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Living Well Alaska

  • Alaska VA Healthcare System
    Leah Bachmeier
    (907) 257-4726
  • Anchorage Senior Center
    Carmen Montano
    (907) 258-7823
  • Homer
    Peggy Ellen Kleinleder
    (907) 235-0369
  • Kenai
    Linda Tannehill
    (907) 262-5824
    &
    Deborah Nyquist
    (907)335-7580
  • Mat-Su
    Julie Cascio
    (907) 745-3360
  • Providence Senior Care Center
    Karen Hollar
    (907) 212-3424
  • Seward
    Caitlin Mackenna
    (907) 224-8556
  • Southcentral Foundation
    Lavina Hess
    (907) 729-4195
  • UAF Cooperative Extension Services
    Leslie Shallcross
    (907) 786-6313 

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Contact Us:

Living Well Alaska:
Better Choices, Better Health


Chronic Disease Self-Management










ABOUT THE PROGRAM


Living Well Alaska: Better Choices, Better Health is a series of 6 classes that help people with chronic illnesses learn ways to self-manage their condition and take charge of their life. In other words it is a Chronic Disease Self-Management Program (CDSMP). The three principles that underlie CDSMP are:
  1. People with different chronic diseases have similar self-management problems and disease-related tasks.
  2. People can learn to take responsibility for the day-to-day management of their diseases.
  3. Confident, knowledgeable patients practicing self-management will experience improved health status and will utilize fewer health care resources.

Watch this 7 minute video explaining the power of Chronic Disease Self-Management - from Better Living in California (their version of Living Well Alaska):

Living Well Alaska classes are held throughout Alaska for people with chronic conditions, such as arthritis, diabetes and heart disease. It is also for people who take care of people with chronic conditions, or just want to learn about how to self-manage chronic conditions. All are welcome.

Living Well Alaska, or CDSMP, helps clients better manage their symptoms and communicate more easily with their providers and loved ones. People who enroll in the classes feel better, are less limited by their illness, and may spend less time at the doctor or in the hospital.


CLASSES


If you are interested in taking a class, the classes are:

  • Six weeks long
  • An average of 2 hours 
  • Composed of approximately 10 people
  • Led by leaders who have received formal training
  • Inexpensive, the cost varies depending on the site, and insurance coverage.

Living Well Alaska classes cover a range of health topics such as:

Two leaders in class.
Nancy & Jose at a 2015 class

  • healthy eating
  • relaxation techniques
  • managing fatigue
  • low impact exercise
  • managing medications
  • problem solving
  • goal setting
  • working with your health care professional.

You may contact one of the programs above or for general questions call Nelly Ayala at 907-269-8035.

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RESEARCH


Benefits of CDSMP

•  Cost-effectiveness:
Frontiers in Public Health, Volume 3, Article 27. Cost-effectiveness of the chronic disease self-management program: Implications for community-based organizations [2015].

  • Assuming 10 participants per class, the cost is approximately $350 per participant 
  • $50,000 to $75,000 per QALY according to national data
  • Assuming, $350 saved per CDSMP participant, we could achieve potential national healthcare savings from $0.7 billion to $65.7 billion by averting from ER visits and hospitalizations if CDSMP reaches a minimum of 1% of adults with at least 1 chronic condition.
  • Increase in health related quality of life (HRQOL) measures, creating a direct effect on QALYs

•  Healthcare Cost:
Frontiers in Public Health, Volume 3, Article 42. Healthcare cost savings estimator tool for chronic disease self-management program: A new tool for program administrators and decision makers [2015].

  • National study of CDSMP showed potential savings of $3.3 billion in healthcare costs by reaching 5% adults with one or more chronic conditions
  • Healthcare savings of $38,803 for a small county
  • Healthcare savings of $732,290 for a metropolitan city
  • Use the Healthcare Cost Savings Estimator Tool  and customize your savings (Download Excel File)

•  Health-related Outcomes:
Preventing Chronic Disease, Volume 10, Issue 1. A Meta-Analysis of health status, health behaviors, and health care utilization outcomes of the chronic disease self-management program [2013].

  • Improvements in self-efficacy
    • Self-efficacy related to physical activity, healthful eating, pain-coping strategies, medication adherence, and improvement in function
  • Direct correlation with improvements in physical activity
  • Crucial for improvements in general health and overall well-being
  • Reductions in depression noted

Clinical Outcomes

•  Self-management interventions showed benefits in health outcomes for patients suffering from Heart Failure, as well as an increase in health-related quality of life.


•  Self-management skills are seen as a standard component of pulmonary rehabilitation programs. Chronic disease self-management is defined as a process that facilitates an individual’s confidence and capability to engage in health-promoting behaviors in order to deal with the impact of their condition on all aspects of their health – a sense of self, physical, emotional, social, and medical domains so as to maximize function and quality of life. The interactive format of the CDSMP deliberately fosters “self-efficacy or confidence” to manage one’s health condition through mastery, vicarious experiences, social persuasion, and reinterpretation of symptoms. CDSMP has been reported to increase self-reported exercise by 30 minutes, and decrease dyspnea (difficulty breathing).

•  Educational programs aimed at increasing the skills and confidence for self-management can reduce pain, fatigue, disability, anxiety, and depression, and they can improve self-rated general health. The benefits in health-related behaviors include increases in aerobic exercise and symptom management. Almost half of participants in a CDSMP class had substantial improvement within the first six months after completion of the six week program, both on anxiety and depression. About 40% of participants continued to show improvement one year after the completion of the program. 

