This application is in response to PA 11-123, Translational Research to Help Older Adults Maintain their Health and Independence in the Community (R01). Using the Replicating Effective Programs (REP) framework, the proposed study will translate a University of Michigan Center for Managing Chronic Disease (CMCD) evidence-based program for older adults with heart disease for a vulnerable older, primarily African American population, in Detroit, Michigan. The study will be conducted in partnership with the Rosa Parks Geriatric Center at the Detroit Medical Center (RPC) and the Detroit Area Agency on Aging (DAAA).
The specific aims of the research are to: (1) adapt, pilot test, and implement the take PRIDE heart disease management program as part of a partnership with the DAAA and RPC; (2) conduct a randomized trial of the translated intervention with 590 participants to assess health outcomes including frequency of cardiac symptoms; functional health status; emergency department visits and hospitalizations for heart disease; (3) assess the translation and implementation of the intervention in the target setting and identify factors that help and hinder the process; (4) assess cost savings associated with the intervention and return on investment (ROI) to the RPC and DAAA; and (5) develop guidelines for scaling up, that is, for replicating the intervention in other low-income areas through the national network of Area Agencies on Aging. Given the aging of our population and the disproportionate burden of chronic disease among low income African American communities, the translation of evidence based programs to support disease-management and reduce health care utilization-e.g., emergency department visits and hospital readmissions--is timely and of great public health significance.
Heart disease is the leading cause of death among older Americans, but heart disease patients can take steps toward improving their health with proper self-management. Through a partnership of the University of Michigan Center for Managing Chronic Disease, the Rosa Parks Geriatric Center of the Detroit Medical Center, and the Detroit Area Agency on Aging, we will adapt a successful group-based program ('take PRIDE') to support heart disease self-management, so that it meets the needs of the older population with heart disease in Detroit, Michigan. We will evaluate the effects of the newly-adapted program on the health and medical care use of participants compared to a randomized control group; assess the program's cost effectiveness; and develop guidelines for 'scaling up' the program through the network of national Area Agencies on Aging.