199479 Multi-dimensional health risk appraisal, advance practice nurse assessments and an empowerment model of well-aging among adults with disabilities

Monday, November 9, 2009

Harriet Aronow, PhD , Nursing Research and Development, Cedars-Sinai Medical Center, Los Angeles, CA
Joan Earle Hahn, PhD, APRN, BC, C , College of Health and Human Services, University of New Hampshire, Durham, NH
Nancy Guenther, MST , Office of Disability and Health, California Department of Public Health, Sacramento, CA
Adults with life-long or acquired disabilities face challenges to well-aging. We present findings of a program of research based on three studies that aim to prevent health problems and promote well-aging among adults with disabilities. We set the program and policy context by describing steps taken to integrate an empowerment model into state affiliated programs and policies. This model evolved from the successful demonstration of comprehensive geriatric assessment (CGA) as a preventive intervention among able-bodied older adults. Our model has two components: (1) A multi-dimensional health risk appraisal (HRA) produces a profile of health risks and strengths, standardized feedback, and recommendations for actions to address health risks; and, (2) An advance practice nurse (APN) delivers an in-home CGA, head-to-toe assessment, health education, and personalized recommendations. We have conducted a pilot study (N = 201) of persons with intellectual and/or developmental disability (IDD) randomized to HRA vs. APN; a small (N = 93) study of HRA among persons with acquired disability; and a longitudinal study (expected N = 150) including concurrent use of HRA and APN. The pilot established feasibility among persons with IDD, demonstrated high prevalence of health problems among adults with IDD, and suggested possible health risk reduction. The second study tested the psychometric properties of the HRA and indicated high risk levels in population with acquired disabilities. The most current study and work with a state department of public health focus on understanding the relationship between healthy behaviors and health outcomes and broad dissemination of the model.

Learning Objectives:
At the end of this presentation, attendees will be able to: (1) Discuss the program and policy implications of aging with acquired or life-long disability; (2) Compare the use of health risk appraisal and advanced nurse practitioner interventions; and (3) Differentiate an empowerment model of well-aging from provider and public health screening programs.

Keywords: Disability, Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: PhD in Health Services Research Many years experience in research in aging, disability, and rehabilitation CV available on request.
Any relevant financial relationships? No

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.