Introduction to the NC Roadmap

The Healthy Aging Roadmap was developed as a resource to set up a more coordinated and systematic effort to promote healthy aging throughout North Carolina. The Roadmap is designed for community and health-care providers interested in implementing health promotion programs to best meet the needs of older adults in their community. To effectively and efficiently provide these types of services, partnerships and collaborations must be developed between different community organizations. The Roadmap will provide a step-by-step guide to the process of identifying a health promotion need in your community, identifying appropriate health promotion programs to meet this need, establishing partnerships to pool resources, and implementing programs.

There are several types of health promotion programs, ranging from exercise classes to bereavement groups to nationally recognized evidence-based health promotion (EBHP) programs. An EBHP program has been developed rigorously tested and demonstrated improved health outcomes with different groups of older adults in different communities and regions. These programs are scripted, meaning that you will attend the same class in California or North Carolina. They generally require a trained instructor and purchase of resources (workbooks, videos, etc.) to offer the programs. Starting an EBHP program at your facility can be a challenge; however these programs have proven benefits. The Roadmap contains step-by-step guide to identify and implement EBHP programs. The steps for developing an EBHP program can be used to develop and offer any health promotion program to your community.

The Roadmap is set up into the following four sections:

1. Program Implementation - details how to establish an EBHP program in your community
2. Database Assessment Tools – help you identify and access specific health information for your county
3. Evidence-Based Health Promotion Programs and Master Trainers – provides an index of all EBHP programs currently happening in North Carolina
4. County Profiles – presents a snapshot of aging for each county in the state and provides examples of health promotion programs offered in different areas

Why is the Roadmap important?

Today, the proportion of the state’s population who are over 65 is approximately 12 percent, or 1.2 million individuals. By 2030, the proportion is expected to grow to 17.7%, or 2.1 million individuals. Between 2000 and 2030, the population in the range of 65-74 years is expected to grow 121 percent, and in the range of 85 and older the growth will be 144%. Though North Carolina projects that 17-18 percent of the total population will be comprised of older adults, four specific counties -Brunswick, Camden, Currituck and Dare- are expected to see an increase in the older population to 26 percent of their total population.¹

As the aging population grows, so do demands on the health care system, the transportation system, community services, providers, and the list goes on. The average adult over 65 is expected to have an average of three health conditions requiring some form of medical treatment. Several of these conditions, such as arthritis, diabetes, obesity, and hypertension can be managed through the appropriate community- and provider-based health promotion programs. In addition, with the appropriate health promotion programs, falls can be prevented and strength and function can be maintained to keep older adults independent in the community as long as possible.

With the expected growth of the population and the increasing demands on the healthcare system, it is imperative that a coordinated and systematic effort be established by community and healthcare providers to offer appropriate health promotion programs. An appropriate program is one that meets the needs of the community and results in desired outcomes. The Roadmap is designed to start and sustain this process to improve the health of all older North Carolinians.

How do I use the Roadmap?

The Roadmap was developed as a guide for providers and clinicians to easily identify the top health conditions of older adults in their community, the resources available to address these conditions and strategies to implement health promotion programming.

The county information is from the 2006 county profiles published by the Division of Aging and Adult Services. Click here for more specific information on your county.

The hospital discharge data and the physician visit data is from the Carolinas Center for Medical Excellence 2006 report.²

How the Roadmap is organized

This website is organized into five sections:

1. Overview of Health Conditions and Health Promotion Programming in North Carolina: This section outlines the current health conditions of older adults in the state and presents examples of the types of health promotion programs offered.

2. Program Implementation Tools : This step-by-step guide uses the RE-AIM framework to walk you through the process of implementing an EBHP program in your county. This section includes how to:

• Use the data from your county to identify health promotion needs
• Apply for funding opportunities
• Develop and formalize community partnerships to maximize resources and enhance program delivery
• Implement and maintain the best evidence-based health promotion program for your community

3. Database Assessment Tools : This section describes the health information databases available to the public. This includes how to:

• Access specific information on a health condition in your county
• Identify and access the appropriate database
• How to use the information once you have it

4. Evidence-Based Health Promotion Programs and Master Trainers in North Carolina:This section lists all EBHP programs currently offered in the state and contact information for master trainers

• A master trainer is someone who has completed a formal training program and is certified to teach an EBHP program or train others to be instructors
• We recommend utilizing the resources in this section to maximize the impact of your programming
• One suggestion is to collaborate with other facilities in your region to share ideas and resources economically bring an EBHP program to your area.

5. County Data : Each county has a page which includes

• A general summary of the status of older adults
• The top five hospital discharge and outpatient diagnoses
• Health promotion programming information from senior services facilities that completed a questionnaire during the survey period.

The information for each county presented is not comprehensive. For detailed demographics, we suggest you access the Division of Adult and Aging Services County Profiles webpage.

The programming information results are from a web-based survey on health promotion programming distributed to all senior centers, YMCAs, and health departments in June, 2007. All facilities who responded by October 2007 are included in this report. The survey asked specifically about the types of health promotion programs offered, if evidence-based or best practice health promotion programs are offered, and about different partnerships to provide programs. The survey can be accessed online by clicking this link.