Healthy Lifetime (HL): An Internet-Based Behavioral Health Coaching Protocol for Older Adults.

By 2060, the number of Americans 65 years and older will more than double, comprising nearly one-quarter of the population in the United States. While there are many advantages to living longer, a byproduct of aging is also a growing incidence of chronic illness and functional health limitations associated with a concurrent rise in chronic disease and disability that impair independent living in the community. We describe a personalized, behavioral health coaching protocol for early intervention that is delivered online to enhance a participant's independent functioning and to increase their self-care capacity with a goal to maintain independent living throughout aging. The electronic platform provides secure access to fillable surveys, health tracking, "just in time" communication with coaches and scheduling of two-way videos launched from the platform site. The 2-month protocol used two-way video conferencing which allowed high fidelity communication to sustain a complex behavioral intervention. Participants indicate high satisfaction with the intervention, the use of the platform, and the technology. While many health systems across the U.S. have ramped up virtual delivery of care in a proactive manner with now more than 70% of out-patient visits conducted through virtual delivery modes in some health systems, there remains much unevenness in this capability across the U.S. Our approach is to create a stable, interoperable, virtual outreach system for personalized professional health coaching that is complementary to medically oriented services that supports the health and functioning of participants as they age.

Diabetes training for community health workers on an American Indian reservation.

OBJECTIVES: To improve the knowledge and skills of community health workers (CHWs) on an American Indian (AI) Reservation related to the management of diabetes to allow CHWs, with no prior formal diabetes education to work more effectively with individuals in the community with diabetes. Training was provided in six "face-to-face" sessions with the CHWs using the Centers for Disease Control and Prevention CHW Training Resource on Heart Disease and Stroke. DESIGN AND SAMPLE: This is a quality improvement program guided by the Model for Improvement: Plan, Do, Study, Act and using a pre-post evaluation design. Ten AI CHWs were recruited for the training. MEASURES: Knowledge and attitudes, participation rates, and participant satisfaction were measured. RESULTS: Knowledge increased overall with largest changes in diabetes, depression and cholesterol. Diabetes attitudes were high and consistent with those found in caregivers who support patient-centered care. Participants reported learning, liking the class, and finding the materials helpful. CONCLUSION: This QI program provided by a public health nurse improved CHW's knowledge of diabetes and the management of diabetes. Next steps include formalizing the Reservation's CHW training program, expanding this training to other AI Health Service areas, and measuring the impact of CHWs in the community.

Bringing evidence-based continuing education on asthma to nurses.

PURPOSE/OBJECTIVE: The objective of the study was to demonstrate how the clinical nurse specialist (CNS) in community health effectively responds to community need. RATIONALE/BACKGROUND: A needs assessment revealed high rates of asthma in the community and a request from nurses for more information on the care and management of persons with asthma. PROJECT/INTERVENTION: The intervention brings evidence-based continuing education on asthma to nurses using the Nurse Asthma Care Education program developed by the National Respiratory Training Center and the University of Michigan to increase nursing awareness of the National Asthma Education and Prevention Program Asthma Guidelines and encourage nursing leadership in asthma control activities. DESIGN: A quasi-experimental study examined the ability of the Nurse Asthma Care Education program to increase nurses' confidence and perception of using the guidelines. SAMPLE: Thirty-four nurses participated in a Nurse Asthma Care Education seminar. METHODS: A preintervention and postintervention survey was conducted. FINDINGS: Significant changes were noted in nurses' perceptions of the helpfulness of the National Asthma Education and Prevention Program Asthma Guidelines (P ≤ .001) and their confidence to use the guidelines (P ≤ .001) regardless of age with some variation by work setting and years of experience. CONCLUSIONS: Using CNSs to assess populations, including nursing populations, and train nurses, the largest number of frontline providers, may be an effective way to increase patient education and improve outcomes related to asthma and other chronic diseases. IMPLICATIONS FOR PRACTICE: The CNS can significantly impact community health by identifying and addressing the needs of those who provide care in the community.