SPANISH ARTHRITIS SELFHELP COURSE

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SPANISH ARTHRITIS SELF-HELP COURSE
Orange County Branch Southern California Chapter
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Discussion Points

• OC Spanish Program
• Need/ Background
• Training
• Program Content
• Evaluation
• Funding
• Implementing Program
• Challenges/ Successes
• Lessons Learned
• Future Need

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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

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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

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Program Goal

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

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Program Objectives

• Empower participants
• Improve function
• Reduce pain and depression
• Reduce number of unnecessary doctor visits

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Program Features

• Program is based on the Arthritis Foundations
  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

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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

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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

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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

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Community Partners
Community Centers
Senior Centers
Resource Centers

• Arthritis Foundation
• OC Branch

Clinics
Schools
Hospitals
Churches
Apartments
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Participant Outreach

• Health Fairs
• Churches
• Flyers
• Radio PSAs
• Newspapers
• Word-of-Mouth

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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)

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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 Lorigs
  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).

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OC Program Funding

• CA Arthritis Partnership Program (CAPP)
• 1999 2004
• Orange Countys United Way
• 1999 2001
• City of Anaheim
• 2003
• Pacific Life Foundation
• 2003 - 2004

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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

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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

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Bilingual Coordinator

• Key person to community
• Able to network
• Knows community
• Culturally responsive
• Knows resources
• Answers Spanish phone calls
• Sends Spanish literature

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Course Challenges

• Child care
• Transportation
• Educational/ literacy level
• Bringing the program to the community
• Weather
• Geography
• Time of day/ year

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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

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Success Stories

• Isela Loza
• Spanish Coordinator
• Orange County Branch
• Gabriela Najera
• Diversity Program Coordinator Chapter Office

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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

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For additional information

• Jenny Broberg, Program Director
• Southern California Chapter, Orange County Branch
• 17155 Newhope Street, Suite A
• Fountain Valley, CA 92708
• [phone]
• jbroberg_at_arthritis.org
• Mireya Peña, Vice President of Public Health and
  Research
• Southern California Chapter
• 4311 Wilshire Blvd., Suite 530
• Los Angeles, CA 90010
• [phone] x. 246
• mpena_at_arthritis.org