The 130th Annual Meeting of APHA

3037.2: Monday, November 11, 2002 - Board 2

Abstract #46520

Does Consumer-Directed Care Affect Smoking and Alcohol Use, and Other Health-Related Behaviors?

Mark Newbrough, MD, Assistant Professor - Medicine, University Health Associates, West Virginia University - Charleston Division, 3110 MacCorkle Avenue, SE, Charleston, WV 25304, 304-347-1342, mnewbrough@hsc.wvu.edu, Bruce Friedman, PhD, Department of Community and Preventive Medicine, University of Rochester, 601 Elmwood Avenue, Box 644, Rochester, NY 14642, William Barker, MD, Department of Community and Preventative Medicine, University of Rochester Medical Center, P.O. Box 644, Rochester, NY 14642, Gerald M. Eggert, PhD, Executive Director, Monroe County Long Term Care Program, Inc./ACCESS, 349 West Commercial Street, Suite 2250, East Rochester, NY 14445, and Brenda Wamsley, MSW, Executive Director, Center for Aging & Healthcare in West Virginia, 517 Market Street, Dils Building, Parkersburg, WV 26101.

Our objective is to compare how the practice of several important health-related behaviors differs between the participants in three intervention groups (Health Promotion Nurse [HPN], Voucher, and HPN plus Voucher [Combination group]) versus a Control group in the "Medicare Primary and Consumer-Directed Care Demonstration." The purpose of the Demonstration is to test the acceptability and effectiveness of three models of consumer-directed care in a population of Medicare beneficiaries who are chronically disabled and at increased risk for hospitalization. Of the 1,609 participants who were randomly assigned to each of four groups (HPN, Voucher, Combination, and Control), about 1,000 are expected to complete the Demonstration. (Approximately 400 are expected to die and another 200 to drop out.) Data on a broad array of self-reported sociodemographic, health status, and empowerment/self-efficacy measures were collected at baseline and 22 months post-baseline. Also collected was information regarding the practice of various health-related behaviors including tobacco and alcohol use, physical activity/exercise, and medication usage. Our hypothesis is that the three intervention groups will experience less use of detrimental behaviors and greater use of beneficial behaviors due to the greater empowerment/self-efficacy that is expected in these groups versus the Control group. Logistic regression analyses (controlling for any baseline differences in health status and other variables) will be performed to compare the practice of these health-related behaviors of each group at baseline and at 22 months. Among those who experienced use of a behavior, the extent of these activities will be investigated using ordinary least squares regression.

Learning Objectives:

Keywords: Alcohol Use, Tobacco

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Current Issues in Health and Health Care for Older Adults

The 130th Annual Meeting of APHA