185243 Community-based clinical prevention : Health as human capital

Wednesday, October 29, 2008: 11:10 AM

Pamela N. Clarke, PhD , School of Nursing, University of Wyoming, Laramie, WY
Carol L. Macnee, PhD , C/O Health as Human Capital Foundation, Cheyenne, WY
Marilyn Fiske, MSN , Human Capital Management Services, Cheyenne, WY
Shawn Petrini, MS , C/O Health as Human Capital Foundation, Cheyenne, WY
Kathy Moore, MSN , Health as Human Capital Foundation, Health Assist, Cheyenne, WY
Judy Rennick, MSN , Health as Human Capital Foundation, Health Assist, Cheyenne, WY
Background: The presentation describes a unique community-based clinical prevention model and the results of a two phase evaluation of that model.

Methods: The Clinical Prevention Model (CPM) is based upon the Health as Human Capital Model that assumes every person is capable of pursuing goals and objectives that contribute to their perceived quality of life. CPM is an intervention aimed at increasing consumer knowledge and choice in use of health and social services in order to promote growth in human capital. High level Master's prepared community nurses and clinical pharmacists help families take ownership of their health and capacity to be productive. The model has been implemented with a sample of high risk Medicaid recipients in two phases. The first phase was a controlled, random assigned study over a year. The second phase is a longitudinal evaluation focused on job assistance and implementation of a new insurance model.

Results: In both the controlled study and the longitudinal evaluation participants completed the CDC Health Related Quality of Life-4 (HRQOL). In the longitudinal study participants also provided work history information and completed an empowerment scale. In the controlled study, nine months following initiation of the intervention the CPM service group showed statistically significant increases in self-rating of health (t(53)=4.2, p<.0001), in the number of days when physical health was not good (t(51)=2.5, p<.05) and in number of days in the past 30 when poor physical and mental health kept them from doing usual activities (t(53)=3.5, p<.001). Independent t-tests indicated significant differences between groups in rating of health (t(90.5)=2.2, p<.05), days physical health was not good (t(94)=2.6, p<.05), and days out of 30 when poor physical and mental health kept them for doing usual activities (t(95)=2.8, p<.01).Data show a 14% decrease in public assistance costs while the control group had a 8% increase. Findings from the longitudinal study and the implications for health policy will be presented.

Conclusions: Given the complexity of the families, the findings are considered very promising. They suggest a new, exciting model for advanced community nursing practice in clinical prevention that improves health and human capital.

Learning Objectives:
By the end of the session, participants will be able to: 1.Define the health as human capital concept in relation to community-based clinical prevention. 2.Identify the quality-cost implications of clinical prevention and decision support for high-risk families. 3.List key elements related to policy change for clinical prevention and implications for a new insurance model.

Keywords: Community-Based Health Promotion, Public Health Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Research and publications in public health and community health nursing; numerous prior educational programs
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Human Capital Management Services Community Health Consultant

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.