Development of coordinator competencies for the Stanford chronic disease management program in Maryland

Virginia Brown, DrPH; Patsy Ezell, PhD

Stanford’s Chronic Disease Management Program is a six-week program delivered in community setting to assist people with chronic disease in managing their health and wellness. The evidence-based program has been found to increase participant exercise, cognitive symptom management, communication with medical professionals, and self-reported decrease in health distress, fatigue, disability and social/role activity limitations.

Maryland is one of the many states that has adopted the program. The program, titled Living Well, is coordinated at the state level by the Maryland Department of Aging (MDoA). The organization subcontracts with county-based agencies to implement the program. Each host agency is responsible for hiring coordinators who run the day to day operations of the program.

A statewide evaluation showed that Living Well program success varied by location and coordinator. To better understand what might be contributing to the difference, MDoA and the University of Maryland Extension (UME) set out to see if the differences were based on the skills of each coordinator, whom were have hired by different agencies and under different job descriptions.

Based on the desire to understand how coordinator skills might influence program outcomes, the following research question was posed:

What competencies are essential to perform the

duties of Maryland’s Living Well Coordinator?

Stanford’s ProgramUME conducted a literature review to inform the competency development process. Research suggested a three stage process: 1) workers, using a pre-developed list of competencies and tasks necessary to perform each, identified what is important; 2) An expert review of the updated competency list based on stage 1 outcomes; and 3) worker validation of amended list before it is finalized.

Using this format, UME conducted a three phase study to explore the competencies and tasks for the Living Well Coordinator position. Three Stage Data Collection Process

Stage 1- Focus GroupsWho: Living Well CoordinatorsWhen: 2-day training in fall 2013Process: The position duties as defined by Stanford University were reviewed and a potential competency list was developed. In small groups, coordinators provided feedback on the list’s accuracy. UME conducted thematic analysis to ensure alignment of competencies and tasks and updated the list accordingly.

Stage 2- Expert ReviewWho: MDoAWhen: Winter 2013Process: The updated list of competencies from stage 1 was sent to MDoA. During an in-person meeting, the agency representatives provided feedback, including what to add, re-wording of competencies to reflect agency needs and categorization of tasks.

Stage 3- Follow-up survey with coordinatorsWho: Living Well CoordinatorsWhen: Summer 2014Process: A Qualtrics survey was constructed. Coordinators were asked for their level of agreement with each competency and task and potential ways to correct issues.

METHODS

Research Question

Next Steps

Training recommendations are being prioritized and developed based on feedback from coordinators and survey results. The University of Maryland-Extension and MDoA will work collaboratively to develop an evaluation tool of coordinators’ current skills and determine what

trainings and skill develop opportunities would enhance performance. A uniform job description will be developed based on these competencies and used state-wide for future Living Well coordinator positions. Finally, the University of Maryland Extension will seek to

validate the competencies with other states participating in the Stanford Chronic Disease Management Program.

RESULTS with Selected Examples from Each Competency

Living Well in MD

The University of Maryland, College of Agriculture and Natural Resources programs are open to all and will not discriminate against anyone because of race, age, sex, color, sexual orientation, physical or mental disability, religion, ancestry, or national origin,

marital status, genetic information, or political affiliation, or gender identity and expression.

Length of Service for Living Well Program Coordinators

Living Well Coordinator Competencies

Communication

Prepare an elevator speech about the

program

Regular communication

between leaders, funding sources and

host agency

Evaluation and Assessment

Conduct fidelity assessments and leader monitoring

Ongoing assessment of community to ensure needs are

met

Management

Schedule, coordinate and track workforce

trainings and updates

Manage agency resources, both fiscal

and in-kind

Education and Training

Educate host agency employees and partners about

program benefits

Educate the community about

the program and its benefits

Technology

Understand and use partner referral

system

Ability to understand and use online

collaborative tools

Professional Behavior

Maintain Confidentiality

Cultural competency and sensitivity to diverse audiences

7%

33%

13%

13%

33%

Less than 1 yr 1-2 years 3-4 years4-5 years 5 or more years