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Transportation to health care appointments is a well-known barrier for many people, especially people living in rural areas. At the Kennebec Valley Community Action Program (KVCAP), 1 of 8 regional transportation centers in Maine, a robust volunteer program consisting of 93 drivers complements a staff of 45 drivers and 23 office staff members. The volunteers drive approximately 5 to 40 hours per week and have served for an average 4.4 years (range, 1-26 y); their ages range from 23 to 88. The volunteer driver program consists of a volunteer coordinator who communicates with volunteers; staff members who schedule rides; a software application (app) that serves as an interface between the agency and the volunteers as they drive clients to and from medical and social service appointments; regular training; recognition events; and incentives. Most clients have no other transportation option and indicated in informal surveys conducted by KVCAP that they would not attend appointments if the volunteer program were not available. In rural settings, volunteer driving networks provide a viable model to help meet the transportation needs of the population. Recruitment and retention of volunteers is an ongoing effort.

Western medicine is undergoing a transition toward transparency of quality and costs, and healthcare systems are striving to achieve the Triple Aim, a framework for improving the patient experience of care, improving the health of populations, and reducing the per capita cost of healthcare. Meanwhile, there is growing recognition of the impact of social determinants of health and a new federal requirement for nonprofit hospitals to implement prevention strategies. A specialized meal delivery program called Simply Delivered for ME (SDM) was formed in an effort to improve care and reduce 30-day hospital readmission rates.The Maine Medical Center (MMC) partnered with the Southern Maine Agency on Aging to offer SDM on a voluntary basis to high-risk Medicare patients already enrolled in the Community-based Care Transition Program (CCTP) at MMC. We report the results of the 2-year intervention in terms of 30-day hospital readmission rates and cost measures (ie, return on investment and cost savings).Of the 622 MMC patients who received SDM during the 24 months, the 30-day readmission rate was 10.3% (compared with the 16.6% 30-day rate of hospital readmission at baseline [ie, before the adoption of CCTP]) for all-cause readmissions. The cost savings for reduced readmissions were $212,160. The return on investment was 387%, or a benefit-cost ratio of $3.87 for every $1.00 spent on meals. Programs such as SDM may reduce the rate of hospital readmission among high-risk older adults and, thereby, yield lower healthcare costs.

Here, we report evaluation results of implementing a health promotion program for individuals with serious mental illnesses. Healthy Amistad aimed to address four behaviors: physical inactivity, nutrition choices, smoking, and seeking access to health care. The evaluation employed a mixed-method study design to assess changes in the health of individuals in the program. Process measures assessed the implementation of the program. A pre-post examination was used to compare data associated with behaviors. Data sources included the 2008 and 2009 annual surveys, clinical data, interviews for staff, interviews with members, and an on-site observation. Participants were staff and members of Amistad. Those involved with the Peer Patient Navigator lost weight; new physically active activities were being offered. A new salad bar and healthier menu was offered in the Amistad cafeteria. Interviews revealed that 11 members lost a total of 150 pounds. The percentage reporting visits to an emergency room more than once in the last 6 months decreased from 58% to 37%, the percentage calling the crisis line less often increased from 75% to 86%, and the percentage reporting that they had become more satisfied with their life since joining Amistad improved from 76% to 88%. Individuals with serious mental illnesses are benefiting from programs that focus on the mitigation of disease states manifested from issues with physical inactivity, nutrition, smoking, and health access. Evaluation of the Healthy Amistad program has shown a positive influence.

Could an annual event be an effective strategy to improve physical activity? Based on 25 years of data, we argue that it could be. Although there are eight recommended strategies to promote physical activity in the Community Guide, there is insufficient evidence for six others. Qualitative data collected from Trek Across Maine participants and other cause-specific events suggests that goal setting (i.e., individually adapted health behavior change) and family-based social support may be key factors in helping individuals become more physically active.

Background: Tobacco settlement funds were used to establish the Healthy Maine Partnerships (HMPs) to reduce tobacco use, increase physical activity, and improve nutrition through local policy and environmental change., Context: The HMP model is a progressive approach to public health. It provides for coordinated efforts between state and local partners for health promotion and disease prevention. Community coalitions, supported with funding and guidance by the state, are the basis for policy and environmental change., Methods: The state awarded contracts and provided program guidance to foster policy and environmental change at the local level. The partnerships' efforts were assessed with a retrospective evaluation that consisted of 2 data collection periods conducted using the same tool. A survey booklet containing lists of possible environmental and policy changes was developed and mailed - once in 2005 and once in 2006 - to all 31 local partnership directors and school health coordinators who completed it. Additional data were collected from the local partnerships in the form of narrative reports required by their funder (Maine Center for Disease Control and Prevention)., Consequences: All local partnerships implemented policy or environmental interventions to address tobacco use, physical activity, and nutrition during the period covered by the surveys (July 2002-June 2005 [fiscal years 2003-2005]). Cumulatively, more than 4,600 policy or environmental changes were reported; tobacco use policies represent most changes implemented. A second round of HMP funding has since been secured., Interpretation: Although the survey methodology had limitations, results suggest that much work has been accomplished by the local partnerships. Plans are to share success stories among partnerships, provide training, and continue to improve the public health infrastructure in Maine.