Resources – State Employee Health Clinics – State Employee Health Nurses – State Employee Assistance Program (behavioral and mental health) • Individual Participants’ Supervisors Logistics • Finding room(s) to hold classes • Advertising • Registration process • Incentives (NOT) Logistics • Finding room(s) to hold classes • Advertising • Registration process • Incentives (NOT) Logistics • Finding Room(s) to hold classes • Advertising • Registration process • Incentives (NOT) Logistics • Finding room(s) to hold classes • Advertising • Registration process • Incentives (NOT) Formal Evaluation • Stanford University’s standard pre and post-program survey tools • Stanford University’s pre and post program “presenteeism” scale (future) Formal Evaluation • Stanford University’s standard pre and post-program survey tools • Stanford University’s pre and post program “presenteeism” scale (future) Informal Evaluation • Weekly meetings of trainers • Verbal reports of progress from participants during classes • Unsolicited verbal reports from participants to trainers between classes • Post-course meeting with State Employee Health Nurse Supervisor and Deputy Director of State Employee Health and EAP programs Comparison of Implementation Issues Community Setting vs. Worksite Setting: Lessons Learned CDSMP Implementation Issues State Health Unit Worksite Setting Community Setting Approvals Approval for participation required by agency and No prior approval for participation required, supervisor for offerings during work day self-referred Participant Cost Participation may be paid for by employer or a Participants may need to pay a small fee on small fee may be charged for class materials their own or be subsidized by a social service agency or organization Purpose Purpose for offering may be altruistic, to increase Purpose for offering may be altruistic, bottom line via “showing up” for work, being decrease medical costs, showcase agency, productive while at work and overall job increase referrals satisfaction System “Closed” system “Open” system Characteristics: Strict adherence required to protect employee Strict adherence required to maintain trust Confidentiality from possible discrimination and to maintain trust within group within group Proximity to other participants during work week, May be more difficult to contact other Networking between contact information readily available, possible participants due to lack of proximity and participants prior contact (+ or -) unfamiliarity Readily available from on-site employee class Available by phone, e-mail or once/week in Support and follow-up leaders, EAP, employee health 5 days/week class Cost-free meeting rooms available but usually not Cost may be associated with use of space. Physical and fiscal the same room every week. Fiscal resources Location and type of space may not be resources available to purchase classroom supplies in bulk ideal, eg. non-accessible at state discount Comparison of Implementation Issues Community Setting vs. Worksite Setting: Lessons Learned (cont.) CDSMP Implementation Issues State Health Unit Worksite Setting Community Setting Advertising opportunities available though Communication system can be more Communication worksite electronic bulletin board, agency targeted to certain geographic, community, newsletter, and physical employee bulletin boards demographic characteristics throughout building. Communication between all parties can take place instantaneously. Participants easily contacted for follow-up Participants may be “lost” to contact Evaluation Participants may “pair up” with a friend to attend Classes held outside of work site. Staffing Participant profile classes. This may impact work environment, i.e. not an issue. Participants less likely to have staffing, if both are from same work area. health background. Participants may have health background. Work hierarchy not an issue Management and non-management staff in class together Future Direction and Plans • Lay Leader Trainings – Intermittent Employee Health Nurses enroll in training – “time only” supported by State Deputy Director of Human Resources – Partner with local AAA in Toledo area to provide Lay Leaders to hold CDSMP classes for ODH employees located in the Toledo District Office – Arthritis Program funding to provide lay leader trainings in partnership with the Ohio Retired Teachers Assn.