•  This program provides patients with the necessary knowledge, skills, and confidence to manage life with a chronic illness and prepares patients to collaborate with their healthcare professionals and the healthcare system. This program focuses on participants with chronic fatigue who have various forms of neuromuscular disease. The program in this study had a limited number of participants, however, 77% of them showed improvement.

Specific Groups

•  Elders – Because of the increase in life expectancy, a greater number of older people will have age-related diseases and may suffer from difficulties due to health decline. In order to optimize well-being of the growing number of older persons in vulnerable health, it seems a priority to enhance coping resources, and by doing so, to empower older persons. CDSMP is a structured program that emphasizes the strengthening of self-management by older persons with deteriorating health in order to empower them to keep in control of their own body and life. CDSMP among this group, has been shown to:

  • Increase physical exercise
  • Lower health distress
  • Improve self-care
  • Improve self-efficacy or confidence

Among participants, with a mean age of 81 years, the program is effective, especially among those with low education. This study supports the applicability of the CDSMP among elders:

•  Employers – Chronic diseases are multi-dimensional and affect all aspects of people’s lives, especially work. There is a growth in obesity and other cardiovascular risk factors, and related chronic conditions among working-aged Americans, interventions are needed to arm middle-aged and older employees with skills and strategies to manage their diseases and associated symptoms. Disease management is increasingly recognized as an important component of workplace health promotion given our again workforce, the prevalence of chronic conditions, and the importance of maintaining a productive and competitive American workforce. Evidence supports the effectiveness and growing importance of disease management programming in workplace settings. CDSMP has been developed based on over 20 years of research at Stanford University, CDSMP is currently offered in over 30 countries and a variety of languages. CDSMP has the advantages of being inexpensive and easy to disseminate. It is not disease specific and can be delivered effectively by lay leader with minimal training using a train-the-trainer model. 

•  Rural Communities – Evidence suggests rural populations generally display a greater prevalence of less healthy behaviors that impact chronic illnesses, including:

  • Sustained unhealthy nutrition
  • Increased prevalence of smoking
  • Lower levels of physical activity
  • Greater levels of psychosocial distress

Rural elders have been reported to have worse physical and mental functional and more restrictions on activity due to chronic conditions. Encouraging self-management may be important in rural communities for a variety of reasons, such as:

  • The greater effect of chronic diseases on morbidity and mortality in rural populations
  • Preventive care is less available in rural areas
  • Rural residents may be less educated about their chronic conditions due to lack of medical staffing

One of the main concerns regarding CDSMP in rural areas is confidentiality. This study showed people to feel more support among the group members in CDSMP. Several respondents stated they felt their CDSMP group was “a safe and comfortable space to share feelings about their conditions.”

•  Asian Communities – CDSMP is studied among foreign-born adults from China, India, and the Philippines. These subgroup makes the fastest-growing ethnic group in the US. CDSMP has been introduced and widely disseminated in the US as a method to empower patients with self-management skills to deal with their chronic conditions. CDSMP has resulted in improved healthcare and health, while potentially saving healthcare costs. Studies have shown that Asian-Americans complete CDSMP at a somewhat higher rate than the general participant population and at about the same rate as Caucasian participants. The study found engaging CDSMP leaders may instruct workshops in a way that provides participants with more enjoyment or educational benefit from each session, thus increasing the participants’ motivation to complete the program.

•  African-American Urban Communities – Currently, over 43 million US residents are 65+ years of age with that number projected to increase to approximately 80 million by the year 2040. Specifically, between the years of 2012 and 2030, it is projected that the non-Hispanic African American population aged 65 years and above will increase 104% in comparison to the 54% projected increase for non-Hispanic Caucasians in the same age group. African Americans are underrepresented in access to CDSMP as a result of a variety of biopsychosocial and sociocultural factors. In this study, African American CDSMP participants were found to be predominantly female, prevalent chronic conditions to be hypertension, arthritis, and diabetes, more likely to participate in senior centers, residential facilities and healthcare organizations.

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Two leaders in class.
Leslie & Linda - 2015 Training

Leader Training


In order to become a leader and implement Living Well Alaska or CDSMP at your organization, you need to first be trained. The State of Alaska, Section of Chronic Disease and Health Promotion, has obtained a multi-site license from Stanford University valid through 2018. All course leaders and master trainers are required to sign an agreement with the State of Alaska to teach Living Well Alaska: Better Choices, Better Health.

Training takes place twice a year. Training is led by Leslie Shallcross. It is approximately four and a half days in Anchorage. You must be present during all days of training in order to receive your certification. It is important to have a Memorandum of Agreement signed between the State of Alaska, and your organization in order to ensure a CDSMP or Living Well Alaska class will take place within the year of training. Please be sure to discuss this with your organization’s leadership team in order to ensure this will be possible, prior to signing up for training.

The State of Alaska follows the Stanford curriculum. Detailed information about the training can be found here. Cost of training is approximately $300. However, scholarships are available from time to time.

For more information contact:

Leslie Shallcross,
Associate Professor of Extension - Youth, Family and Community Development,
UAF School of Natural Resources and Extension
1675 “C” Street
Anchorage, Alaska 99501
Phone: 907-786-6313
Fax: 907-786-6312
E-mail: lashallcross@alaska.edu


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Contact Us

Nelly Ayala, RN MSN
Alaska Diabetes Prevention and Control Program Manager
Phone: (907) 269-8035
E-mail: nelly.ayala@alaska.gov

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