Measuring impact of Chronic Disease Self-Managed Programs among rural populations

In 2008 the Idaho Physical Activity and Nutrition Program (IPAN) initiated the Living Well in Idaho (LWI) chronic disease self-management program (CDSMP)in collaboration with the Idaho Commission on Aging (ICOA), local public health and other community-based organizations, and researchers from the Center for the Study of Aging at Boise State University. The LWI program is an evidence-based CDSMP designed by researchers from Stanford University. Over 40% of Idaho's population resides in rural areas making access to healthcare services challenging. Additionally, 43 of Idaho's 44 counties have been identified as medically underserved and many rural residents face significant economic challenges. The LWI intervention was delivered in three rural district health regions in Idaho from 2008 to 2010. Participants were recruited at Senior Centers and district health departments and asked to complete a pre-intervention and a 6-month post-intervention survey. Findings from matched surveys were analyzed to determine changes in Health Status, Healthcare Utilization and Health Behaviors. Respondents were primarily white females over the age of 65, residing in rural or frontier areas, and suffering from 1 or more chronic condition. Sixty-one percent (61%)reported income of less than $24,999 and 65% had a high school education or less. Findings demonstrated significant changes in health status. Those reporting lower incomes experienced more positive changes in health status, days effected by physical or mental health, and improved communication with physicians. Access to on-going community based programs could be the key to better health outcomes and overall quality of life for this population.