Arthritis Success Stories In Genesee County

Submission Date: April 2015

Entry Type: Case Study

State/Territory Submitted on the Behalf of: Michigan

States/Territories Involved: Michigan

Funding Source: NACDD

Domain Addressed:

Health Systems Strategies

Public Health Issue:

• Genesee County, which includes its major urban area of the City of Flint, MI – remains a “community in recovery” due to the recent economic shift in the automotive industry, having experienced significant unemployment and population declines coupled with overwhelmingly poor measures for both health factors and health outcomes.
• Arthritis is common, disabling, and costly.  In 2011, 2.35 million Michigan adults, 31% of the population age 18 and older reported doctor-diagnosed arthritis.  One in two Michigan adults with arthritis (1.2 million people) reported arthritis-attributable activity limitations.  Arthritis results in $5.6 billion in lost wages and health care costs in our state each year.  People with arthritis are two to three times more likely to report having other chronic diseases such as diabetes, cardiovascular disease or depression.
• For individuals, the CDC has emphasized the importance of being well-informed about the condition, working with healthcare providers to get an early diagnosis and explore treatment options, learning to be an active self-manager for long term health conditions, and being physically active.
• Despite striking more than 50 million Americans, arthritis is an often misunderstood disease with a core of common myths surrounding it. Comments such as aches and pains are common with getting older and people with arthritis should avoid exercising poses concern for people dealing with the disease. Therefore, providing education is important in treating the symptoms of arthritis.

 

Project Objectives:

The overall objective is to combine coalition partner knowledge, expertise, resources and energy to employ policy, systems and environmental changes to improve the level of physical activity of people affected by arthritis in Flint and surrounding communities.  NKFM seeks to encourage this physical activity by the following:

• Develop and implement the EF program at one additional site in Flint with a total of ~25 participants
• Establish that  90% of participants have improved or maintained their physical abilities, using standardized Fitness Assessments
• Conduct 10  trial physical activity behaviors throughout the Flint area community
• Disseminate materials and messages to promote physical activity to people with arthritis
• Train at least 10 new EF instructors in Flint

Program Action:

• The Enhancing Flint’s Fitness Project, with the leadership and support of the Flint: Better Health Together Coalition partners, work together to ensure that Flint residents affected by arthritis have access to the most current information about the disease, and access to self-management support and physical activity programs appropriate for their needs.  A key to building capacity has been strategic collaborations with organizations across multiple sectors at both the state and local levels that are well-versed in the factors that shape health behaviors and advance community well-being.
• These multi-sector partnerships are critical to addressing the many challenges of impacting community health issues and chronic disease prevention.  The Great Lakes Center for Health Innovations (GLC), a division of the National Kidney Foundation of Michigan (NKFM), has leveraged local partnerships in Flint and Genesee County to form a coalition consisting of individuals from community organizations, local businesses, faith-based organizations, government, education institutions, and other stakeholders.
• Enhance Fitness (EF), an evidence-based, physical activity program shown to increase strength, boost activity levels, and elevate mood has been the key to addressing the need for increased activity among residents and the conduit in providing arthritis education.  Enhance Fitness is offered through several licensed sites throughout the city of Flint and in demonstration format to increase visibility and encourage overall physical activity. Arthritis presentations were partnered with key EF and community locations, strengthening the importance of physical activity.

Data/Other Information Collected:

The EF team has strong experiece in monitoring project outcomes and collecting project data. Functional Fitness assessments are conducted by trained EF instructors for identifying at-risk participants, program planning, evaluation, goal setting and increasing participant motivation.The fitness assessments focus on aspects of  balance, mobility,upper body strength and lower body strength on participants that attend EF classes regularly.   The  EF Flint program included 6 active EF locations and 3 trial locations from January – December 2014 serving ~503 unduplicated participants , with a total of 538 one hour documented sessions.  Fitness checks for these locations as a whole demonstrated the following: 68% of participants improved or maintained lower body strength; 59% improved or maintained upper body strength; 88% improved in measures of balance and the most impressive number of all is that 93% of participants state that EF classes has improved their physical abilities.

 

Other data collected on participants include general demographic data such as gender, race, chronic diseases, age and income.

Impact/Accomplishments:

• The National Kidney Foundation held Four Arthritis Workshops in Genesee County in which there were ninety-three participants (73 women and 20 men).Forty percent of workshop participants report having some form of arthritis.
• Arthritis workshops have been key to the promotion of Flint area EF classes with and average of  ten percent attending as new participants. These new participants have directly related this behavior change to information provided during arthritis workshops and connecting exercise to arthritis symptom relief.
• One participant  testamonial discussed her dependence on the use of  NSAIDS to manage arthritis pain. After attending the arthritis workshop, and  EF  classes on a  more regular basis; she has noticed less arthritic pain and dependence on pain killers to ease her symptoms.
• Three trial EF sites were established in Flint:  Northstar Missionary Baptist Church(NMBC), My Brothers Keeper(MBK) and Burton Senior Center(BSC). These sites held a total of 70 sessions of EF from February 2014 – December 2014, hosting an ~ 600 individuals (many duplicate participants).
• Established one new EF site with the conversion of Northstar Missionary Baptist Church to an official site in August 2014.
• Trained 4 NMBC parishoners as EF instructors.
• Held 2 successful EF trainings for EF instructor candidates (Feb. 2014 &  Feb. 2015)
• Trained 16 new instructors to serve the Flint area.

Challenges/Lessons Learned:

Establishing sustainability is always a major factor when embedding programs into the community. The bigger challenge is to build strong communities around physical activity in vulnerable populations. Strategies for NKFM to further the current  program are to work closely with locations and the community to develop culturally appropiate transition plans to ensure long-term sustainability. Another challenge is locating committed, qualified fitness instructors for the program. The next concern is the identification of skilled Arthritis  presenters, those well versed in Arthritis and managing challenges accordingly.  Lastly, and the biggest challenge is developing sustainable funding streams for potential and current  EF  locations.  For example, although the Burton Senior Center was slated for full EF implentation, reevaluation by their administration noted the inability to sustain programming long-term post NKFM involvement.

 

Next Steps:

NKFM will continue to distribute arthritis educational  information as well as provide EF demonstrations to the community.  Our  goal  is to ensure that all Enhance Fitness locations as well as community partners have awareness regarding  treatment optoins for managing arthritis through education and physical activity. Other plans include to work with each new location individually in the creation of sustainable programming plans and identifying key needs for success.

The development of a firm long term plan will be vital to creating a healthy community, knowledgable in the connection between Arthritis and physical activity.  NKFM would also like to provide additonal Arthritis presentations to the community at large.

Program Areas:

Arthritis

State Contact Information:

MI

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