Table 1 Principles underpinning the Aging, Community and Health-Community Partnership Program (ACHRU-CPP)
Component | Feature(s) |
|---|---|
Self-efficacy | • strengthening confidence of clients and their family caregivers in their abilities to monitor their health, make decisions, and adopt healthy self-care behaviors |
Collaborative practice | • involving all members of the care team (interventionists, clients and family caregivers) in all decisions relating to the program • emphasizing flexibility in responses so that individual client preferences can be effectively met • integrating and sharing knowledge from all members of the care team into decisions • optimizing the scopes of practice of the interventionists (e.g., professionals trained in health promotion and prevention can fully utilize these skills, all team members can participate in care planning) |
Holistic care | • working with clients to apply self-management principles to the unique set of chronic conditions and risk factors they face (e.g., income, social supports) • developing a care plan that is realistic in view of the client’s strengths, challenges and preferences • integrating evidence-based practices for diabetes with those relating to the other chronic conditions |
Caregiver engagement and support | • inviting caregivers to actively participate in home visits, group sessions, and case conferences • incorporating caregiver insights/feedback into the development of a care plan that best meets the client’s needs • ensuring that support services are provided to caregivers to promote their health and wellbeing and assist them in the caregiving role |