SPANISH ARTHRITIS SELF-HELP COURSE

Orange County Branch

Southern California Chapter

Discussion Points OC Spanish Program

Need/ Background Training Program Content Evaluation Funding

Implementing Program Challenges/ Successes Lessons Learned

Future Need

Need in Orange County 31% of Orange County residents are Latino

(930,000)*

25.6% OC Latinos speak Spanish in the home*(25.6% of 930,000 total OC Latinos = 238,080)

1 in 3 people are affected by arthritis(1/3 of 238,080 = 78,566)

78,566 Spanish-speaking OC residents have arthritis

* 2000 Census Bureau

Background

1996 – community needs assessment identified arthritis education as a priority in the Spanish-speaking community

Content used for the course was the Stanford University-developed Spanish Self-Help Course, modeled after the original Arthritis Self-Help Course

Program Goal

GOAL - to improve the functional outcome and quality of life for Spanish speaking arthritis patients in Orange County

Program Objectives Empower

participants Improve function Reduce pain and

depression Reduce number of

unnecessary doctor visits

Program Features Program is based on the Arthritis Foundation’s

Arthritis Self-Help Course

Culturally Relevant Spanish Version developed by Stanford University (Kate Lorig, RN, Dr.P.H. and Virginia Gonzalez, MPH)

Offered FREE to the community at 21 different sites throughout Orange County

OC Program began in 1999

Program taught by “Promotoras”

“Promotoras” Lay health educator Recruited from Spanish-speaking

community Participants feel greater comfort and

ease learning from peers Special training & certification

provided by Stanford University and Arthritis Foundation

Promotora Training Trained by “Master Trainers”

Two day training in Southern CA

Integrate cultural relevance

Lack of Promotoras and Master Trainers in Southern CA

Need funding to offer trainings

Program Content Six week course (two hour weekly classes)

Topics include: exercise, depression, self-talk, nutrition, doctor-patient relationship, pain management, medication, alternative treatments, relaxation techniques

Course Book: “Como Convivir con su Artritis”Bull Publishing 1-800-676-2855

Audiotapes: Relaxation - “Lado dos: Un Jardin de flores” Exercise – “Lado uno: Hagamos ejercicio”Stanford University 1-800-725-9424

Community Partners

Arthritis FoundationOC Branch

CommunityCenters

ClinicsSchools

Hospitals

Senior Centers

Apartments

Churches

Resource Centers

Participant Outreach Health Fairs

Churches

Flyers

Radio PSA’s

Newspapers

Word-of-Mouth

People Served

OC Program 1999 – 2004

Total Classes = 49

Total Participants Attended = 594

Total Participants Graduated = 453(Completed at least 4 out of 6 classes)

Program Evaluation Andrew Wong, MD, Olive View – UCLA Medical

Center conducted evaluation

Participants improved self-management skills, knowledge of arthritis, appropriate seeking of health care for arthritis, and implemented changes in self-care behavior related to arthritis

Found to be evidence-based

Findings were consistent with Kate Lorig’s English-based ASHC model

Wong, A, Harker, J, Lau, V, Shatzel, S, Port, L. Spanish Arthritis Empowerment Program: A Dissemination and Effectiveness Study. Arthritis & Rheumatism (Arthritis Care & Research) 2004; 51(3).

OC Program Funding CA Arthritis Partnership Program (CAPP)

1999 – 2004

Orange County’s United Way 1999 – 2001

City of Anaheim 2003

Pacific Life Foundation 2003 - 2004

Budget to Implement Spanish Program Spanish Coordinator Training

Master Trainer Materials

• Manuals• Books• Audiotapes (exercise and relaxation)

Class Instructors (2 instructors/class, 1 sub) Materials

• Books for participants• Audiotapes

Implementation in Your Community An initial “needs assessment” is crucial Use your local Hispanic network

system to reach this “hard-to-reach” population

Identify “promotora” systems already in place in your community

Create partnerships with local hospitals or health departments

Hire bilingual coordinator Liaison between AF and community

Bilingual Coordinator Key person to community

Able to network

Knows community

Culturally responsive

Knows resources

Answers Spanish phone calls

Sends Spanish literature

Course Challenges

Child care Transportation Educational/ literacy level Bringing the program “to the

community” Weather Geography Time of day/ year

Lessons Learned Partner with community organizations using a lay-

leader model Attendance builds through referrals Certificates of completion and pot-luck dinners

during last class increases retention Inclement weather negatively impacts attendance Participants often bring family members Coordinator is vital for program Continuation of funding will be important for the

maintenance and consistency of these programs

Success Stories

Isela LozaSpanish CoordinatorOrange County Branch

Gabriela NajeraDiversity Program Coordinator Chapter Office

Need for Future Funding is necessary to maintain

this vital program in Orange County 594 people have benefited from the 49

classes offered throughout OC Many more people can benefit from this

program This program can be modeled on a

local, state and national level

For additional information:Jenny Broberg, Program DirectorSouthern California Chapter, Orange County Branch17155 Newhope Street, Suite AFountain Valley, CA 92708(714) 436-1623jbroberg@arthritis.org

Mireya Peña, Vice President of Public Health and ResearchSouthern California Chapter4311 Wilshire Blvd., Suite 530Los Angeles, CA 90010(323) 954-5760 x. 246mpena@arthritis.org