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1 Webinar Instructions Thank you for joining today, please wait while others sign in. Phone Dial in: Access code: # Due to the large number of participants, all lines will be muted during the call. If you want to ask a question, you can type in your question into the box. A non-profit service and advocacy organization National Council on Aging

2 May I put you on hold? No! Please do not put us on hold! A non-profit service and advocacy organization National Council on Aging

3 Taking Control of Your Health in the New Jersey Prison System Presented by Margaret Conrad, DNP Maria Delgado, RN UMDNJ / University Correctional HealthCare

4 The Facts Chronic disease is the principal cause of disability Is a major reason for seeking healthcare Accounts for 70% of all health care expenditures in this country. Chronic disease self-management programs can improve health benefits while reducing health care costs.

5 The Issue State Prisons release most inmates to the community, and about half of the population return primarily into our urban centers. This fluid relationship between the prison system and the broader community situates correctional health care at the forefront of many of our most pressing public health challenges.

6 The Problem People with chronic diseases should receive care that meets national standards, both in the community and during incarceration. Recently evidence based practice models have become available to guide the routine management of chronic disease by achieving specific patient oriented outcomes. Currently, there are few evidence-based models delivered to prison populations.

7 The Solution The Stanford University Chronic Disease Self- Management Program (CDSMP) is a cost effective selfmanagement education program that allows organizations to provide self-management support across multiple diseases and conditions.

8 Assumptions about the CDSMP Program Patients with different chronic diseases have similar selfmanagement problems and disease-related tasks. Patients can learn to take day-to-day responsibility for their diseases. Confident, knowledgeable patients practicing selfmanagement will experience improved health status and use fewer health resources. Source: Lorig and Holeman 2003

9 Implementing a CDSMP in the Correctional Setting A grant was awarded to University Correctional Healthcare (UCHC) by the New Jersey Department of Health and Senior Services (NJDHSS) in October of 2009 to implement the Stanford University Chronic Disease Self-Management Program within the prison system. UCHC initiated the six-week evidence based Chronic Disease Self-Management Program (CDSMP) in January, 2010

10 Can it Work in the Correctional Setting? The Answer is Yes! The success of the program depends on the mutual support of the participants, facilitators, providers and the site administration. The New Jersey Department of Corrections (NJDOC) were instrumental in the success of the program. The UMDNJ Medical and Mental Health Providers supported the program and referred inmates from the chronic disease clinics. We have three Master Trainers, over 35 Staff Peer Leaders and hold the six-week groups at 15 different locations across the state. We also have waiting lists for both group and peer leader trainings.

11 Obstacles Education of our staff, DOC administration/officers Security Levels Inmate movements and counts Finding appropriate rooms

12 Inmate Feedback It is really helpful for people to come in and give us insight into our illnesses I ve learned new ideas on how to manage my asthma and how to set weekly goals Thank You for teaching us how to deal with our Chronic issues without giving up! Each week we learned something different about ourselves, and family members too!

13 Inmate Feedback This was a great motivator for me to get back into my exercise routine, and this class has been a good influence for others. The workshops provide me with a lot of insightful information and different ways to manage my illness. I now feel confident in my approach to life. I hope you can do more of these groups for others because it does provide a new prospective.

14 Inmate Feedback I can now go out in the court yard and ask how someone is feeling and really mean it! This let me know that I am not alone and other inmates have the same problems This group is great! I feel the leaders are talking with us not at us! This group will help me take care of myself when I finally get out of here. Thank You!

15 The NJ prison program Take Control of Your Health, will be presented at the upcoming National Commission on Correctional Health Care Annual Conference in Las Vegas on October 13, If interested in learning more about implementing this CDSMP program in your state prisons, please register in advance at: for program title Chronic Disease Self Management Promotion Groups in the New Jersey Prison System Unable to attend? Feel free to contact Dr. Conrad by at or by phone (609)

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17 Living Longer Living Stronger in Oklahoma Prisons Melanie Spector, Ed.D, LPC, LADC Pastor H. David Lee, CDSMP/LLLS Master Trainer

18 LLLS A Collaborative Process LLLS DOC Offender Trainers LLLS Master Trainers Volunteer Trainers and DOC Staff trainers

19 HIGHLIGHTS In August 2009, Oklahoma Department of Corrections (DOC) and the Oklahoma State Department of Health (OSDH) collaborated to implement the Stanford University Chronic Disease Self Management Program (referred to in Oklahoma as the Living Longer, Living Stronger (LLLS) with Chronic Conditions) into the prison system.

20 PROGRAM OBJECTIVES DOC staff, offenders and community volunteers will be trained by LLLS-OSDH (on going). Program evaluation and fidelity will be monitored by OSDH (on going). LLLS-OSDH will collect and evaluate lessons learned by workshop leaders.

21 PROGRESS Objectives #1 & #2 At each site, coordinators were identified and instructed on workshop promotion, handouts, data collection, and reporting. Each initial workshop was monitored by an LLLS-OSDH Master Trainer. Objective #3 LLLS Master Trainers encourage leaders to identify the use of positive interventions by participants at each session.

22 DOC Significant Highlights DOC has utilized an established 18 year old peer education program to enforce the ideology of each one, reach one, teach one. DOC peer educators evolved from teaching about infectious to chronic diseases.

23 DOC Significant Highlights With help from Deputy Director Kenny Holloway DOC has recognized LLLS as an official DOC program. Ten days of good time is provided for offenders who complete all classes.

24 DOC Significant Highlights Chief Medical Officer Don Sutmiller, DO designed a LLLS protocol to track pre and posttest measures for offender s cholesterol, weight, blood pressure and HGB A1c to assess differences before and after the LLS intervention.

25 WORKSHOPS OSDH At this time ODOC has conducted 23 workshops: 1. Clara Waters CCC (4) Workshops (41) Participants 2. Eddie Warrior CCC (3) Workshop (44) Participants 3. Hillside CCC (2) Workshops (18) Participants 4. Jess Dunn CC (9) Workshops (105) Participants 5. Kate Barnard (1) Workshop (8) Participants 6. Oklahoma City CCC (2) Workshop (15) Participants 7. Union City CCC (2) Workshop (18) Participants 23 Workshops 249 Participants

26 CHALLENGES 1. Concerns were expressed by some offenders that staff involvement might negatively effect offender participation. 2. Following the first training, workshops were delayed due to an increased workload of staff and statewide furloughs.

27 CHALLENGES 3. Offenders were concerned about the Participant Information Form, which asks about family information. 4. Losing offender trainers due to early parole or release dates causing suspension of workshops until other people could be trained.

28 Offenders Are Talking

29 Offenders Are Talking Living Longer Living Stronger taught me a better way of handling my chronic pain and ways to help deal with every day life while having Lupus. My teachers gave me a better understanding than most doctors ever have.

30 Offenders Are Talking Living Longer Living Stronger taught me a lot about my health and the importance of my medication. I learned how to set goals and stick to them. Since the class I have lost 21 pounds. This was a great class.

31 Offenders Are Talking Living Longer Living Stronger has had a tremendous impact on my life. I learned exercises that I never would have thought to do and learned to set goals and was given the tools to be able to achieve those goals each week. I would like to thank the people that offered this class to me.

32 Offenders Are Talking When I call home I feel like I am giving back. I ask about my families health and tell them I am eating better and exercising.