Teri Bridgett remembers several years ago being afraid even to do chores in her own home and feeling dependent on others while recovering from hip and knee replacement surgery.
The 62-year-old East Liberty resident with osteoarthritis, spinal stenosis and diabetes was once a prisoner of the pain that accompanies the chronic conditions of a large percentage of the aging population. But after attending a Vintage senior center program developed at Stanford University and replicated nationally, she's regained the independence of her younger life.
Ms. Bridgett is now gardening, dancing, exercising, eating right and mentoring others her age and older with chronic conditions to do likewise. She's a peer leader and master trainer in the Better Choices, Better Health program, consisting of a series of free, six-session workshops at 23 sites around Allegheny County this spring and summer.
As a former workshop participant who knows how it worked for her, the bubbly grandmother and great-grandmother is one of the biggest promoters of how the group interaction and support system of Better Choices, Better Health can encourage many others who feel weak.
"I was just living in fear and doubt of my own capabilities with my chronic diseases, and then as I took the program I got so much done in the six weeks, it just surprised me," she said. "I just soared."
More than 150 people 60 and older enrolled in the program locally last year, and plans call for educating over twice that many county residents with chronic diseases in 2011-12.
It's part of an effort launched a year ago by the U.S. Department of Health and Human Services, which provided $27 million for programs around the country based on Stanford's Chronic Disease Self-Management Program.
Federal officials say two-thirds of Medicare spending is for beneficiaries with five or more chronic conditions. The Stanford program has shown that hospital utilization, doctors' visits and other health-care costs can be reduced if those individuals develop more knowledge of, confidence in and control over their health through the interactive workshops.
The Vintage center in East Liberty actually began training mentors and holding classes based on the Stanford program in 2008, using funding from the Pittsburgh Foundation and United Way of Allegheny County. The county-wide expansion that started last year came from Allegheny being named one of four counties to share in a $1 million HHS grant funneled through the Pennsylvania Department of Aging.
This month, 17 individuals attended four days of local training to enable them to join other peer leaders who will run the upcoming workshops -- each to have 10 or more participants -- at senior centers, housing sites and elsewhere. In the workshops:
• Two peer leaders of similar age to participants discuss how to develop better diet and exercise habits, techniques for pain management, and other lifestyle improvements, including a program book taken home to supplement the class discussion.
• Every participant develops an "action plan" each week of the healthy lifestyle steps the individual will take toward goals that can be accomplished with high confidence, and they report back to the group the following week on their level of success.
• The peer leaders offer positive feedback throughout, whatever the outcome, and the group members provide helpful suggestions to one another based on their own experiences.
So how does that make a difference, considering every American regularly hears advice to exercise more and eat better -- with it rarely making an impact -- and New Year's resolutions and other vows to do so quickly fall by the wayside?
Those who have been through the program sum it up in one word: accountability.
"Those things you say you're going to do, you've got to report that, and that has a lot of effect," said Gil Cutruzzula, elders program director of the Three Rivers American Indian Center, which has hosted two workshops and is starting a third in Hazelwood May 4.
The 60-year-old Marine veteran with diabetes took the program himself last year, and he said his sugar levels are closer to normal as a result of doing morning pushups and taking more neighborhood walks ever since. He knows women who used to be homebound who get out regularly for activities since taking the program.
"There's a competitive thing to it. The people in the workshop see that 75-year-old Mary is doing all that, and the person says, 'I'm only 67. I should be doing that too,' " Mr. Cutruzzula explained. "Nobody gets put down if they don't do it, but we try to push a little bit among all the participants."
If that sounds like a form of peer pressure, those running the program stress it's positive in nature. Criticism of participants by either peer leaders or their fellow classmates is forbidden, while group discussion of how to solve individuals' problems is considered an asset -- but the advice is only dispensed after checking whether the individual having difficulty wants it.
"It's the process of the program, not so much the content, that makes it effective," said John Miller, the project coordinator for the Allegheny County Area Agency on Aging. "It's the interactive experiences they learn from. They're not just hearing from one person or expert but from peers giving ideas."
People like Ms. Bridgett can start with small goals -- in her case, it was just planting flowers in front of her home. Before long, they branch out, such as by gaining new understanding of food nutrition labels or learning how to question doctors about their medical conditions.
One of those taking peer leader training this month, Sheila Johnson, 64, of Penn Hills, said attending a workshop last year taught her relaxation techniques to deal with the pain of her neuropathy, arthritis and spinal stenosis. Through reading, listening to a meditative CD or other distractions, she's been able to quit taking prescription painkillers.
"It never dawned on me before that there are other ways I could manage besides medication because the doctor doesn't mention anything besides medications," Ms. Johnson said. "The pain doesn't go away ... but you learn to manage the pain, instead of the pain managing you."
Another former participant studying to be a peer leader, Maron Washington, 79, of Penn Hills, began doing hour-long workouts with a home treadmill and stationary bike as a result of the course. He still has arthritis and hypertension, but he has a better energy level and doesn't use those as excuses for idleness.
"It brought me into focus on a lot of problems I had just accepted as a part of aging," but which he realized he could do something about, Mr. Washington said.
One of the reasons government officials are so high on the Stanford program is that it had sound research and objective evaluations associated with it showing positive impacts on health conditions and medical costs.
Vintage had the University of Pittsburgh's Graduate School of Public Health conduct an evaluation last year of local workshops. It found many participants reported they were now questioning their doctors more effectively, and they "felt less frustrated, and more participants, overall, reported their health to be very good or excellent, six months following their last class."
Juanita Pless, a health coordinator for the state aging department, said the federal grant is funding similar workshops in Berks, Cambria and Philadelphia counties. The goal is to reach nearly 3,000 Pennsylvanians over two years, with 520 having taken the courses thus far.
While the hope is to expand the program eventually to the 63 other counties, Ms. Pless said, it's unclear if government or other funding will be available to do so.
More information on the Better Choices, Better Health program, including the dates and sites for workshops throughout Allegheny County, is available at www.alleghenybetterhealth.org or by leaving a message at 412-350-4242 to be mailed a schedule.
Gary Rotstein: email@example.com or 412-263-1255.