Aging - SENIOR - Healthy Aging for Older Adults

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Centers for Disease Control and Prevention

State-Based Examples of Network Innovation, Opportunity, and Replication (SENIOR) Grants

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The Aging States Project* (PDF- 294), completed in October 2002, was a cooperative effort between the National Association of Chronic Disease Directors (NACDD) and the National Association of State Units on Aging (NASUA) with support provided by both the Centers for Disease Control and Prevention (CDC) and the Administration on Aging (AoA). The project assessed the health-related needs, activities, and partnerships occurring between state health departments and state units on aging, both of which have a shared responsibility for ensuring the health of the nation's older adults. Recommendations were made to CDC and AOA to promote increased collaboration between the public health and aging services networks, and to support health promotion and disease prevention programs for older adults at the state and local level.

Although state units on aging and state health departments bring different resources, approaches, and partners to the table in addressing older adult health, many of these elements are complementary. Collaborations that combine the prevention expertise of the state health departments with the community outreach capacity of the state units on aging can build the momentum needed to address the needs of the rapidly expanding number of older adults in the United States. The SENIOR grant program is an effort to provide assistance to state health agencies interested in establishing or expanding current health and aging activities.

Grantees are funded at approximately $15,000 for one year projects that include local implementation of an evidence-based program or improving state level capacity to address the health needs of older adults. This modest amount of funding provides necessary resources to implement or expand programs and some states have been very successful in leveraging additional support to expand and sustain these efforts over the history of the program.

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In Fiscal Year 2003, CDC and AoA jointly built upon the needs identified in the Aging States Project to support public health and aging services agencies in 10 states (Arkansas, California, Iowa, Maine, Maryland, Massachusetts, Michigan, North Carolina, Oklahoma, Wyoming) that expressed interest and willingness to work together to improve the health of older adults. States selected activities in physical activity, proper nutrition, Medicare preventive services, arthritis, and stress management. The funding was minimal but supported coordination, program planning, evaluation, and communications at the state and local level through area agencies on aging, health departments, and senior centers.

In Fiscal Year 2004, CDC and AoA again funded mini-grants for state health departments and state units on aging to collaborate, but added an additional focus on implementing evidence-based health promotion and disease prevention programs for older adults. The grants were again administered through NACDD and NASUA who funded 14 states (Arizona, Arkansas, Florida, Idaho, Kansas, Maine, Maryland, Montana, Nebraska, New Jersey, Texas, Virginia, Washington, West Virginia) to focus activities in one of three subject areas: clinical preventive services, physical activity, and chronic disease self management.

Fiscal Year 2005 marked the third year of the SENIOR grants. CDC and the NACDD funded 11 state partnerships (Arizona, Iowa, Kansas, Maryland, Massachusetts, Michigan, New Jersey, North Carolina, Rhode Island, South Carolina, Utah) who implemented evidence-based health promotion and disease prevention programs in one of three areas offered in prior years: clinical preventive services, physical activity, and chronic disease self management. Oral health assessment and promotion was added as a fourth area of focus in Fiscal Year 2005.

Currently in Fiscal Year 2006, 11 state partnerships (Arizona, Colorado, Florida, Iowa, Massachusetts, New Jersey, New York, North Carolina, Oregon, Pennsylvania, South Carolina) have been funded in one of three components. The first component is implementation of an evidence-based health promotion and disease prevention program in one of three areas: increasing regular physical activity, expanding the use of chronic disease self-management techniques, or reducing falls. The offering of falls prevention programs such as A Matter of Balance is a new addition to the FY 2006 SENIOR grants. The second component funds the development of state health department readiness for action for healthy aging. This track called Opportunity grants is also a new offering for FY 2006 and has the following intended outcomes:

states will be able to more strategically promote healthy aging and take advantage of opportunities to improve the health status of older adults;

state health departments will have effective partnerships with state aging agencies that contribute to collaborative planning and action at the state and local levels; and

state policies will recognize the importance of initiating, supporting, and integrating specific healthy aging efforts into chronic disease and other programs.

The last component focuses on grants to fund the assessment and promotion of older adult oral health. Project descriptions for the current grantees are listed below:

Arizona – Creating the Critical Link: Healthy Aging Communication Network (HACN) (Opportunity Grant)
The Healthy Aging Initiative (HAI) of the Arizona Department of Health Services, the Arizona Department of Economic Security, Adult and Aging Administration, and the Governor’s Advisory Council on Aging will develop a communication and information-sharing network. The project will create an agreement between the partners to identify expectations and set priorities to focus on health promotion and disease prevention efforts for older adults. An internal health department survey of chronic disease programs will be conducted to determine current collaboration between HAI and chronic disease programs and to identify opportunities for collaboration. Finally, the project will create a toolkit and Web site that includes integrated design and packaging for common health messages and information to be used by the HAI, Department programs, the HACN and other key partners. The tool kit will be made available in print and on the HAI Web site.

Colorado – Training and Implementation of the Arthritis Foundation Exercise Program (Physical Activity)
The Colorado Department of Public Health and Environment, Aging and Adult Services, and the Consortium for Older Adult Wellness (COAW) will implement the Arthritis Foundation Exercise Program in six rural, underserved counties in Colorado through 10 congregate meal sites (i.e., places where nutritious meals are served to groups of older adults). The program intends to duplicate previously piloted methods in rural areas of Colorado, and to assure program sustainability through instructor networking and community support. Each site plans to conduct six, 6-week sessions, reaching approximately 600 older adults.

