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Searching for WISDOM: Lessons from the WISEWOMAN Projects

I. Searching for WISDOM: Lessons from the WISEWOMAN Projects. Julie C. Will Patricia Poindexter Centers for Disease Control and Prevention Atlanta, Georgia. General Themes. Focus on “Searching” Share lessons learned along the way. Topics. Overview of WISEWOMAN

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Searching for WISDOM: Lessons from the WISEWOMAN Projects

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  1. I

  2. Searching for WISDOM: Lessons from the WISEWOMAN Projects Julie C. Will Patricia Poindexter Centers for Disease Control and Prevention Atlanta, Georgia

  3. General Themes • Focus on “Searching” • Share lessons learned along the way

  4. Topics • Overview of WISEWOMAN • Capturing Grassroots “Success” • Sharing Early Lessons Learned • Describing Best Practices • Conclusions

  5. Topics • Overview of WISEWOMAN • Capturing Grassroots “Success” • Sharing Early Lessons Learned • Describing Best Practices • Conclusions

  6. Vision • A world where any woman can access preventive health services and gain the wisdom to improve her health.

  7. Mission • To provide low-income, under- or uninsured 40-64 year old women with the knowledge, skills, and opportunity to improve diet, physical activity, and other lifestyle behaviors to prevent, delay and control cardiovascular and other chronic diseases.

  8. WISEWOMAN Components • Baseline screening for cardiovascular disease risk factors • Lifestyle interventions sessions • Referral for medical care, if needed • Systems for accessing low-cost medications • One-year follow-up screening

  9. Abnormal Medical referral & Follow-up Alert Immediate medical referral Ensure treatment Recruited from B and C Program Cardiovascular Risk Factor Screening Risk Factor Counseling Lifestyle intervention for diet, physical activity and/or tobacco More active Better diet Decreased smoking Reduced CVD risk factors Diagnostic tests. Enrolled in intervention Medical treatment if needed

  10. Standard Enhanced WISEWOMAN 2005 1 of each

  11. New Leaf Patient-centered Assessment and Counseling for Exercise & Nutrition Project Active Dietary Approaches to Stop Hypertension (DASH) Dietary Guidelines for Americans 10,000 Steps State Quitlines Smoking Cessation Classes Interventions Vary By Project

  12. ¡Vida Saludable, Corazón Contento!: Promoting Healthy Living and a Happy Heart in Latino Women • Needed intervention materials for Spanish-speaking women • Culturally appropriate adaptation process of A New Leaf • Multiple-level material design, evaluation and revision

  13. Traditions of the Heart:Culturally Sensitive Program Promotes Health For Alaska Native Women • Needed easily understood intervention for lay and professional use • Tailored A New Leaf for Alaska Native women • Formative research essential for culturally appropriate materials

  14. RE-AIM Model From www.re-aim.org

  15. WISEWOMAN projects have reached more than 30,000 low-income women across America 6,800 New Women Screened 12,803 6,371 3,133 1,471

  16. WISEWOMAN projects have provided more than 60,000 lifestyle intervention sessions 22,973 Intervention Sessions 30,283 8,750 4,122

  17. Reductions in Systolic Blood Pressure Among Women with Abnormal Values at Baseline * * * * * Reduction in SBP, mmHg * indicates statistical significance at the 5% level

  18. Reductions in Total Cholesterol Among Women with Abnormal Values at Baseline * * * Reduction in TC, mg/dl * * * indicates statistical significance at the 5% level

  19. Reductions in Smoking Rate (Percent Change) Percent Reduction in Smoking Rate * indicates statistical significance at the 5% level

  20. Reductions in 10-yr CHD Risk (Percent Change) Percent Reduction in 10-year CHD risk * * * indicates statistical significance at the 5% level

  21. WISEWOMAN Projects 1995: Massachusetts, North Carolina, Arizona 1999: Alaska (Southcentral Foundation) Arizona doesn’t reapply 2000: Iowa, Alaska (SEARHC), Connecticut, Michigan, Nebraska, South Dakota, Vermont 2001: California and Illinois 2003: Missouri and West Virginia 2004: Minnesota

  22. Adoption: Length of Time from Funding to 1st Screening and 1st to 500th Woman Screened. Projects designated as NON-RESEARCH at the time of funding award.

