Overview
Contents
For the general population, participation in health promotion and wellness programs has been shown to improve quality of life and overall health, reduce medical care costs, and lower mortality rates.
The Living Well with a Disability Program, developed by researchers at The University of Montana, Rural Institute on Disabilities, is a health promotion or wellness program for adults with physical disabilities. It is the culmination of ten years of research aimed at reducing the severity and incidence of secondary conditions. A secondary condition occurs when a person with a disability develops a complication related to his or her impairment. Secondary conditions can include psychological as well as physical limitations, such as depression and pressure sores.
Preliminary research revealed that participants who complete the eight-week Living Well workshop experience a 37% decrease in limitation due to secondary conditions and report a significant decrease in depression levels. This preliminary research has been replicated with similar results.
The Living Well with a Disability Program is an eight-week workshop that introduces a process for setting and clarifying goals, as well as teaching skills for generating, implementing, and monitoring solutions. Goal setting and problem solving becomes the framework for developing healthy lifestyles and making the necessary connection between health and function. Keeping quality of life issues at the forefront, Living Well with a Disability teaches skills for:
- Preventing health problems
- Keeping health problems under control
- Physical conditioning or fitness
- Developing and maintaining healthy relationships
- Beating the blues
- Information seeking and systems advocacy
- Goal setting
- Making healthy lifestyle changes.
The Living Well Workbook is broken into ten chapters. The following outline gives a brief overview of each chapter's contents.
Chapter 1
Setting Goals
- Select an area in your life you want to work on
- Write a clear description of your current situation in that area
- Write a clear description of what you want your future to look like in that area
- Write a goal statement
Chapter 2
Solving Problems
Solving Problems: Navigating the Sometimes Bumpy Road to Success
- Planning a strategy to achieve your goal
- Searching for creative solutions
- Deciding which solutions to try
- Making time
- Tracking you progress toward your goal
- Observing your own behavior
- Rewarding yourself
Chapter 3
Healthy Reactions
Healthy Reactions: Don't Feel Bad Without a Good Reason
- Thoughts and feelings
- Changing the way you think
- When to search for new explanations
- Your reaction to positive events in your life
Chapter 4
Beating the Blues
Beating the Blues: Just Do Something!
- How to jump-start yourself
- Thinking helpfully
- Preventing a depressive lifestyle
Chapter 5
Healthy Communication
Healthy Communication: It Takes Two to Reach an Understanding
- Understanding others by using active listening
- Making yourself understood
- Talking with people who are non-disabled
Chapter 6
Seeking Information
Seeking Information: Knowledge is Power--Plug In!
- What is information seeking
- Why and when to seek information
- Collecting information
- What to do with all this information
Chapter 7
Physical Activity
Physical Activity: Use It (Your Body) or Lose It (Your Ability)
- Physical activity checklist
- Benefits of increased physical activity
- Possible activities
- How to increase physical activity
Chapter 8
Eating Well to Live Well
Eating Well to Live Well: You Are What You Ate Last Week
- Just exactly what is food
- The seven USDA guidelines
- The food pyramid
- Changing your body and size through nutrition
- Major nutrients and secondary health problems
- Track your eating habits
Chapter 9
Systems Advocacy
Systems Advocacy: Your Community Needs You
- Problem analysis and identifying solutions
Chapter 10
Staying Healthy
Staying Healthy: Hanging on to the New You
- Arranging your environment
- Self-monitoring
- Rewarding yourself
- What to do when you don't want to do anything
The Living Well with a Disability Program is an eight-week, sixteen-hour workshop. Group leaders, trained in teaching Living Well materials, may be laypersons, peers or professionals. It is preferable to have two facilitators per workshop. (See Training Opportunities) Cost considerations for conducting a Living Well workshop include Living Well Workbooks for each participant at $22 each, room rental, facilitator training, facilitator wages, and participant recruitment.
Living Well workshops run smoothly with approximately eight to ten participants. Higher numbers reduce the opportunity for each participant to share progress or problems. Also, many participants feel intimidated in larger groups. Groups with fewer than 5 people seem to have less group cohesiveness and peer support.
Worksheets and exercises are placed throughout the materials, giving participants a chance to take concrete examples from their own lives and apply the techniques taught in class. Group discussion and check-ins are important, as is the community that builds around the discussions and shared experiences of participants.
Over 300 individuals have completed the Living Well workshop and filled out a series of surveys which focus on a variety of health issues. Surveys were administered prior to the start of Living Well, immediately following the workshop, at 2 months, 4 months, and 1 year after the program. This data was gathered to determine efficacy questions concerning the program as well as the cost-effectiveness in terms of health care costs.
Survey questions include demographic information, disability information, prevelence of secondary conditions, health care utilization, health care expenses, general income data, health status, perceived limitations, feelings, lifestyle traits and personal goals. Although we are still in the early stages of data analysis, Living Well participation is associated with a 10% decline in costs for medical services and has a statistically significant reduction in the prevelance and/or severity of secondary conditions and depression.