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National Association of Chronic Disease Directors
General Member Call
March 28th, 2013
“Integrating Efforts to Support Livable Communities Across the Lifespan”
Division of Population Health
National Center for Chronic Disease Prevention and Health Promotion
About Today’s Call
Highlights importance of integrating mobility and
livable communities into public health activities
Provides information about activities of the CDC’s
Healthy Aging Program (HAP) and AARP
Stimulates dialogue among call participants, HAP and
AARP
Informs HAP and AARP efforts to support future work
that promotes the health and well-being of older adults
Supports CDC/NCCDPHP Domain #2: Environmental
Approaches
Introductions
Lynda Anderson, PhD
Director, Healthy Aging ProgramApplied Research and Translation Branch
Amy Levner,
AARP
Introductions
Cheryl Schott, MPH
Consultant, Michigan Public Health Institute
Amy Slonim, PhD
CDC-AARP Liaison
Webinar Dialogue Objectives
Describe the shifting demographics in the US
population
Share overviews of priorities, activities and resources
of CDC Healthy Aging Program and AARP Livable
Communities
Engage in dialogue about state and local public health
opportunities to integrate older adults issues in work
with communities, state and local elected officials and
partners
Tell Us Few Things About Yourself
Check the box that best represents your professional affiliation:
• -- State and local public health
• -- Aging Services
• -- Academia
• -- Federal government
• -- Other
*
Lynda Anderson, PhDDirector, Healthy Aging ProgramApplied Research and Translation Branch
CDC’s Healthy Aging ProgramWork on Mobility
Transformative Demographic Shifts
The number of older adults are growing faster than any
other age group
By 2015, there will be more people over age 65 than
those aged 15 or younger
By 2030, 20% of the U.S. population will be 65 years
of age or older
Adults age 65 or older are twice as likely to be living in
poverty as they were a decade ago
* Anderson LA et al. The public's perceptions about cognitive health and dementia among the United States
population: a national review. Gerontologist 2009;49(51):S3-11.
CDC’s Healthy Aging ProgramWork on Mobility
Objectives
Provide a brief history and rationale for current work in
mobility and older adults
Summarize the findings from the mobility and older
adults concept mapping work and resulting framework
Discuss next steps
Mobility
Optimal mobility* is defined “as being able to safely and
reliably go where you want to go, when you want to go,
and how you want to reach your designation, and is key a
component of healthy aging.”
* Modified from the CDC-HAN Mobility Workgroup and Satariano et al. (2012) AJPH
Concept Mapping Applied to Mobility
� Engages stakeholders
� Applies multi-dimensional scaling and cluster analysis
� Creates visual maps of relationships among ideas
� Provides a foundation for prioritizing action items
Steps in Concept Mapping
Planning: Develop a focused question and identify participants
Idea Generation: Experts and interested community members invited to respond to focused question
Data Collection: Participants sort and rate the results of the idea generation
Analysis: Creates visual maps of relationships among ideas
Interpretation and Use: Develop conceptual framework and identify priorities
Develop a Focused Question
“One specific action that can lead to positive change in mobility for older adults in the U.S. is…”“One specific action that can lead to positive change in mobility for older adults in the U.S. is…”
Specific Aim: To engage stakeholders to create a framework that will contribute to promoting mobility in community-dwelling older adults as a coordinated response across agencies and organizations.
Specific Aim: To engage stakeholders to create a framework that will contribute to promoting mobility in community-dwelling older adults as a coordinated response across agencies and organizations.
Sort and Rate Ideas
Each idea was rated for
potential impact and
achievability
Each idea was rated for
potential impact and
achievability
102 ideas were
sorted into groups
102 ideas were
sorted into groups
Work quickly and effectively
under pressure
49
Organize the work when
directions are not specific.
39
Decide how to manage multiple
tasks.20 Manage resources
effectively.4
Conceptual Framework: Mobility and Older Adults
Housing andAccessibility
Policy
CoordinatedAction
Community Supports
Training
Research to Practice
Transportation
Built Environmentand Safety
Independenceand Engagement
Independence and Engagement
Identify one or more communities to serve as environmental models or as examples of
mobility-sensitive or friendly communities.
Engage community volunteers in conducting walkability audits.
Actively encourage recognition of and planning for older adults to continue to be active in the years when mobility will be
limited.
Make available a variety of evidence-based physical activity and fall prevention/education programs, both in-home and in
community based settings, that can be scaled for different locales or communities.
Identify and support physical activity programs that can accommodate people aging with disabilities.
Support the use of programs for exercise to maintain strength and improve balance.
Encourage the use of available health self-management tools, like online, buddy systems, in person support and information,
group support and so on.
Identify and promote critical programs related to driving and older adults, including persons with cognitive and physical
limitations.
Encourage ways to promote intergenerational physical activity and connection to family, friends and community to provide
social supports.
Encourage shops or large retail or entertainment locations to provide and support mobility options
for their customers.
Repurpose locations like community centers so they can better serve the needs of adults and persons
with disabilities.
Coordinated ActionInclude mobility and older adults in coordinated chronic disease prevention and health
promotion state plans.
Engage older adults, though interactive participatory methods, in voicing their strengths and
priorities in promoting mobility.
Implement a certification process for age-friendly communities.
