AFRAID OF DATA? EXPLORING YOUR DATA FOR CQI

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1 AFRAID OF DATA? EXPLORING YOUR DATA FOR CQI Lake County Tribal Health Consortium Lake County, CA Gemalli Austin, DrPH, RD, CDE, Diabetes Education Program Manager Lake County Tribal Health Consortium, Inc. Cathy Ferron, MBA, Evaluator, Ferron & Associates

2 Using Data for Improving DSMP Completion Analyzing Data on Participant Confidence for CQI Exploring Health Measures Data for further CQI analysis Future CQI Questions to be considered Learning Objectives

3 Lake County Tribal Health Between September 2016-March 2018, 11 DSMP workshops were held at 8 sites around the lake 6 Tribal sites, a Senior Center & LCTHC Total of 91 participants, with 41% completion rate

4 DSMP Participant Demographics 91 participants, with overall completion rate of 41% 100% Native American 73% Female; 27% Male 89% Live with others; 11% live alone 62% under age 60; 28% in 60 s; and 10% 70 and older Conditions of Participants 86% have 2 or more chronic conditions Diabetes 73% Hypertension 60% Obesity 53% Chronic Pain 49% Anxiety/Depression 35%

5 Problem Statement: We are having trouble retaining participants to become DSMP workshop completers. Possible Causes People Do health conditions of participants affect completion rate? Are completion rates different for participants who live alone or with others? Environment Is there a seasonal impact on completion rates? Communication Does communicating through the tribe and use of tribal site help completion rates? Methods Does the scheduled time affect completion rates? Do specific classes have more dropouts than others?

6 Does the health condition(s) of participants have bearing on our completion rate? Conditions of Participants Completion Rate 2 or more conditions 42.4% Diabetes 41.6% Hypertension 42% Obesity 42% Chronic Pain 42% Anxiety/Depression 42% Program Response: Provided training on Mental Health First Aid to be able to better respond to participant needs. Opportunities for stretch breaks during classes.

7 Does participant living arrangement have bearing on our completion rate? Living Arrangement Completion Rate Overall 41.0% Lives Alone 31.8% Lives with Others 43.9% Program Response: Develop better connections for those living alone with Lifestyle Coach or other workshop participants. Upcoming Motivational Interviewing training for Lifestyle Coaches & Community Leaders.

8 Is there a seasonal effect on our completion rate? 100% % of Participants Completing 80% 60% 40% 36.4% 57.7% 38.3% 20% 0% Sept 2016-Mar 2017 Mar 2017-Sept 2017 Sept 2017-Mar 2018 Program Response: Developed outreach plan & HDAC members are working on specific areas of outreach. Providing transportation options.

9 Does location of workshop have bearing on completion rate? Program Response: Better connections to tribal organizations, including Casinos and TANF programs. Door-to-door outreach on Rancherias.

10 Does scheduled time of workshop have bearing on completion rate? 100% % of Participants Completing 80% 60% 57% 54% 40% 20% 0% 27% Morning Afternoon Evening Program Response: Offering more evening workshops. Considering weekend offerings (based on recent response to clinic needs assessment) to test response.

11 Which class(es) have greatest number of participant drop-outs? Class #1 Class #2 Class #3 Class #4 Class #5 Class #6 Total Participants # of DropOuts from previous class Program Response: More practice and coaching of Community Leaders to improve delivery of material and increase participant enthusiasm and engagement in each class.

12 Topic Results of Participant Confidence Data Analysis for CQI Purposes #1: Prepare & eat healthy foods #2: Identify nutrients in foods #3: Include physical activity in daily routine & manage stress in positive manner Average Change in Confidence Level ANOVA Test for Significance P<.05 % of Participants w/positive change or maintained Confidence Level P= % P= % P= % #4: Manage emotional eating & portion sizes #5: Manage difficult emotions #6: Maintain selfmanagement practices P= % P= % P= %

13 Developing Health Measure Data for DSMP Completers Patients Gender Age # of Health Conditions N=37 73% F 27% M Under 45 8% Age % Age % Age % 2 or more Health Conditions 95% 4 or more Health Conditions 78% Diabetes Obesity Hypertension 81% 62% 76%

14 Example of Health Measure Dashboard for DSMP Completers Patient # Weight Pre/Post BP Pre/Post Systolic/Diastolic #1 / #2 / #3 / #5 / #6 / #7 / #9 / #10 / #12 / #13 / A1C Pre/Post

15 Next Steps Continue looking for answers related to low completion rates and test ideas for improvement Cultural enhancement similar to Wisdom Warrior Continue expanding health measure data dashboard for completers to better understand health status of postworkshop participants Develop comparison group of non-completers Continue expanding referral tracking & participant connections to aftercare to make long-term health changes

16 QUESTIONS OR COMMENTS? Contact Lake County Tribal Health Consortium, Lakeport, CA Gemalli Austin Diabetes Prevention & Chronic Disease Self- Management Program