New Journal Article Links AAA Involvement in Evidence-Based Programs with Reduced Nursing Home Use

It is no surprise to AAA staff that their work has positive impacts across the community. A new article, Achieving Population Health Impacts Through Health Promotion Programs Offered by Community-based Organizations, published in the March 2021 issue of Medical Care, examined how AAA involvement in evidence-based programs was associated with reducing potentially avoidable nursing home use.

Combining data from the 2008-2016 AAA National Surveys with county-level health outcome data, researchers found that when a AAA began offering an evidence-based program (EBP), potentially avoidable nursing home use decreased by 6.5 percent, and increased breadth of EBP offering was also associated with a significant reduction.

Title III D requirements that health promotion programs be evidence-based has increased AAA involvement in EBPs significantly. In 2008, about 73 percent of AAAs offered one or more EBPs; in 2019 it was nearly 100 percent. Researchers set out to test how the expansion of EBPs delivered by AAAs influenced health care use and spending at the county level. They matched up AAA planning and service areas to counties, using data from 2008-2016 AAA National Surveys along with county-level health outcome data. Findings suggest that when a AAA began offering an EBP, potentially avoidable nursing home use decreased by an average of 6.5 percent. When AAAs increased the breadth of EBP program offerings, nursing home use for those with low-care needs also decreased. 

Researchers then investigated the role of implementation capacity using a scale measuring physical capabilities (e.g., technology and data systems), human capabilities (e.g., staff, fundraising skills) and coordination capabilities (e.g., coordination and planning systems). They split the sample in half—above median implementation capacity, and below median implementation capacity—and again looked at the change in health outcomes when EBP were added. The findings suggest that AAA delivery of EBP reduces low-care needs nursing home use only for those AAAs with above-median implementation capacity.

While the positive impact of EBP on individuals is well-documented, this study offers the first results suggesting that national scale-up of health promotion programs through the AAAs has contributed to reductions in avoidable health care use by older adults at the community level, particularly in areas where the AAA has a high implementation capacity.

These results suggest that offering EBP contributes to AAAs' mission of helping individuals remain living independently for as long as they desire—and that strengthening organizational capacity to administer these programs may lead to even greater community-level improvements.

Article citation:
Brewster, Amanda L.; Wilson, Traci L.; Curry, Leslie A.; Kunkel, Suzanne R. Achieving Population Health Impacts Through Health Promotion Programs Offered by Community-based Organizations, Medical Care: March 2021 - Volume 59 - Issue 3 - p 273-279.



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