Partner with state coalitions on fall prevention to identify community safety activities that may be useful for local
communities.
Encourage states to develop, implement and evaluate their own physical activity plans modeled after the National Physical
Activity Plan.
Public awareness campaigns about the benefit of physical activity for older adults that include a call to participation and
action for older adults.
Identify and support a guide for smaller towns that want to adopt a bike/ped master plan for their town.
Work with schools and others to seek opportunities for intergenerational connections, like reciprocal tutoring and
volunteering.
Develop a comprehensive, multi-faceted approach to healthy aging, coordinated across agencies, through information and
assistance and care coordination.
Encourage states to develop, implement and evaluate their own fall prevention plans modeled after
the National Fall Prevention Plan.
In what programmatic or functional areas are you most fully integrating the perspectives and needs of older adults?
WE WANT TO HEAR FROM YOU . . .
WE WANT TO HEAR FROM YOU . . .
Do you include the perspective
of older adults in your chronic
disease efforts around
mobility?
Healthy Aging Mobility Scan:An Assessment of State Mobility Work
Cheryl Schott, MPH
Consultant, Michigan Public Health Institute
National Association of Chronic Disease Directors
General Member Call
March 28th, 2013
Scope of Work/Methods
Reviewed ten state health department websites:
Searched: 1) A-Z index/site maps, 2) Homepages, 3) Website search engine
Particular attention given to physical activity, walking, obesity prevention, arthritis, disability, fall prevention, transportation, and healthy/livable communities programs
Relevant URL’s and sub-links, summary of findings, and key documents were recorded on a search log and document review form
• Arkansas• California• Florida• Kansas• Michigan
• New York• North Carolina• Texas• Vermont• Washington State
Findings
All states reviewed are actively involved in policy and
environmental efforts to promote healthy communities
Strategies include:
Changes to the built environment
Adopting Complete Streets policies
Improving public transportation
Promoting access and safety
Developing joint-use agreement
Older adults are recognized as a special population in
several states’ plans and reports
Inclusion of strategies specific to the aging population varies
Examples: Older Adults
Built Environment
Healthy Kansas Community Assessment and Planning Tool includes considerations for older adults and people with disabilities such as:
wheelchair access
resting space for pedestrians
visual/sound signals at cross-walks
assistance with snow/ice removal
in-door walking programs
Photo credit: Dan Burden, www.pedbikeimages.org
Walkable Communities
California Walkable Neighborhoods for Seniors project provides workshops on how to make communities more walkable for seniors and offers local walking groups
The Arkansas Department of Health and Arkansas Coalition for Obesity Prevention (ArCop) has partnered with AARP to conduct Active Living Workshops and walkability assessments as part of their Growing Healthy Communities initiative
Photo credits: Luciano Rizzi and Dan Burden, www.pedbikeimages.org
Examples: Older Adults
Supports community efforts to conduct assessments and initiate improvements to make communities more elder friendly and livable for all ages
Florida, Michigan and North Carolina are among the states with such programs
Administered by state aging departments, versus public health, although they may collaborate on certain components
Communities For A Lifetime/Aging in Place
Transportation
California Health in All Policies Task Force addresses transportation issues for the aging population
Plans to model future transit access to essential destinations
Sponsors an annual Senior Safe Mobility Summit
Provides training to healthcare professionals on assessing older adults’ functional driving skills
A few states (e.g. Kansas, Texas, Vermont) address access to health care or other services by promoting transportation assistance for those in need
Photo credit: Dan Burden, www.pedbikeimages.org
Arthritis, Disability & Fall Prevention
Most states reviewed also address mobility issues through arthritis, disability, and/or fall prevention programs
Primarily address personal mobility such as activity limitations (e.g., trouble walking, climbing stairs, activities of daily living)
Kansas Arthritis Program promotes changes to the built environment to facilitate physical and social activity among people with arthritis; disability program promotes community improvement of non-automobile travel systems (e.g., sidewalks, curb cuts, etc.) for people with disabilities
Surveillance/Data Collection
BRFSS data on activity limitations (e.g., trouble walking short distance, climbing stairs) among people with arthritis or disabilities
Fall injury and mortality data among older adults
Percent of older adults who engage in recommended amounts of physical activity
Michigan - limited data on the use of local trails and parks among older adults (collected through an evaluation of their Building Healthy Communities program)
In development - policy, environmental and built environment indicators promoting mobility
What partnerships do you use to promote active communities for older adults?
WE WANT TO HEAR FROM YOU . . .
What challenges do you face when integrating mobility into new or existing programs?
WE WANT TO HEAR FROM YOU . . .
Call for Papers
Special Supplemental Issue Health Education & Behavior
Fostering Engagement and Independence: Opportunities and Challenges for an Aging Society
Guest Editors: Lynda A. Anderson, PhD and Thomas R. Prohaska, PhD
250-word abstract describing the manuscript by May 20, 2013
Submit to Debbie Gordon Messer at [email protected]
Email follow-up to be sent with additional information
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: [email protected] Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official
position of the Centers for Disease Control and Prevention.
For more information about the Healthy Aging Program:
Visit www.cdc.gov/aging
Telephone: 770 488-5360
Division of Population Health
National Center for Chronic Disease Prevention and Health Promotion