Community Health Advisor Program
Submission Date: December 2012
Entry Type: Case Study
State/Territory Submitted on the Behalf of: South Carolina
States/Territories Involved: South Carolina
Domain Addressed:Community-Clinical Linkages
Public Health Issue:Patients with chronic disease have a difficult experience managing their hypertension and other chronic disease risk factors. Palmetto Health has designed a Lifestyle University program to address this problem for their patients and those referred to them. Lifestyle University is a series of classes offered by Palmetto Health to help adults in the community manage their conditions of hypertension, pre-diabetes, diabetes and obesity. The classes are organized to make participation easy and exciting. Through interactive classes, participants learn about real solutions to life-long weight and eating struggles, stress management issues and individual exercise plans. Access to routine blood pressure screenings, blood work and health assessments will allow participants to take charge of their health by knowing their numbers and making permanent lifestyle changes.
Project Objectives:The objective of the Hypertension Clinic is to reduce the overall rates of uncontrolled hypertension through patient care, comprehensive education, community outreach, and research dissemination. Lifestyle University challenges its participants to make a priority of taking care of themselves. It teaches valuable concepts to help lower blood pressure, lose weight, eat better and improve overall health by making lifestyle changes.
Program Action:Partner with the Palmetto Health Center for Senior Hypertension to target individuals age 55 and older, and those who are physician-referred due to poor hypertension control. Community Health Advisors (CHAs) teach Lifestyle University (LU) classes that promote lifestyle changes related to hypertension control.
Lifestyle University Manual at: https://www.chronicdisease.org/resource/resmgr/cvh/sc_lifestyle_u_manual.pdf
Community Health Advisor Manual at: https://www.chronicdisease.org/resource/resmgr/cvh/sc_comunity_h_advisor_manual.pdf
Data/Other Information Collected:CHA’s conducted a Lifestyle University (LU) follow-up telephone survey to ask questions related to continued adoption of lifestyle changes encouraged in the LU program and to determine if participants have continued to manage their high blood pressure. The Palmetto Health epidemiologist developed the survey, compiled the data, and provided analysis. Extended follow-up beyond program completion with LU participants will help document the effectiveness of the LU and CHA programs and support packaging the LU and CHA programs for spread across the state.
Impact/Accomplishments:The Community Health Advisor program has impacted over 700 adults enrolled in the Palmetto Health’s LU classes. Survey results collected in 2010-2011 are as follows:
Consumption of fruits and vegetables increased from pre to post; consumption is still in the 1-2 servings range, however this increase is statistically significant. Consumption of low fat dairy products also increased somewhat (still in the 1-2 servings range); this increase is also statistically significant. Consumption of packaged foods decreases slightly (none to low amount of servings); this change is not statistically significant. Participants reported an increase in the number of times they exercise per week from a little over twice to more than 3 times; this increase is statistically significant. In addition, the duration of exercise increased slightly from pre to post evaluation; this difference is statistically significant. Participants’ performance on the Perceived Stress Scale [PSS] decreased from baseline to post evaluation indicating reduced stress; this difference is statistically significant. In addition, the participants self-rate health decreased somewhat from pre to post, indicating a better rating of their general health; this change is also statistically significant. There was improvement in blood pressure values and weight from the first class to the last class. Systolic blood pressure decreased by almost 3 mm Hg and diastolic blood pressure decreased by 3 mm Hg; these changes are statistically significant. Weight decreased slightly from first to last class; this difference also is statistically significant.
Challenges/Lessons Learned:Scalability: insufficient funding has prevented spread of this program to other areas in the state.
Next Steps:Palmetto Health is looking into packaging this program more cost effectively so that it can be expanded statewide to other hospitals. Palmetto is also partnering with Palmetto Baptist to expand the program to adjoining counties within their own satellite branches.
Program Areas:Public Health Practice
State Contact Information:
SC
Joy F. Brooks, MHA, Director
SC Department of Health and Environmental Control
803-545-4497
brooksjf@dhec.sc.gov