  23. Adoption: Length of Time from Funding to 1st Screening and 1st to 500th Woman Screened. Projects designated as RESEARCH at the time of funding award. *Project J has not started screening women yet; the number of days is from the date of funding to 4/15/05.

  24. Percent of Participants Who Completed At Least One Intervention Session Percent

  25. WISEWOMAN projects have maintained their screening effort each year 6,800 New Women Screened 12,803 6,371 3,133 1,471

  26. Topics • Overview of WISEWOMAN • Capturing Grassroots “Success” • Sharing Early Lessons Learned • Describing Best Practices • Conclusions

  27. WISEWOMAN WORKS: A Collection of Success Stories

  28. Why Use Success Stories? • Qualitative complements quantitative research • Simple, one-page format more likely to be read than other formats • Pictures and quotes personalize program results • Supports WISEWOMAN funding • Everyone likes stories!

  29. Reaching Multiple Audiences Through Success Stories • Congress/Decision makers • Engage or gain support • Facilitate decision making • Health care providers • Generate new ideas • Adapt and adopt “successful” ideas • Share information - nontraditional publications • Women • Expand reach through program promotion • Foster social support • Incentive

  30. Mary Ellen’s Story: Right on Time for Her Health • WISEWOMAN helped Mary Ellen approach health holistically • Positive and encouraging staff set health goals together • She is now a WISEWOMAN “champion”

  31. TA: health professionals TA: participants Version 1 Version 2 Two Sides to Every Story • Quote from Mary Ellen • Picture of Mary Ellen • Program background/wordy • Less text/more benefits • Lessons learned focuses on key elements of a successful program • Lessons learned focuses on why women like Mary Ellen should attend the program • Uses: New programs, training staff, shared lessons • Uses: Recruitment and outreach; Incentive

  32. Healthwise Partnership Promotes Physical Activity for WISEWOMAN Participants in Winston-Salem WISEWOMAN YWCA Diabetes Control United Way YWCA Scholarships Reduce Cost and Access Barriers for Women

  33. Success Stories Categories • Empowering and Motivating Women • Expanding Staff Capacity • Giving Access to Counseling and Medication • Responding to Women’s Needs • Building Partnerships

  34. “These women are dealing with a number of issues: poverty, health problems, and addiction. We try to be someone they can talk to about what they’re struggling with.”Carolyn Townsend,North Carolina WISEWOMAN Director

  35. “New Leaf is a great tool. It helps us find out if there are things going on in a woman’s life that influence her smoking. Maybe she’s worried she’ll gain weight if she quits, or maybe she’s depressed, like Sally, and smoking helps her forget about her problems for a few minutes.” Lori Green,Local WISEWOMAN Coordinator

  36. WISEWOMAN Works has been used to promote women’s heart health in a number of ways. Success stories can: • Offer a low-cost way to document program success • Help programs gain support for successful activities • Inform others about successful program interventions • Acknowledge the innovative strategies used by program staff and partners

  37. Topics • Overview of WISEWOMAN • Capturing Grassroots “Success” • Sharing Early Lessons Learned • Describing Best Practices • Conclusions

  38. Lessons Learned From Phase 1:1995-1998

  39. Three Original Projects Arizona (AZ) Massachusetts (MA) North Carolina (NC)

  40. Methods • Case study design • Document Reviews • Telephone Interviews • Identified cross-case lessons and themes • Summarized results

  41. Key Features:

  42. Key Features (cont’d):

  43. Key Features (cont’d):

  44. RESULTS - REACH • NBCCEDP implementation stage affects WISEWOMAN recruitment • Multiple channels and personal contact are effective • Outreach into the community is important

  45. RESULTS- REACH (cont’d) • Recruitment is enhanced when funds are designated for outreach • Program participation may be influenced by the types of no-cost services offered • Participation may be affected by general barriers and lifestyle behavior specific barriers

  46. RESULTS- Effectiveness • Participant commitment is required • Agencies and professionals need individualized support

  47. RESULTS- Adoption • WISEWOMAN focus on screening and intervention is labor intensive • Blending programs with different emphases and aims can be difficult - streamline WISEWOMAN to fit the NBCCEDP approach • Intervention should have a flexible design to accommodate individual, group or phone sessions

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