Academic journal article Journal of Allied Health

Student-Facilitated Health Promotion Intervention for Chronic Disease Self-Management in At-Risk Elders

Academic journal article Journal of Allied Health

Student-Facilitated Health Promotion Intervention for Chronic Disease Self-Management in At-Risk Elders

Article excerpt

Reflections from the Field

A student-facilitated and faculty-supervised health promotion program for chronic disease management in at-risk elders was developed based on the belief that individual contact with high-risk elders will facilitate improved health behaviors while enhancing the real-life experiences of students through interdisciplinary collaboration and community-based learning. Subjects were seven students enrolled as health professions academic majors at the university who served as student health advocates in the Healthy Elder Living Program (HELP). The data collected included student reflection questionnaires, field notes from the HELP staff, and communication logs between the HELP coordinator and students. As student health advocates, the students made visits to at-risk elders to reinforce recommendations from health care providers, to review adherence to the Health Promotion Inventory (HPI), and to interact socially with the client through discussion of health- and non-health-related issues. A training model for health promotion was developed based on identification of four common themes of student performance as health advocates. Overall, students demonstrated a greater appreciation for the complexity of social, psychological, and physical aspects of chronic disease as a result of participation in this program for at-risk elders. They were able to apply professional skills learned in the classroom while providing a needed service to elders. At-risk clients also benefited from the HELP intervention, showing improved physical performance and less depression. J Allied Health 2010; 39:120-127.

WITH THE PUBLICATION of the Surgeon General's Report in 1979 adopting a set of national health objectives, health promotion moved from an individualized disablement approach to a community prevention focus. Healthy People 2010 has evolved based on the findings from Healthy People 2000 to address two overarching goals: 1) "to increase the quality and years of healthy life," and 2) "to eliminate health disparities."1 The Healthy People 2010 database has identified several major health challenges, including 18.2 million Americans who have diabetes, obesity in 64% of the US adult population, and heart disease and stroke which account for >40% of all adult deaths each year. Increasing awareness and providing education regarding poor health behaviors that affect these major health challenges are needed to reduce the growing cost of health care in the United States. This is particularly true given the aging population, who suffer from a greater number of medically related conditions that impact their overall health status and ability to participate actively in society. One program designed to help maintain or improve the overall health status of frail elders is the Senior Corps Senior Companion Program. This government-supported program trains low-income people age 60 and older to provide respite to caregivers, identification of potential medical issues that should be addressed, and friendship to frail elders and their families.2

Within the context of the present health care system, there are few opportunities for health care professionals to assist community-dwelling elders in managing their chronic health conditions. Complex health conditions experienced by elders are most often managed by a family practitioner primarily through the use of pharmaceutical interventions, diagnostic testing, and medical procedures. A limited amount of counseling regarding lifestyle and medication management is provided in the doctor's office, with follow up occurring intermittently at 6-month to 1-year intervals. Acute health problems are treated on an intermittent and short-term basis as they arise. For the remainder of the time, community-dwelling individuals with complex health conditions are expected to manage their own health.1·3'6 This may include a caregiver in the home, though very often the individual and their caregiver(s) have similarly limited levels of health knowledge. …

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