The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #56806

Brenda Wamsley, MSW¹, Hongdao Meng, MPH², Bruce Friedman, PhD², and T. Franklin Williams, MD³. (1) Executive Director, Center for Aging & Healthcare in West Virginia, 517 Market Street, Dils Building, Parkersburg, WV 26101, 304-422-2853, bwamsley@citynet.net, (2) Department of Community and Preventive Medicine, University of Rochester, Box 644, Rochester, NY 14642, (3) Monroe Community Hospital, 435 East Henrietta Road, Rochester, NY 14620

Functional status is a key predictor of health care service use, especially hospital and nursing home admissions. The amount of difficulty and dependence individuals experience in performing activities of daily living (eating, toileting, bathing, dressing, grooming, transferring, walking) and instrumental activities of daily living (using telephone, traveling, shopping, preparing meals, housework, taking medicine, managing money) have a direct influence on their ability to take care of themselves through disease self management. Unfortunately, few treatments have been developed under rigorous study conditions that demonstrate effectiveness in slowing functional decline in an already moderately to severely impaired population. This study presents findings from a randomized controlled trial of a health promotion intervention conducted with a chronically ill Medicare population (N=1,605). Results indicate a significant treatment effect in slowing functional decline among study subjects who completed the 24-month intervention. Participants who received health promotion nurse benefits reported –0.61 fewer ADL limitations on a 12 point scale (P=0.01) controlling for baseline ADL. An overview of the intervention and a description of the study design will be presented along with key findings related to functional outcomes. Implications for Medicare modernization will be discussed.

Learning Objectives:

• Recognize the importance of functional status as a key outcome in research on health and aging;
• Articulate the components of a health promotion; disease self-management intervention tailored to the functional needs of chronically ill older adults; and
• Understand the relevance of the study outcomes for Medicare modernization.

Keywords: Health Promotion, Chronic Illness

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.