Florida – Orange County Chronic Disease Self-Management Program (Disease Self-Management)
The Florida Department of Health and Florida Department of Elder Affairs, partnering with the Orange County Health Department and the Senior Resource Alliance, will train 10 volunteer leaders in the Chronic Disease Self-Management Program (CDSMP). Trained instructors will then conduct six, 6-week courses, reaching at least 60 older adults. CDSMP participants will be primarily Orange County residents aged 60 years and older. The Orange County Senior Resource Alliance previously offered the Arthritis Foundation Exercise Program, and has identified that 61% of seniors in this community are interested in taking health-related courses.

Iowa – Iowa’s Senior Smiles 2006 (Oral Health)
The Department of Public Health will work with the Department of Elder Affairs and the University of Iowa College of Dentistry to expand on the successes of the Iowa Senior Smiles 2005 SENIOR grant project. The expansion will target three new counties and provide training for public health nurses to conduct dental assessments for older adults covered under the Medicaid Elderly Waiver Program, as well as individuals receiving case management services. Individuals needing treatment will be referred to local dentists and oral health kits will also be distributed. The project incorporates two areas identified for improvement from the previous project – training to help nurses feel more comfortable working in the mouths of their patients, and the development of a task force to assess the current status of oral health care in nursing homes.

Massachusetts – Massachusetts Healthy Aging Initiative (Opportunity Grant)
The Massachusetts Department of Public Health and the Massachusetts Executive Office of Elder Affairs plan to build capacity in Massachusetts for developing and sustaining a statewide healthy aging advisory committee. While there are many healthy aging activities currently in place, there is neither a definitive infrastructure nor a strategic plan for the implementation of evidence-based health promotion programs. The committee will provide state leadership, communication and coordination for healthy aging activities. A statewide needs assessment and inventory of healthy aging resources and programs will be conducted. Lastly, the committee will partner with an area agency on aging, in a targeted region of Massachusetts, to demonstrate and evaluate a process for implementing evidence-based programs statewide.

New Jersey – Blueprint for Healthy Aging in New Jersey (Opportunity Grant)
The New Jersey Department of Health and Senior Services, a joint state health department/state unit on aging, and the statewide Health Promotion Advisory Group will collaborate to develop and disseminate The Blueprint for Healthy Aging in New Jersey. This Blueprint will educate key decision makers about older adult health status in New Jersey, raise awareness of benefits that can be achieved through healthy behaviors, and highlight evidenced-based health promotion programs that can be supported and replicated throughout the state. The Blueprint will be distributed to elected officials, local health departments, area agencies on aging, and local foundations, and be made available through the Department’s Web site.

New York – Senior Health Improvement Program (Disease Self-Management)
The New York State Department of Health’s Arthritis Program, in collaboration with the New York State Office for the Aging and the Columbia County Department of Health, will train instructors in two evidenced-based programs – the Chronic Disease Self-Management Program (CDSMP) and the Arthritis Foundation Exercise Program (AFEP). Each of these programs will be implemented in Columbia County, a sprawling, rural area in the eastern part of the state where there is currently no arthritis-specific or structured exercise programs offered. Participants in the classes will have the opportunity to move from the CDSMP classes to the AFEP classes. The project expects to train a total of 12 leaders, offer a minimum of six of each type of class, and reach approximately 200 residents.

North Carolina – The North Carolina Roadmap for Healthy Aging (Opportunity Grant)
In partnership with the North Carolina Division of Aging and Adult Services and the North Carolina Healthy Aging Coalition, the North Carolina Division of Public Health will develop a North Carolina Roadmap for Healthy Aging to provide a more coordinated and systemic focus on efforts to promote healthy aging within the Divisions and among partners in the Coalition. The Roadmap will provide direction and concrete strategies for programming in health promotion, disease prevention and chronic disease self-management, and for maximizing the use of each service network’s capacities, resources, and partnerships. Project evaluation will assess the collaborative planning process and help promote a sustained partnership. Lessons learned in North Carolina may be of value to other states undertaking similar efforts.

Oregon – Oregon Healthy Aging (Opportunity Grant)
The Health Promotion and Chronic Disease Prevention Program and the Seniors and People with Disabilities Division, both located within Oregon’s Department of Human Services, plan to build on an initial planning effort that recommended the formation of a healthy aging coalition. The goal of the project will be to build statewide partnerships to promote healthy aging, increase awareness in both the aging and public health networks of effective evidenced-based programs, and support the implementation of statewide strategies to promote healthy aging. The program plans to focus on collaborations among groups working on specific disease areas.

Pennsylvania –Oral Health in the Older Adult: Strategies for Intervention (Oral Health)
The Pennsylvania Department of Health and Aging, the University of Pittsburgh School of Dental Medicine, and the University of Pittsburgh Center for Healthy Aging will continue their existing, strong partnership to improve the oral health of Allegheny county older adults. This project will work with older adults participating in the Community Health Ambassador Program (CHAP), a 6-week training course that teaches older adults to be ambassadors for healthy aging in their community. This project will assess oral health behaviors, knowledge, and utilization among participants in CHAP, as well as design interventions to address identified needs of the participants, and develop a component within the training program focused on oral health care.

South Carolina – Lee County Fall Prevention Partnership Project (Falls Prevention)
The South Carolina Department of Environmental Control and the Lieutenant Governor’s Office on Aging will partner with local faith and community organizations to implement A Matter of Balance, a fall prevention program. The program will be offered in Lee County, an underserved, rural area where the poverty level is 21% versus 14% for the state, and the population is nearly 50% African American. The project will develop a training plan, recruit and train local instructors, and provide mini-grants to community organizations as an incentive to offer the program.

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